bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting strength outcomes for upper limb nerve transfer surgery in tetraplegia
Authors: Stanley Edward A. , Hill Bridget , McKenzie Dean P. , Chapuis Pierre , Galea Mary P. , van Zyl Natasha
Published: August 2022

We report a retrospective study of 112 nerve transfers in 39 participants to investigate predictors of strength outcomes after nerve transfer surgery for upper limb reanimation in tetraplegia. We measured clinical and pre- and intraoperative neurophysiological assessment variables and compared them with strength outcomes 2 years after nerve transfer surgery. We found statistically significant improvement in Medical Research Council strength grades after nerve transfer surgery with lower cervical spine injuries (between one and two grades), lower donor nerve stimulation thresholds (half of a grade), greater motor evoked potential activity in recipient nerves (half of a grade) and greater muscle responses to intraoperative stimulation of donor (half of a grade) and recipient nerves (half of a grade).

Level of evidence: III
Classification of Marine Algae–Derived Compounds by the Mechanism Responsible for Decreasing Lipoxygenase-Catalyzed Lipid Hydroperoxides
Authors: Kurihara Hideyuki , Yachiyama Kenta , Morimoto Chihiro
Published: August 2022

Lipoxygenase (LOX)-mediated lipid hydroperoxides (LHPOs) are converted to physiologically active mediators. Thus, decreasing hydroperoxides is important for diminishing various health-related risks. In this study, decreasing compounds of LOX-catalyzed LHPOs were investigated and classified by mechanism using a modified triple LOX-indamine dye formation (IDF) method. The compounds 2,3-dibromo-4,5-dihydroxybenzyl methyl ether (1) and fucoxanthin (2) were isolated from algae as compounds that can decrease hydroperoxides. Along with previously isolated pheophytin a (3), a chlorophyll-related compound, and purchased nordihydroguaiaretic acid (4), a well-known lipoxygenase inhibitor, all the compounds were examined to determine the mechanisms responsible for decreasing LHPOs by using a modified triple LOX-IDF method. Compounds 1 and 4 were found to be LOX inhibitors, compound 2 was a decomposer of the produced LHPOs, and compound 3 was both an inhibitor and a decomposer of the produced LHPOs.
Fruit Availability Influences Forest Elephant Habitat Use in a Human Dominated Landscape, Campo-Ma’an, Southern Cameroon
Authors: Djoko Isaac B. , Weladji Robert B. , Granados Alys , Paré Patrick , Body Guillaume
Published: August 2022

Background and Research Aim

African forest elephants ( Loxodonta cyclotis) are critically endangered yet research on factors influencing their resource use is limited in Central Africa. We assessed the influence of fruit availability, land use types, and anthropogenic activity on forest elephant presence and relative abundance in the southwest part of the Campo-Ma’an Technical Operational Unit (CMTOU) to better understand elephant habitat use in human dominated systems and inform elephant management strategies.

Methods

We used 17 camera trap stations and surveyed 17 line transects to monitor forest elephant presence and relative abundance as a function of fruit availability, tree species richness, and land use types. Our study area spanned a gradient of human disturbance and included a National Park (NP), Forest Management Unit (FMU), and Community Land (CL).

Results

Forest elephants were more likely to occur in areas with increased fruit availability and tree species richness. Also, the likelihood of their presence was higher in CL than in FMU and NP. Elephant relative abundance was negatively affected by human activities such as hunting and logging. The relationship between elephant relative abundance and fruit availability was stronger in CL and NP as compared to the FMU. Elephant relative abundance was higher during the rainy season.

Conclusion

Forest elephant habitat use was positively affected by fruit availability across land use types, and negatively affected by human activities in the southwest part of the CMTOU.

Implications for Conservation

Continued monitoring of elephant responses to food availability in CMTOU is warranted to track changes in elephant habitat use. Knowledge of the distribution of fruiting trees consumed by forest elephants may allow managers to predict hotspots of habitat use, and to therefore develop effective management strategies.
Introduction to the Special Issue on School Counselors Addressing Education, Health, Wellness, and Trauma Disparities
Authors: Johnson Kaprea F. , Ieva Kara , Byrd Janice
Published: August 2022

This special issue is on school counselors addressing education, health, wellness, and trauma disparities. The focus is on current and former school counselors’ collective experiences to contextualize the impact of the pandemic(s) on the lives and work of school counselors and the disruption to the lives of the students and families served. The collection of nine articles provides a window into the experiences of school counselors during the COVID-19 pandemic.
School Counselors and Refugee Students: Application of the Refugee Well-Being Project Intervention to Address the Social Determinants of Health
Authors: Harrichand John J. S. , Su Yi-Wen , Hyun Jung H. , Anandavalli S.
Published: August 2022

As migration and displacement continue to increase around the world, guidelines are needed clarifying how school counselors can use their power and privilege in working with refugee students and their families across K–12 education, more so in relation to the COVID-19 pandemic. We introduce the Refugee Well-Being Project intervention to school counselors and school counselor interns, focusing on the social determinants of health impacting the overall well-being of refugee students.
Empirically Examining the Effectiveness of Teaching Blogs on University Course Instruction
Authors: Wang Yu-Min , Chiou Chei-Chang
Published: August 2022

