bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Google Analytics to Explore Dissemination Activities for an Online CKD Clinical Pathway: A Retrospective Study
Authors: Chong Christy , Smekal Michelle , Hemmelgarn Brenda , Elliott Meghan , Allu Selina , Wick James , McBrien Kerry , Jackson Wes , Bello Aminu , Jindal Kailash , Scott-Douglas Nairne , Manns Braden , Tonelli Marcello , Donald Maoliosa
Published: May 2022

Background:

Data on dissemination strategies that generate awareness of clinical pathways for kidney care are limited.

Objective:

This study reports the application of Google Analytics to describe the reach and use of the Chronic Kidney Disease Pathway (CKD-P) using a multi-faceted dissemination strategy.

Design:

The design of this study is a retrospective descriptive study.

Setting:

This study was conducted in Alberta, Canada.

Patients:

Individuals who accessed the CKD-P Web site between November 5, 2014, and May 31, 2019.

Measurements:

Dissemination activities included print, electronic, in-person meetings, and a laboratory prompt. We used Google Analytics over a 5-year period to evaluate the following CKD-P Web site user metrics: number of sessions, pageviews, visit duration, user path, and bounce rate (when an individual visits a single page of the Web site and leaves the Web site without interacting with additional pages).

Methods:

We plotted dissemination activities alongside Web site metrics using control charts and described the data using means and percentages. We performed chi-square test for trends to evaluate year-over-year usage.

Results:

There were 83 294 users, 90 805 sessions, and 231 684 pageviews. The overall bounce rate was 45.7%. Each user had an average of 1.5 sessions and a session duration of 2 minutes and 8 seconds. There was a significant positive trend for total annual users ( P = .008), new users ( P = .009), number of sessions ( P = .006), and pageviews per day ( P = .016).

Limitations:

We were unable to confirm if users were primary care providers and if word-of-mouth dissemination among providers/researchers drove people to use the CKD-P.

Conclusions:

Google Analytics was a useful and accessible tool for evaluating CKD-P reach and use trends. It was challenging to identify how individual dissemination activities contributed to CKD-P reach; however, repeated dissemination appeared to play a role in increasing CKD-P use.

Trial registration:

Not applicable—observational study design.
“Take heed that ye offend not—despise not—hinder not—one of these little ones”: Charlotte Mason and her educational proposal
Authors: Sendra Ramos Susana , Astiaso Pedro Lara , López Susana Miró
Published: May 2022

Charlotte Mason (1842–1923) was a well-known English educator whose work and legacy is certainly worthy of consideration today. One of the most interesting aspects of her philosophy of education is the fact that she adopts an anthropological approach: the consideration of the child as a person whose natural desire to know can only be satisfied with an education centered in the great books, the narrative method and the importance of relations. Her wide experience as a teacher, parental advisor, and teacher trainer, as well as the application of her method with surprisingly good results, constitute an endorsement of her proposal.
A 9-Month-Old Boy With “3 Months of Croup” a Devil Inside
Authors: Sah Amit , Civelli Valerie F. , Donath Christina , Mandviwala Lulua , Heidari Arash
Published: May 2022

Coccidioidomycosis (CM) is an endemic fungal disease that is prevalent in the Southwestern United States, Mexico, and Central and South America. The majority of cases are asymptomatic. Symptomatic cases primarily present with pneumonic disease, varying in severity from mild to severe. In a minority, extrapulmonary disease is known to occur. These disseminated cases typically manifest as meningitis, osteomyelitis, synovitis, and integumentary. Coccidioidomycosis has been identified in nearly every part of the body, including the soft tissues and cartilaginous tissues of the oropharynx. Disseminated CM to the larynx specifically in the pediatric populations is rarely documented. This is a case of persistent stridor misdiagnosed as viral croup in a 9-month-old male with protracted disease. Herein, diagnosis and treatment of laryngeal mass found to be CM are defined with a salutatory outcome.
Validation of the Romanian Communication Skills Ability Scale – CSAS-RO – A Tool for Medical Schools
Authors: Steriu Andreea , Bratu Eugenia Claudia , Cioran Nicoleta Valentina , Brînduşe Lăcrămioara Aurelia
Published: May 2022

In medicine ability to communicate requires training and continuous development.