Blogs have the potential to be integrated as learning tools to help students learn and reflect. Many educators have incorporated the use of teaching blogs to enhance teaching and learning outcomes in higher education settings. However, research conducted to empirically examine the effectiveness of blog use in education is rare. This study intends to help fill the remaining gaps in the research; there are two main purposes: (1) to examine, using a field quasi-experiment, whether the use of teaching blogs in university course instruction enhances student learning outcomes; and (2) to empirically understand the determinants and impacts of the extent of student blog use on university’s course learning via a questionnaire analysis. Two separate studies were conducted. The experimental results of Study 1 show that using teaching blogs not only enhances learner satisfaction, but also increases university students’ learning achievement. The Study 2 results show that higher quality teaching blogs positively influence the extent of student blog use, which in turn positively influences student learning satisfaction and achievement. This study extends our knowledge and insights regarding the use of teaching blogs within the higher education domain.
MYTime: A Mindfulness and Yoga Program to Promote Health Outcomes in Parents of Children With Autism Spectrum Disorder
Authors: Ketcheson Leah R , Wengrovius Carissa M , Staples Kerri L , Miodrag Nancy
Published: August 2022

Background

Parenting a child with Autism Spectrum Disorder can be stressful and result in health consequences for the caregivers, a population that is often overlooked and underserved. While mind-body interventions such as mindfulness yoga can help promote positive health outcomes, limited research has explored the impact of such a program on caregivers of children on the autism spectrum.

Objective

The primary objective of this pilot study was to evaluate the effects of a 12-week mindfulness yoga program (MYtime) on perceived stress, anxiety, and depression among urban caregivers of children on the autism spectrum.

Methods

Twenty-seven parents were randomized into either MYTime (n = 13) or the control group (n = 14). Perceived Stress Scale (PSS) and Depression, Anxiety, and Stress Scale (DASS) were administered.

Results

The MYTime group reported lower stress, depression and anxiety while the control group maintained similar scores across pre- and post-assessment. Following 12 weeks of participation the PSS and DASS scores improved by 25% and 49% respectively for parents in the MYTime group. In comparison, PSS scores worsened by 5% and DASS scores improved by 17% for the Control group. Differences in pre-and post-assessment scores were not significant for either group ( P > .05).

Conclusion

The results from this pilot study indicate that a mindfulness yoga program could be considered among feasible interventions aimed at improving the health of parents of children on the autism spectrum.
“This is Real, This is the Way that Things are”: Hooking up as a Pathway for Sexual Identity Development Among SGM Emerging Adults
Authors: Hanna-Walker Veronica , Snapp Shannon , Campos Eva B. , Saldana Xochitl , Watson Ryan J.
Published: August 2022

Hooking up may be one pathway for sexual and gender minority (SGM) emerging adults to explore their sexual identity development while they navigate heteronormative milestones. Framed by Dillon et al.’s (2011) model of universal sexual identity development, we examined 24 interviews with SGM emerging adults to understand whether and how hooking up aided in the development of their sexual identities beyond their sexual orientation. Although some participants already reported stable sexual identities prior to hooking up, we identified that hooking up did lead others to develop their sexual preferences more fully, better understand their sexual identity, and strengthen their connections to the SGM community. These findings suggest that hooking up can facilitate positive sexual development among sexual and gender minority emerging adults.
Color Change Evaluation of Three Universal Resin Composites after Storage in Water: An In Vitro Study
Authors: Akgül Sinem , Gündoğdu Ceyda
Published: August 2022

Aim:

The aim of this in vitro study was to evaluate the color changes of three different universal resin composites after immersion in distilled water for one month.

Materials and Methods:

Omnichroma, Estelite Σ Quick, and Filtek Universal Restorative were investigated. Ten disk shaped specimens (6 mm diameter, 2 mm thickness) were prepared according to the manufacturers’ instructions for each material. After polishing, initial color measurements were taken followed by individual storage of the specimens in distilled water at 37 °C for one month when color measurements were repeated. The change in the color of each resin composites (Δ E00) was calculated with a digital method, using the CIEDE2000 color difference formula. The data were analyzed using one-way ANOVA followed by Tukey post-hoc test ( P < .05).

Results:

All resin composites exhibited acceptable color change after one month. Omnichroma exhibited the highest color change (2.26 ± 0.48) value while Filtek Universal Restorative showed the lowest (1.14 ± 0.38) value. All color parameters influenced the Δ E00 values in all groups except Filtek Universal for Δ L* and Δ b values.

Conclusion:

When performing composite resin restorations, especially for esthetic purposes, polymerization may lead to change in the color of restorative material over time, but it should be considered whether this is within acceptable limits.
A Pathway for Esophageal Obstruction is Associated with Decreased Cost and Length-of-Stay
Authors: Klutts Garrett N. , Tingquist Nicholas D. , Pagteilan John , Muesse Jason L. , Sexton Kevin W. , Marino Katy , Steliga Matthew A.
Published: August 2022

Malignancy of the esophagus or mediastinum can present with obstruction. Our focus is to identify the most effective means of managing this population. Data was gathered from a single institution for patients admitted with esophageal obstruction. Patients were categorized based on admission to thoracic surgery or the hospitalist service. Primary end-points were hospital length-of-stay (LOS) and hospital cost. The mean LOS was 4.4 days when admitted to thoracic surgery versus 13.5 days when admitted to a hospitalist ( P = .0005). The mean overall cost was $43,902 less per patient when admitted to thoracic surgery ($75 809 vs $31 907; P = .003).
New Approaches to Neoadjuvant Treatment for Locally Advanced Esophageal Cancer
Authors: Tankel James , Ferri Lorenzo
Published: August 2022

The treatment paradigm of esophageal carcinoma is evolving as is the appreciation that histology drives treatment decisions. For adenocarcinoma, neoadjuvant chemotherapy followed by en bloc transthoracic resection is the gold standard of care. In this setting, the addition of radiotherapy does not seem to be associated with a survival benefit. For squamous cell carcinoma, neoadjuvant chemoradiotherapy is currently the best therapeutic option. However, modern neoadjuvant chemotherapy regimens may engender better survival outcomes for these patients too. Moreover, the role of immunomodulating therapies and selective surgical approaches are yet to be fully appreciated and may influence future recommendations.
Palliation of Malignant Dysphagia: Dilation, Stents, Cryoablation or PDT: The GI Perspective
Authors: Ellis Daniel J. , Kubiliun Nisa M. , Tavakkoli Anna
Published: August 2022

Management of malignant dysphagia can be challenging given the number of options available, including esophageal stenting, radiation therapy, cryoablation, and photodynamic therapy (PDT). Our article discusses our approach to palliation of malignant dysphagia from a gastroenterologist’s perspective.
How Do I Do It—ESD for ESCC
Authors: Nishimura Makoto
Published: August 2022

Endoscopic submucosal dissection (ESD) has gained popularity in recent decades as a reliable and curative resection technique for early gastrointestinal tract neoplasms worldwide. Recent advances in multiple devices have enabled ESD to be a more accessible and safer procedure in the US. For esophageal ESD, it is crucial to expand our knowledge of the differences between esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). This article describes the diagnosis, ESD devices/techniques, and post-ESD management for ESCC.
Endoscopic Treatment for Disease Persistence/Recurrence after Definitive Chemoradiotherapy for Esophageal Cancer
Authors: Sharma Prabin , Modayil Rani , Stavropoulos Stavros N.
Published: August 2022

We will start our review with 2 illustrative cases, one of Barrett’s adenocarcinoma and one of squamous carcinoma, that received salvage endoscopic treatment at our center after definitive surgery and/or chemoradiation. This will help provide a clinical framework for the subsequent discussion of how to approach this infrequent but complicated scenario of endoscopic salvage for esophageal cancer recurrence/ persistence after chemoradiation therapy.
Arthroscopic Posterior Glenoid Augmentation With Distal Tibial Allograft
Authors: Dean Robert S. , Dennis Eric J. , Torres LeeAnne F. , Rider Danielle E. , Trasolini Nicholas A. , Gehrman Max D. , Waterman Brian R.
Published: August 2022

Background:

Posterior glenohumeral instability is much less common than anterior instability, and there is a paucity of studies looking at glenoid bone loss as it relates to posterior instability. However, while the data are not as robust, posterior glenoid bone loss can lead to recurrent instability and failed soft tissue procedures. Arthroscopic posterior glenoid augmentation with distal tibial allograft (DTA) is a minimally invasive option to restore stability and preserve function.

Indications:

The primary indication for posterior glenoid augmentation is posterior instability with >20% to 25% posterior glenoid bone loss or recurrent posterior instability after prior stabilization procedure. In this case, the patient is a 21-year-old man with recurrent instability after 2 prior soft tissue stabilization procedures.

Technique Description:

The patient was positioned in lateral decubitus, and portals were established. Arthroscopic evaluation was performed to assess the labrum, biceps, rotator cuff, glenoid, and humeral head. Glenoid mobilization was performed, and an incision was made for introduction of the bone block. The glenoid was prepared, and a trial was used to guide preparation of the graft, which was harvested from the articular cartilage of the distal tibia. The graft was irrigated and bathed in platelet-rich plasma (PRP) and then introduced and positioned for maximal coverage of the defect. Screw fixation was performed with two 3.75-mm screws. The posterior capsule was reapproximated, and a layered closure was performed.

Results:

Previous studies have reported significant improvements in patient-reported outcomes, high rates of healing, and no cases of recurrent instability after DTA for anterior glenoid bone loss. Additional studies have reported few patients with recurrent instability and no instances of partial or non-union. Significant loss of range of motion has not been reported in the most recent case series. One previous study reported significantly improved patient-reported outcomes and near-complete osseous reabsorption with DTA after failed Latarjet procedure.