Aim

To validate the Communication Skills Ability Scale in Romanian. Study design: cross-sectional observational interrupted large case series. Sample and setting: all year 5 medical undergraduate students enrolled at UMF Carol Davila, Bucharest (UMFCD). A two field tests study: 1) 2nd semester of the 2017/2018 academic year (n = 361); 2) 2018/2019 academic year (n = 703).

Methodology

The Romanian translation of CSAS® was used.

Results

The CSAS-RO confirms the 2-Factor scale; internal consistency: Cronbach-α coefficient was 0.894 for the PAS (0.870 CSAS®) and 0.754 for the NAS (0.805 CSAS®) All item-total and item-rest correlations satisfied the criterion of more than 0.30, ranging from 0.32 to 0.71 with the exception of items 17 (field test 1) and item 11 (field test 2)

Conclusion

CSAS-RO is valid to use with medical students. The reuse of the scale with a longitudinal study design will allow to assess any new educational needs for communication ability in medical students plus add the remaining property to test (the test-retest reliability).
COVID-19 in patients with hematologic malignancy
Authors: Langerbeins Petra , Hallek Michael
Published: May 2022

The coronavirus infectious disease (COVID-19) shows a remarkable symptomatic heterogeneity. Several risk factors including advanced age, previous illnesses, and a compromised immune system contribute to an unfavorable outcome. In patients with hematologic malignancy, the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is significantly reduced explaining why the mortality rate of hematologic patients hospitalized for a SARS-CoV-2 infection is about 34%. Active immunization is an essential pillar to prevent SARS-CoV-2 infections in patients with hematologic malignancy. However, the immune response to SARS-CoV-2 vaccines may be significantly impaired, as only half of patients with hematologic malignancy develop a measurable antiviral antibody response. The subtype of hematologic malignancy and B cell–depleting treatment predict a poor immune response to vaccination. Recently, antiviral drugs and monoclonal antibodies for pre-exposure or postexposure prophylaxis and for early treatment of COVID-19 have become available. These therapies should be offered to patients at high risk for severe COVID-19 and vaccine nonresponders. Importantly, as the virus evolves, some therapies may lose their clinical efficacy against new variants. Therefore, the ongoing pandemic will remain a major challenge for patients with hematologic malignancy and their caregivers who need to constantly monitor the scientific progress in this area.
Exploring attractor bifurcations in Boolean networks
Authors: Beneš Nikola , Brim Luboš , Kadlecaj Jakub , Pastva Samuel , Šafránek David
Published: May 2022

Background

Boolean networks (BNs) provide an effective modelling formalism for various complex biochemical phenomena. Their long term behaviour is represented by attractors–subsets of the state space towards which the BN eventually converges. These are then typically linked to different biological phenotypes. Depending on various logical parameters, the structure and quality of attractors can undergo a significant change, known as a bifurcation. We present a methodology for analysing bifurcations in asynchronous parametrised Boolean networks.

Results

In this paper, we propose a computational framework employing advanced symbolic graph algorithms that enable the analysis of large networks with hundreds of Boolean variables. To visualise the results of this analysis, we developed a novel interactive presentation technique based on decision trees, allowing us to quickly uncover parameters crucial to the changes in the attractor landscape. As a whole, the methodology is implemented in our tool AEON. We evaluate the method’s applicability on a complex human cell signalling network describing the activity of type-1 interferons and related molecules interacting with SARS-COV-2 virion. In particular, the analysis focuses on explaining the potential suppressive role of the recently proposed drug molecule GRL0617 on replication of the virus.