Discussion/Conclusion:

Arthroscopic posterior glenoid augmentation with DTA is a viable treatment option for patients with shoulder pain and instability with >20% to 25% posterior glenoid bone loss and/or following prior stabilization procedures.
Differential DNA methylation in Pacific oyster reproductive tissue in response to ocean acidification
Authors: Venkataraman Yaamini R. , White Samuel J. , Roberts Steven B.
Published: August 2022

Background

There is a need to investigate mechanisms of phenotypic plasticity in marine invertebrates as negative effects of climate change, like ocean acidification, are experienced by coastal ecosystems. Environmentally-induced changes to the methylome may regulate gene expression, but methylome responses can be species- and tissue-specific. Tissue-specificity has implications for gonad tissue, as gonad-specific methylation patterns may be inherited by offspring. We used the Pacific oyster (Crassostrea gigas)— a model for understanding pH impacts on bivalve molecular physiology due to its genomic resources and importance in global aquaculture— to assess how low pH could impact the gonad methylome. Oysters were exposed to either low pH (7.31 ± 0.02) or ambient pH (7.82 ± 0.02) conditions for 7 weeks. Whole genome bisulfite sequencing was used to identify methylated regions in female oyster gonad samples. C- > T single nucleotide polymorphisms were identified and removed to ensure accurate methylation characterization.

Results

Analysis of gonad methylomes revealed a total of 1284 differentially methylated loci (DML) found primarily in genes, with several genes containing multiple DML. Gene ontologies for genes containing DML were involved in development and stress response, suggesting methylation may promote gonad growth homeostasis in low pH conditions. Additionally, several of these genes were associated with cytoskeletal structure regulation, metabolism, and protein ubiquitination — commonly-observed responses to ocean acidification. Comparison of these DML with otherCrassostreaspp. exposed to ocean acidification demonstrates that similar pathways, but not identical genes, are impacted by methylation.

Conclusions

Our work suggests DNA methylation may have a regulatory role in gonad and larval development, which would shape adult and offspring responses to low pH stress. Combined with existing molluscan methylome research, our work further supports the need for tissue- and species-specific studies to understand the potential regulatory role of DNA methylation.
Accumulation and regulation of anthocyanins in white and purple Tibetan Hulless Barley (Hordeum vulgare L. var. nudum Hook. f.) revealed by combined de novo transcriptomics and metabolomics
Authors: Yao Xiaohua , Yao Youhua , An Likun , Li Xin , Bai Yixiong , Cui Yongmei , Wu Kunlun
Published: August 2022

Background

Colored barley, which may have associated human health benefits, is more desirable than the standard white variety, but the metabolites and molecular mechanisms underlying seedcoat coloration remain unclear.

Results

Here, the development of Tibetan hulless barley was monitored, and 18 biological samples at 3 seedcoat color developmental stages were analyzed by transcriptomic and metabolic assays in Nierumuzha (purple) and Kunlun10 (white). A total of 41 anthocyanin compounds and 4186 DEGs were identified. Then we constructed the proanthocyanin-anthocyanin biosynthesis pathway of Tibetan hulless barley, including 19 genes encoding structural enzymes in 12 classes (PAL,C4H,4CL,CHS,CHI,F3H,F3’H,DFR,ANS,ANR,GT, andACT). 11 DEGs other thanANRwere significantly upregulated in Nierumuzha as compared to Kunlun10, leading to high levels of 15 anthocyanin compounds in this variety (more than 25 times greater than the contents in Kunlun10).ANRwas significantly upregulated in Kunlun10 as compared to Nierumuzha, resulting in higher contents of three anthocyanins compounds (more than 5 times greater than the contents in Nierumuzha). In addition, 22 TFs, includingMYBs,bHLHs,NACs,bZips, andWD40s, were significantly positively or negatively correlated with the expression patterns of the structural genes. Moreover, comparisons of homologous gene sequences between the two varieties identified 61 putative SNPs in 13 of 19 structural genes. A nonsense mutation was identified in the coding sequence of theANSgene in Kunlun10. This mutation might encode a nonfunctional protein, further reducing anthocyanin accumulation in Kunlun10. Then we identified 3 modules were highly specific to the Nierumuzha (purple) using WGCNA. Moreover, 12 DEGs appeared both in the putative proanthocyanin-anthocyanin biosynthesis pathway and the protein co-expression network were obtained and verified.

Conclusion

Our study constructed the proanthocyanin-anthocyanin biosynthesis pathway of Tibetan hulless barley. A series of compounds, structural genes and TFs responsible for the differences between purple and white hulless barley were obtained in this pathway. Our study improves the understanding of the molecular mechanisms of anthocyanin accumulation and biosynthesis in barley seeds. It provides new targets for the genetic improvement of anthocyanin content and a framework for improving the nutritional quality of barley.
Moderate sedation with single-dose remimazolam tosilate in elderly male patients undergoing transurethral resection of the prostate with spinal anesthesia: a prospective, single-arm, single-centre clinical trial
Authors: Zhao Tang-yuan-meng , Chen Di , Sun Hu , Xu Zhi-xin , Lyu Song , Wang Tao , Liu Li-li
Published: August 2022

Background

Remimazolam tosilate (RT) is a newly listed benzodiazepine for sedation and anesthesia featuring quick onset of effects, short maintenance and recovery times, which is currently under research. This trial was conducted to determine the median effective dose (ED50) and the 95% effective dose (ED95) of single-dose remimazolam for moderate sedation in elderly patients undergoing transurethral resection of the prostate (TURP) under spinal anesthesia, and to evaluate its efficacy and safety.

Methods

Thirty male patients aged 65–80 years old were recruited for selective TURP. Remimazolam was administered intravenously to pain-free patients (VAS score < 1) within 1 min of successful spinal anesthesia by the same anesthesiologist. We used modified Dixon’s up-and-down sequential allocation method to determine the ED50 and ED95 of the agent with an initial dosage of 0.1 mg/kg. Successful sedation was defined as an MOAA/S score ≤ 3 and above 1. A score of > 3 was deemed as failed sedation. Recruitment continued until ten independent pairs (from successful sedation to failed sedation) would give a reliable estimation of the ED50 and ED95 of RT and their 95% confidence intervals.

Results

The ED50 of remimazolam was 0.063 (95% C.I. 0.045–0.073) mg/kg. Its ED95 was 0.079 (95% C.I. 0.07–0.137) mg/kg. Remimazolam was safe in its application.

Conclusions

A single-dose of RT proves to be safe for assisted sedation during TURP in elderly male patients under spinal anesthesia with a lower incidence of adverse events. Its ED50 and ED95 were 0.063 mg/kg and 0.079 mg/kg, respectively.

Trial registration

http://www.chictr.org.cn (ChiCTR2100051912).
Catastrophic health expenditure among Chinese adults living alone with cognitive impairment: findings from the CHARLS
Authors: Li Chenxi , Jin Shuyi , Cao Xingqi , Han Ling , Sun Ning , Allore Heather , Hoogendijk Emiel O. , Xu Xin , Feng Qiushi , Liu Xiaoting , Liu Zuyun
Published: August 2022

Background

The catastrophic health expenditure of older adults results in serious consequences; however, the issue of whether cognitive status and living situations contribute to such financial burdens is uncertain. Our aim was to compare the differences in catastrophic health expenditure between adults living alone with cognitive impairment and those adults living with others and with normal cognition.

Methods

We identified 909 observations of participants living alone with cognitive impairment (cases) and 37,432 observations of participants living with others and with normal cognition (comparators) from the 2011/2012, 2013, 2015 and 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS). We used propensity score matching (1:2) to create matched cases and comparators in a covariate-adjusted logistic regression analysis. Catastrophic health expenditure was defined as an out-of-pocket cost for health care ≥40% of a household’s capacity to pay.

Results

In comparison with participants living with others and with normal cognition, those adults living alone with cognitive impairment reported a higher percentage of catastrophic health expenditure (19.5% vs. 11.8%, respectively, P < 0.001). When controlling for age, sex, education, marital status, residence areas, alcohol consumption, smoking status and disease counts, we found that this subpopulation had significantly higher odds of having catastrophic health expenditure (odds ratio [OR] = 1.89, 95% confidence interval [CI]: 1.40, 2.56). Additional analyses confirmed the robustness of the results.

Conclusions

This study demonstrated that adults living alone with cognitive impairment in the CHARLS experienced a high burden of catastrophic health expenditure. Health care policies on social health insurance and medical assistance should consider these vulnerable adults.
Effect of an exercise intervention on global cognition after transient ischemic attack or minor stroke: the MoveIT randomized controlled trial
Authors: Deijle Inger A. , Hemmes Roelofjan , Boss H. Myrthe , de Melker Edwin C. , van den Berg Bob T. J. , Kwakkel Gert , van Wegen Erwin , Bosboom Wendy M. , Weinstein Henry C. , van Schaik Sander M. , Van den Berg-Vos Renske M.
Published: August 2022

Background

Patients with a transient ischemic attack (TIA) or ischemic stroke are at increased risk of developing cognitive impairment in the subacute phase. At present, the effects of exercise on cognitive functioning following a TIA or stroke are not fully known. The purpose of this trial was to investigate the effect of exercise on global cognition.

Methods

The MoveIT trial is a single-centre, observer-blinded, randomized controlled trial involving a 1-year exercise intervention consisting of a 12-week group exercise program, combined with three counselling visits to the physiotherapists over a 9-month period. The control group received standard care. The primary outcome was global cognitive functioning, assessed at one year, using the Montreal Cognitive Assessment (MoCA). Secondary outcomes included cardiorespiratory fitness, the cardiovascular profile, and attainment of secondary prevention targets, anxiety, depression and fatigue at one and two years.

Results

The experimental group consisted of 60 patients, while the control group consisted of 59 patients. The mean age was 64.3 years and 41% were female. No between-group differences were found on global cognitive functioning (MD, 0.7 out of 30, 95% CI, − 0.2 to 1.6) or on secondary outcome measures at 12 months. The only significant between-group difference was found for fatigue, in favour of the experimental group at 12 months (MD, 0.6 out of 63, 95% CI, 0.1 to 1.1).

Conclusions

No benefit of this exercise intervention was found regarding global cognition. Future studies need to focus on optimizing rehabilitation strategies for this vulnerable group of patients.

Trial registration

http://www.trialregister.nl. Unique identifier: NL3721.

Date first registration: 06-03-2013.
Self-reported vomiting during pregnancy in North-east Nigeria: perceptions, prevalence, severity and impacts
Authors: Yargawa Judith , Hill Zelee , Fottrell Edward
Published: August 2022

Background

Vomiting is a common ailment during pregnancy, often linked to negative impacts on women’s quality of life. Very little is known about the issue in low income settings, particularly Sub-Saharan Africa, with studies from high income settings predominantly informing the evidence base. This study aimed to explore how women perceive vomiting during pregnancy and to measure its prevalence, severity and impacts in North-east Nigeria.