Conclusions

The proposed method creates a working analogy to the concept of bifurcation analysis widely used in kinetic modelling to reveal the impact of parameters on the system’s stability. The important feature of our tool is its unique capability to work fast with large-scale networks with a relatively large extent of unknown information. The results obtained in the case study are in agreement with the recent biological findings.
Opioid prescribing practices at hospital discharge for surgical patients before and after the Centers for Disease Control and Prevention’s 2016 opioid prescribing guideline
Authors: Langnas Erica , Bishara Andrew , Croci Rhiannon , Rodriguez-Monguio Rosa , Wick Elizabeth C. , Chen Catherine L. , Guan Zhonghui
Published: May 2022

Background

The Centers for Disease Control and Prevention’s (CDC) March 2016 opioid prescribing guideline did not include prescribing recommendations for surgical pain. Although opioid over-prescription for surgical patients has been well-documented, the potential effects of the CDC guideline on providers’ opioid prescribing practices for surgical patients in the United States remains unclear.

Methods

We conducted an interrupted time series analysis (ITSA) of 37,009 opioid-naïve adult patients undergoing inpatient surgery from 2013–2019 at an academic medical center. We assessed quarterly changes in the discharge opioid prescription days’ supply, daily and total doses in oral morphine milligram equivalents (OME), and the proportion of patients requiring opioid refills within 30 days of discharge.

Results

The discharge opioid prescription declined by -0.021 (95% CI, -0.045 to 0.003) days per quarter pre-guideline versus -0.201 (95% CI, -0.223 to -0.179) days per quarter post-guideline (p < 0.0001). Likewise, the mean daily and total doses of the discharge opioid prescription declined by -0.387 (95% CI, -0.661 to -0.112) and -7.124 (95% CI, -9.287 to -4.962) OME per quarter pre-guideline versus -2.307 (95% CI, -2.560 to -2.055) and -20.68 (95% CI, -22.66 to -18.69) OME per quarter post-guideline, respectively (p < 0.0001). Opioid refill prescription rates remained unchanged from baseline.

Conclusions

The release of the CDC opioid guideline was associated with a significant reduction in discharge opioid prescriptions without a concomitant increase in the proportion of surgical patients requiring refills within 30 days. The mean prescription for opioid-naïve surgical patients decreased to less than 3 days’ supply and less than 50 OME per day by 2019.
Functional limitations before and after cancer diagnosis and contributing factors: findings from the China health and retirement longitudinal study
Authors: Yang Rumei , Liu Yin , Jiang Yun , Fleming Daniel J. M. , Fauth Elizabeth B.
Published: May 2022

Background

Although there is a general trend of functional decline with age, there lacks an understanding of how cancer diagnosis and other factors may contribute to this trend. This study aimed to examine functional limitation trajectories among adults with and without cancer, and before versus after the cancer diagnosis, and to explore potential contributing factors associated with functional trajectories among cancer survivors.

Methods

The sample were middle-aged and older Chinese adults who participated in all 3 waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011–2015). Ordinary and multiphase growth curve analyses were conducted to examine (1) differences in functional trajectories between participants with (n = 139) and without cancer (n = 7,313), (2) pre-and post-cancer diagnosis changes in functional limitations among those who reported a cancer diagnosis over the 4-year timeframe, and (3) contributing factors associated with functional trajectories among cancer survivors, guided by the Disablement Process Models, including psychological (depressive symptoms), physical (pain and falls), cognitive (self-reported memory problems), and environmental (social contact and available support) factors.

Results

There was a trend of increased functional limitations among all participants over time (unstandardized β = 0.17, p < .0001). However, participants with cancer did not differ from non-cancer participants in neither the level (unstandardized β = 0.77, p = .08) nor the rate of functional decline (unstandardized β = -0.43, p = .07). Functional limitation trajectories were different pre- versus post-cancer diagnosis, although not in expected directions (unstandardized β = -0.48, p < .05). Cancer survivors with greater pain had higher levels of functional limitations which were sustained over time compared to those with less pain (unstandardized β = 0.93, p < .001).

Conclusions

The study confirmed that Chinese middle-aged and older adults had overall decreased functional decline over time. A novel finding that cancer survivors experienced less rapidly functional decline after the cancer diagnosis suggested that cancer diagnosis might serve as an inflection point at which early intervention is promising to slow the functional decline. In addition, findings that within-person contributing factors, such as pain, can be influential in functional limitation trajectories suggested that more attention is needed to pay to patients with cancer-pain. These findings demonstrated the heterogeneity of functional limitation trajectories and needs for person-centered interventions among Chinese cancer survivors.
A suspected case of hyponatraemia induced rhabdomyolysis: a case report
Authors: Reakes Edward , Drak Douglas , Gracey David
Published: May 2022

Background

Hyponatraemia is a documented but under-recognised cause of rhabdomyolysis, with the contrasting treatment strategies for the two conditions posing a unique challenge. Balancing the need for aggressive fluid replacement for the treatment of rhabdomyolysis, with the risk of rapidly correcting hyponatraemia is imperative.

Case presentation

A 52-year-old gentleman with a background of HIV infection and hypertension presented with seizures following methamphetamine use, acute water intoxication, and thiazide use. He was found to have severe hyponatraemia, and following initial correction with hypertonic saline, was commenced on a fluid restriction. After two days he developed abdominal wall and thigh pain, along with oliguria. Laboratory data demonstrated markedly elevated creatine kinase levels and deteriorating renal function. A diagnosis of rhabdomyolysis and severe acute kidney injury was made and aggressive fluid replacement commenced, leading to full resolution of the hyponatraemia, rhabdomyolysis and acute kidney injury.

Conclusion

Hyponatraemia-induced rhabdomyolysis is rare but can cause significant morbidity and mortality if left untreated. Physicians should consider measuring creatine kinase levels in all patients presenting with severe hyponatraemia, particularly in the presence of other risk factors for rhabdomyolysis. Fluid replacement strategies must be considered in relation to the relative onset and risk of over-correcting hyponatraemia.
Functional status and its related factors among stroke survivors in rehabilitation departments of hospitals in Shenzhen, China: a cross-sectional study
Authors: Zhou Jing , Liu Fang , Zhou Mingchao , Long Jianjun , Zha Fubing , Chen Miaoling , Li Jiehui , Yang Qingqing , Zhang Zeyu , Wang Yulong
Published: May 2022

Background

Many stroke survivors have multiple chronic diseases and complications coupled with various other factors which may affect their functional status. We aimed to investigate the factors associated with poor functional status in hospitalized patients with stroke in Shenzhen, China.

Methods

In this cross-sectional study, four urban hospitals were selected using convenient sampling, and all stroke patients in these four hospitals were included using cluster sampling. The functional status of stroke survivors was evaluated using Longshi Scale. Explanatory variables (factors affecting functional status comprising age, sex, body mass index, smoking, alcohol consumption, complications, and chronic conditions) were collected. Ordinal logistic regression was used to examine which factors were associated with poor functional status.

Results

Stroke survivors with poor functional status accounted for 72.14% and were categorised as the bedridden group based on Longshi scale, 21.67% of patients with moderate functional limitation were categorised as the domestic group, and 6.19% of the patients with mild functional restriction were categorised as the community group. The highest dependence scores were noted for feeding (73.39%), bowel and bladder management (69.74%) and entertainment (69.53%) among the bedridden group, and housework (74.29%) among the domestic group. In the adjusted model, the odds of poor functional status were higher among stroke patients with older age (odds ratio [OR] = 2.39, 95% CI: 1.55–3.80), female sex (OR = 1.73, 95% CI: 1.08–2.77), duration of stroke more than 12 months (OR = 1.94, 95% CI: 1.28–2.95), with pulmonary infection (OR = 10.91, 95% CI: 5.81–20.50), and with deep venous thrombosis (OR = 3.00, 95% CI: 1.28–7.04).