Methods

Qualitative in-depth interviews, focus group discussions, family interviews and a cross-sectional household survey were carried out between December 2015 and November 2016 with women who had given birth within the past two years. Purposive sampling and thematic analysis were used in the qualitative studies. A three-staged cluster sampling with 640 women and descriptive analyses were used in the survey.

Results

Women in the qualitative studies reported that vomiting was a normal part of pregnancy, unless a woman vomits after eating, has poor appetite, is not well-nourished, cannot perform chores, is overwhelmed by it or has to go to hospital. In the survey, 35.4% (95% CI 26.5–45.5) of women reported any vomiting during their last pregnancies and of these only 21.1% said it had stopped entirely within the first trimester. Over half of women who reported vomiting did so at least three times per day most days and 34.7% were vomiting five or more times per day during the most severe period. Care-seeking was reported by 61.5%. Both the qualitative and quantitative data found that vomiting impacted women in multiple ways including nutritionally, physiologically, mentally, financially and martially; 50.8% of women with any vomiting in the survey perceived the overall severity of the condition negatively.

Conclusion

Vomiting during pregnancy is dually seen as normal and problematic depending on its characteristics and impacts. The burden appears to be high with many women seeking care for the condition.
Neoadjuvant nivolumab + T-VEC combination therapy for resectable early stage or metastatic (IIIB-IVM1a) melanoma with injectable disease: study protocol of the NIVEC trial
Authors: Rohaan Maartje W. , Stahlie Emma H. A. , Franke Viola , Zijlker Lisanne P. , Wilgenhof Sofie , van der Noort Vincent , van Akkooi Alexander C. J. , Haanen John B. A. G.
Published: August 2022

Background

Trials investigating neoadjuvant treatment with immune checkpoint inhibitors (ICI) in patients with melanoma have shown high clinical and pathologic response rates. Treatment with talimogene laherparepvec (T-VEC), a modified herpes simplex virus type-1 (HSV-1), is approved for patients with unresectable stage IIIB-IVM1a melanoma and has the potential to make tumors more susceptible for ICI. Combination ICI and intralesional T-VEC has already been investigated in patients with unresectable stage IIIB-IV disease, however, no data is available yet on the potential benefit of this combination therapy in neoadjuvant setting.

Methods

This single center, single arm, phase II study aims to show an improved major pathologic complete response (pCR) rate, either pCR or near-pCR, up to 45% in 24 patients with resectable stage IIIB-IVM1a melanoma upon neoadjuvant combination treatment with intralesional T-VEC and systemic nivolumab (anti-PD-1 antibody). Patients will receive four courses of T-VEC up to 4 mL (first dose as seroconversion dose) and three doses of nivolumab (240 mg flatdose) every 2 weeks, followed by surgical resection in week nine. The primary endpoint of this trial is pathologic response rate. Secondary endpoints are safety, the rate of delay of surgery and event-free survival. Additionally, prognostic and predictive biomarker research and health-related quality of life evaluation will be performed.

Discussion

Intralesional T-VEC has the capacity to heighten the immune response and to elicit an abscopal effect in melanoma in combination with ICI. However, the potential clinical benefit of T-VEC plus ICI in the neoadjuvant setting remains unknown. This is the first trial investigating the efficacy and safety of neoadjuvant treatment of T-VEC and nivolumab followed by surgical resection in patients with stage IIIB-IVM1a melanoma, with the potential of high pathologic response rates and acceptable toxicity.

Trial registration

This trial was registered in the European Union Drug Regulating Authorities Clinical Trials Database (EudraCT- number: 2019–001911-22) and the Central Committee on Research Involving Human Subjects (NL71866.000.19) on 4th June 2020.

Secondary identifying number: NCT04330430.
Association between metabolic syndrome, C-reactive protein, and the risk of primary liver cancer: a large prospective study
Authors: Song Mengmeng , Liu Tong , Liu Hai , Zhang Qi , Zhang Qingsong , Wang Yiming , Ma Xiangming , Cao Liying , Shi Hanping
Published: August 2022

Background and aims

High-sensitivity C-reactive protein (hs-CRP) levels and metabolic syndrome (MetS) are known to be associated with an increased incidence of different cancers. We aimed to evaluate the effect of MetS combined with high hs-CRP levels on the risk of primary liver cancer (PLC).

Methods

Participants were recruited from the Kailuan cohort study and were classified into four groups according to the presence or absence of MetS and inflammation (hs-CRP ≥ 3 or < 3 mg/L). The associations of MetS and inflammation with the risk of PLC were assessed using Cox proportional hazards models.

Results

This study included 92,770 participants. The mean age was 51.4 years old. Over a median follow-up of 13.02 years, 395 participants were diagnosed as PLC. Compared to the control participants without inflammation (hs-CRP < 3 mg/L) and MetS (n = 69,413), participants with high hs-CRP levels combined with MetS (n = 2,269) had a higher risk of PLC [hazard ratios (HR) 2.91; 95% confidence interval (CI), 1.77–4.81], and participants with high hs-CRP levels and without MetS (n = 14,576) had the same trend (HR, 1.36; 95%CI, 1.05–1.75). However, participants with low hs-CRP levels and MetS (n = 6,512) had no significant association with an elevated risk of PLC (HR, 1.18; 95%CI, 0.76–1.82). After excluding participants who had cancer during the first year of follow-up, sensitivity analysis showed the same trend. In addition, co-occurrence of MetS and high hs-CRP levels had significant interactive effects on the risk of PLC between the sexes (P < 0.001) and the patients with HBV infection (P = 0.012).