Conclusions

Older adults (age ≥ 60 years) and women were more likely to exhibit poor functional status post-stroke. Pulmonary infection and deep venous thrombosis were related to an increased risk of being dependent on activities of daily living. Therefore, clinical and rehabilitation interventions aimed at preventing or treating these common complications should be addressed to deal with subsequent dysfunction post-stroke. Since all data were obtained in metropolitan areas where the economy is well developed, future studies should be conducted in rural areas and economically less developed cities.
Machine learning to predict pregnancy outcomes: a systematic review, synthesizing framework and future research agenda
Authors: Islam Muhammad Nazrul , Mustafina Sumaiya Nuha , Mahmud Tahasin , Khan Nafiz Imtiaz
Published: May 2022

Machine Learning (ML) has been widely used in predicting the mode of childbirth and assessing the potential maternal risks during pregnancy. The primary aim of this review study is to explore current research and development perspectives that utilizes the ML techniques to predict the optimal mode of childbirth and to detect various complications during childbirth. A total of 26 articles (published between 2000 and 2020) from an initial set of 241 articles were selected and reviewed following a Systematic Literature Review (SLR) approach. As outcomes, this review study highlighted the objectives or focuses of the recent studies conducted on pregnancy outcomes using ML; explored the adopted ML algorithms along with their performances; and provided a synthesized view of features used, types of features, data sources and its characteristics. Besides, the review investigated and depicted how the objectives of the prior studies have changed with time being; and the association among the objectives of the studies, uses of algorithms, and the features. The study also delineated future research opportunities to facilitate the existing initiatives for reducing maternal complacent and mortality rates, such as: utilizing unsupervised and deep learning algorithms for prediction, revealing the unknown reasons of maternal complications, developing usable and useful ML-based clinical decision support systems to be used by the expecting mothers and health professionals, enhancing dataset and its accessibility, and exploring the potentiality of surgical robotic tools. Finally, the findings of this review study contributed to the development of a conceptual framework for advancing the ML-based maternal healthcare system. All together, this review will provide a state-of-the-art paradigm of ML-based maternal healthcare that will aid in clinical decision-making, anticipating pregnancy problems and delivery mode, and medical diagnosis and treatment.
Association of serum vitamin D status with gestational diabetes mellitus and other laboratory parameters in early pregnant women
Authors: Luo Caihong , Li Zhiju , Lu Yunya , Wei Fang , Suo Dongmei , Lan Shiyan , Ren Zhengyuan , Jiang Runchang , Huang Fang , Chen Aiyue , Jiang Liejun , Huang Huayi , Guo Xiaoling
Published: May 2022

Background

The association between serum 25-hydroxy vitamin D (25(OH)D) status and gestational diabetes mellitus (GDM) gained attention in recent years, however the conclusion is still controversial due to many interfering factors, such as region of living, environment, lifestyle, and food supplements. Other metabolites (laboratory parameters) are also important in reflecting gestational states. This study aimed to investigate the association of serum 25(OH)D status in early pregnancy with GDM and other laboratory parameters in pregnant women.

Methods

A total of 1516 pregnant women whose blood glucose were normal before pregnancy in the city of Foshan in Guangdong, China were enrolled in this study. GDM was diagnosed between 24 to 28 weeks of pregnancy following the guidelines from the American Diabetes Association. Maternal serum 25(OH)D and other laboratory parameters—including hematology, coagulation, chemistry, and bone density—were measured utilizing various analytical methods in clinical laboratory at gestational weeks 11 to 14.

Results

The average 25(OH)D concentration was 59.1 ± 12.6 nmol/L. None of the study subjects had 25(OH)D < 25 nmol/L; 434 (28.6%) women had 25(OH)D deficiency (< 50 nmol/L), 882 women (58.2%) had 25(OH)D insufficiency (50–74 mmol/L) and 200 women (13.2%) had 25(OH)D sufficiency (≥ 75 nmol/L). There were 264 (17.4%) women diagnosed with GDM. There was not, however, an association between serum 25(OH)D in early pregnancy and GDM. Interestingly, women with more parity and high serum alkaline phosphatase levels had higher serum 25(OH)D levels. There was a possible positive association between serum 25(OH)D and pre-albumin, and a possible negative association between serum 25(OH)D, creatinine, and thrombin time. This study did not find an association between serum 25(OH)D and bone density.

Conclusions

There were no associations between maternal serum 25(OH)D concentration in early pregnancy and the risk of GDM or bone density. There were, however, correlations between serum 25(OH)D and parity, seasoning at sampling, serum alkaline phosphatase, creatinine, pre-albumin, and coagulation factor thrombin time, which need further study to explain their pathophysiology and clinical significance.
Burden of cancers in India - estimates of cancer crude incidence, YLLs, YLDs and DALYs for 2021 and 2025 based on National Cancer Registry Program
Authors: Kulothungan Vaitheeswaran , Sathishkumar Krishnan , Leburu Sravya , Ramamoorthy Thilagavathi , Stephen Santhappan , Basavarajappa Dharmappa , Tomy Nifty , Mohan Rohith , Menon Geetha R. , Mathur Prashant
Published: May 2022

Background

Cancer is the major cause of morbidity and mortality worldwide. The cancer burden varies within the regions of India posing great challenges in its prevention and control. The national burden assessment remains as a task which relies on statistical models in many developing countries, including India, due to cancer not being a notifiable disease. This study quantifies the cancer burden in India for 2016, adjusted mortality to incidence (AMI) ratio and projections for 2021 and 2025 from the National Cancer Registry Program (NCRP) and other publicly available data sources.

Methods

Primary data on cancer incidence and mortality between 2012 and 2016 from 28 Population Based Cancer Registries (PBCRs), all-cause mortality from Sample Registration Systems (SRS) 2012–16, lifetables and disability weight from World Health Organization (WHO), the population from Census of India and cancer prevalence using the WHO-DisMod-II tool were used for this study. The AMI ratio was estimated using the Markov Chain Monte Carlo method from longitudinal NCRP-PBCR data (2001–16). The burden was quantified at national and sub-national levels as crude incidence, mortality, Years of Life Lost (YLLs), Years Lived with Disability (YLDs) and Disability Adjusted Life Years (DALYs). The projections for the years 2021 and 2025 were done by the negative binomial regression model using STATA.

Results

The projected cancer burden in India for 2021 was 26.7 million DALYsAMI and expected to increase to 29.8 million in 2025. The highest burden was in the north (2408 DALYsAMI per 100,000) and northeastern (2177 DALYsAMI per 100,000) regions of the country and higher among males. More than 40% of the total cancer burden was contributed by the seven leading cancer sites — lung (10.6%), breast (10.5%), oesophagus (5.8%), mouth (5.7%), stomach (5.2%), liver (4.6%), and cervix uteri (4.3%).

Conclusions

This study demonstrates the use of reliable data sources and DisMod-II tools that adhere to the international standard for assessment of national and sub-national cancer burden. A wide heterogeneity in leading cancer sites was observed within India by age and sex. The results also highlight the need to focus on non-leading sites of cancer by age and sex. These findings can guide policymakers to plan focused approaches towards monitoring efforts on cancer prevention and control. The study simplifies the methodology used for arriving at the burden estimates and thus, encourages researchers across the world to take up similar assessments with the available data.
Prognostic value of CD4+ T lymphopenia in non-small cell lung Cancer
Authors: Eberst Guillaume , Vernerey Dewi , Laheurte Caroline , Meurisse Aurélia , Kaulek Vincent , Cuche Laurie , Jacoulet Pascale , Almotlak Hamadi , Lahourcade Jean , Gainet-Brun Marie , Fabre Elizabeth , Le Pimpec-Barthes Françoise , Adotevi Olivier , Westeel Virginie
Published: May 2022

Background

There is a paucity of data regarding the prognostic influence of peripheral blood CD4+ T lymphopenia in non-small cell lung cancer (NSCLC). Therefore, we investigated the prognostic value of T lymphopenia in NSCLC.