Conclusions

Participants with co-occurrence of MetS and high hs-CRP levels have an elevated risk of PLC.

Trial registration

Kailuan study, ChiCTR–TNRC–11001489. Registered 24 August, 2011-Retrospectively registered,http://www.chictr.org.cn/showprojen.aspx?proj=8050
Individual changes in stress, depression, anxiety, pathological worry, posttraumatic stress, and health anxiety from before to during the COVID-19 pandemic in adults from Southeastern Germany
Authors: Wechsler Theresa F. , Schmidmeier Melissa , Biehl Stefanie , Gerczuk Jennifer , Guerrero-Cerda Fiorella-Maria , Mühlberger Andreas
Published: August 2022

Background

Many studies have previously compared the prevalence or sample means of distress and mental health problems from before to during the COVID-19 pandemic, while results on changes at the individual-level, and regarding multiple outcome measures are demanded.

Methods

This online study investigated individual changes in stress and mental health from before the COVID-19 pandemic to the first lockdown in adults from Southeastern Germany. This region was selected as it was where SARS-CoV-2 was first documented in Germany, and also due to the implementation of strict stay-at-home orders and social contact prohibitions. From April 10–27, 2020, we collected state measures and their clinical relevance for the subareas of perceived stress: worries, tension, joy, and demands. We also collected information regarding the following mental health problems: depression, anxiety, pathological worry, posttraumatic stress disorder (PTSD), and health anxiety; as well as retrospective measures of how participants felt they have changed in comparison to before the pandemic, ranging from worse to better.

Results

The analytical sample comprised 396 adult participants. On average, participants experienced increases in worries, tension, and lack of joy, and increases in mental health problems, but a decrease in demands. Perceived increases in symptoms of depression (26.0%) and PTSD (25.5%) were significantly more frequent than in symptoms of anxiety (particularly acute fear and panic) (5.6%), pathological worry (9.8%), and health anxiety (7.3%) (ps<.001). One per 10 participants (10.4%) reported an increase in depressive symptoms, and nearly two per 10 (18.4%) an increase in PTSD symptoms and additionally showed a clinically relevant symptom strain during lockdown. Interestingly, mainly non-specific PTSD symptoms associated with a general stress reaction were experienced to be increased.

Conclusion

The findings suggest a dissociation of perceived changes in subareas of stress and mental health with a particular experience of increases in depressive and general stress symptoms and a decrease in external demands. This points to a need for a more differentiated view on the impact of the COVID-19 pandemic on stress and mental health, and for targeted interventions for mental health problems arising frequently during the pandemic.
Development and validation of a maternal anxiety for neonatal jaundice scale in China
Authors: Yan Qin , Li Dandan , Yin Xiaoxv , Jiang Nan , Sun Na , Luo Qing , Pang Xin , Fan Lichun , Gong Yanhong
Published: August 2022

Background

Maternal anxiety induced by neonatal jaundice has adverse effects on maternal and infant health, but there was no specific tool to identify the anxiety level of mothers. This study aims to develop a Maternal Anxiety for Neonatal Jaundice Scale (MANJS) and to validate it in the target population.

Methods

An initial 11-items MANJS was developed through literature review, expert panel consultation, and a pilot-test. Subsequently, mothers of neonates with jaundice were recruited from the Maternal and Child Health Hospital of Hainan Province, China, from June to December 2018, for a formal questionnaire survey. Based on the data collected, the scale was validated for construct validity, convergent validity, discriminant validity, content validity, and internal consistency reliability after the items screening.

Results

The reliability and validity of MANJS were validated in 1127 mothers of jaundiced neonates. After the item with cross-loadings was removed using exploratory factor analysis, MANJS consisted of two dimensions and 10 items, with a cumulative variance contribution of 74.36% and factor loadings above 0.6 for all items. The confirmatory factor analysis identified three items with cross-factor loading or error correlation and then they were removed orderly. The further confirmatory factor analysis showed a good construct validity for the 7-item MANJS, with standardized root mean square residual (SRMR) = 0.029, root mean square error of approximation (RMSEA) = 0.068, comparative fit index (CFI) = 0.961, Tucker-Lewis index (TLI) = 0.937, incremental fit index (IFI) = 0.961, normed fit index (NFI) = 0.954, goodness of fit index (GFI) = 0.998, adjusted goodness of fit index (AGFI) = 0.996, respectively. The average variance extracted values (AVE) of the two factors were 0.80 and 0.72, and the combined reliability (CR) were 0.94 and 0.88, respectively. Cronbach’s alpha was 0.90 for the MANJS, and split-half reliability was 0.72.

Conclusions

MANJS was demonstrated to have satisfactory reliability and validity in evaluating maternal anxiety caused by neonatal jaundice among Chinese postpartum women.
Measuring the effects of the COVID-19 pandemic on Diné and White Mountain Apache school personnel, families, and students: protocol for a prospective longitudinal cohort study
Authors: Allison-Burbank Joshuaa D. , Ingalls Allison , Rebman Paul , Chambers Rachel , Begay Renae , Grass Ryan , Tsosie Alicia , Archuleta Shannon , Barlow Allison , Larzelere Francene , Hammitt Laura , Tingey Lauren , Haroz Emily
Published: August 2022

Background

This paper describes the protocol for a longitudinal cohort study, “Project SafeSchools” (PSS), which focuses on measuring the effects of COVID-19 and the return to in-person learning on Diné (Navajo) and White Mountain Apache (Apache) youth, parents, and educators. The early surges of the COVID-19 pandemic led to the closure of most reservation and border town schools serving Diné and Apache communities. This study aims to: (1) understand the barriers and facilitators to school re-opening and in-person school attendance from the perspective of multiple stakeholders in Diné and Apache communities; and (2) evaluate the educational, social, emotional, physical, and mental health impacts of returning to in-person learning for caregivers and youth ages 4–16 who reside or work on the Diné Nation and the White Mountain Apache Tribal lands.

Methods

We aim to recruit up to N = 200 primary caregivers of Diné and Apache youth ages 4–16 and up to N = 120 school personnel. In addition, up to n = 120 of these primary caregivers and their children, ages 11–16, will be selected to participate in qualitative interviews to learn more about the effects of the pandemic on their health and wellbeing. Data from caregiver and school personnel participants will be collected in three waves via self-report surveys that measure COVID-19 related behaviors and attitudes, mental health, educational attitudes, and cultural practices and beliefs for both themselves and their child (caregiver participants only). We hypothesize that an individual’s engagement with a variety of cultural activities during school closures and as school re-opened will have a protective effect on adult and youth mental health as they return to in-person learning.

Discussion

The results of this study will inform the development or implementation of preventative interventions that may help Diné and Apache youth and their families recover from the negative impact of the COVID-19 pandemic, and positively impact their health and wellness.
Homicide rates are spatially associated with built environment and socio-economic factors: a study in the neighbourhoods of Toronto, Canada
Authors: Mohammadi Alireza , Bergquist Robert , Fathi Ghasem , Pishgar Elahe , de Melo Silas Nogueira , Sharifi Ayyoob , Kiani Behzad
Published: August 2022

Objectives

Homicide rate is associated with a large variety of factors and therefore unevenly distributed over time and space. This study aims to explore homicide patterns and their spatial associations with different socioeconomic and built-environment conditions in 140 neighbourhoods of the city of Toronto, Canada.

Methods

A homicide dataset covering the years 2012 to 2021 and neighbourhood-based indicators were analysed using spatial techniques such as Kernel Density Estimation, Global/Local Moran’sIand Kulldorff’s SatScan spatio-temporal methodology. Geographically weighted regression (GWR) and multi-scale GWR (MGWR) were used to analyse the spatially varying correlations between the homicide rate and independent variables. The latter was particularly suitable for manifested spatial variations between explanatory variables and the homicide rate and it also identified spatial non-stationarities in this connection.

Results

The adjusted R2of the MGWR was 0.53, representing a 4.35 and 3.74% increase from that in the linear regression and GWR models, respectively. Spatial and spatio-temporal high-risk areas were found to be significantly clustered in downtown and the north-western parts of the city. Some variables (e.g., the population density, material deprivation, the density of commercial establishments and the density of large buildings) were significantly associated with the homicide rate in different spatial ways.

Conclusion

The findings of this study showed that homicide rates were clustered over time and space in certain areas of the city. Socioeconomic and the built environment characteristics of some neighbourhoods were found to be associated with high homicide rates but these factors were different for each neighbourhood.
The secular trend of enterovirus A71 after the implementation of preventive measures in Taiwan
Authors: Hu Ya-Li , Chen Chiu-Mei , Wang En-Tzu , Kuo Hung-Wei , Shih Wei-Liang , Fang Chi-Tai , Liu Ding-Ping , Chang Luan-Yin
Published: August 2022

Background

Enterovirus A71 (EV A71) is one of the most important enteroviruses related to morbidity and mortality in children worldwide. This study aimed to analyse the secular trend of EV A71 in Taiwan from 1998 to 2020 and to evaluate the effectiveness of infection control measures.

Methods

We collected the epidemiological data of EV A71 from disease surveillance systems in Taiwan. We analysed the association between the secular trend of EV A71 and preventive measures such as hand washing, case isolation, and suspension of classes.

Results

The incidence of enterovirus infections with severe complications (EVSC) decreased from 16.25 per 100,000 children under six in 1998 to less than 9.73 per 100,000 children under six after 2012 (P = 0.0022). The mortality rate also decreased significantly, from 3.52 per 100,000 children under six in 1998 to 0 per 100,000 children under six in 2020 (P < 0.0001). The numbers of EVSC and fatalities were significantly higher in the years when EV A71 accounted for more than 10% of the annual predominant serotypes (p < 0.05). After the implementation of many non-pharmaceutical interventions in 2012, the incidence of EVSC and mortality rate decreased significantly (p < 0.001).

Conclusions

After implementing active enterovirus surveillance and preventive measures, we found that the incidence of EVSC and fatalities due to EV A71 in Taiwan decreased significantly from 1998 to 2020. Continuous surveillance and strengthened infection control policies are still needed in the future.