Materials

Treatment-naive patients with a pathological diagnosis of NSCLC, at clinical stage I to IV were included in the prospective TELOCAP1 study. Lymphocytes count was evaluated in peripheral blood by flow cytometry. CD4+ and CD8+ T lymphopenia were defined as an absolute count of < 500/μL and < 224/μL respectively. The prognostic value of T lymphopenia was analyzed in the whole population, in local/loco-regional (stage I-IIIB) and in advanced (stage IV) NSCLC disease, using the Kaplan-Meier method and Cox regression models for survival curves and multivariate analysis, respectively.

Results

Between July 2010 and January 2014, 169 evaluable patients with clinical stage I to IV NSCLC were prospectively enrolled. The prevalence of CD4+ and CD8+ T lymphopenia was similar in the study population (around 29%). Patients with CD4+ T lymphopenia showed lower overall survival than those with CD4+ T lymphocytes count > 500/μL (median overall survival (OS) 16.1 versus 21.7 months, hazard ratio (HR): 1.616 [95% CI: 1.1–2.36], p = 0.012). This association with OS was especially marked in local/loco-regional NSCLC stages (median OS, 21.8 versus 72 months, respectively, HR: 1.88 [95% CI: 0.9–3.8],p = 0.035). Multivariate analysis confirmed the worse prognosis associated with CD4+ T lymphopenia in local/loco-regional NSCLC, but not in metastatic patients (HR 2.028 [95% CI = 1.065–3.817]p = 0.02). Restricted cubic spline analysis showed that patients with CD4+ T lymphocytes count ≤500/μL displayed a high risk of death regardless of NSCLC clinical stage. There was no obvious relationship between CD8+ T lymphopenia and clinical outcome.

Conclusion

We identified CD4+ T lymphopenia as an independent prognostic factor in local/loco-regional stages of NSCLC and CD4+ T lymphopenia is also associated with a high risk of death, regardless of NSCLC clinical stage.

Trial registration

EUDRACT: 2009-A00642–55.
Overexpression of angiogenic factors and matrix metalloproteinases in the saliva of oral squamous cell carcinoma patients: potential non-invasive diagnostic and therapeutic biomarkers
Authors: Cai Meijuan , Zheng Zhichao , Bai Zhibao , Ouyang Kexiong , Wu Qiuyu , Xu Shaofen , Huang Lihuan , Jiang Yingtong , Wang Lijing , Gao Jie , Pathak Janak L. , Wu Lihong
Published: May 2022

Backgrounds

Salivary biomarkers hold huge potential for the non-invasive diagnosis of oral squamous cell carcinoma. Angiogenic factors and matrix-metalloproteinases (MMPs) are highly expressed in OSCC tissue, but their expression patterns in the saliva are unknown. This study aimed to analyze the levels of angiogenic factors and MMPs in tumor tissue and saliva of OSCC patients.

Methods

OSCC-tissue, adjacent normal tissue (ANT), saliva from OSCC patients, and healthy controls were obtained. The expression patterns of angiogenic factors and MMPs were analyzed by immunohistochemistry, protein chip array, and RT-qPCR.

Results

Results showed higher expression of ANG, ANG-2, HGF, PIGF, VEGF, MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, MMP-10, MMP-13, TIMP-1, and TIMP-2 in OSCC-tissues compared to the ANT. Among the overexpressed markers in OSCC-tissues, HGF, VEGF, PIGF, PDGF-BB, MMP-1, MMP-3, MMP-8, MMP-9, MMP-10, MMP-13, and TIMP-2 were significantly upregulated in the saliva of OSCC patients compared to healthy controls.

Conclusions

The levels of HGF, VEGF, PIGF, MMP-1, MMP-3, MMP-8, MMP-9, MMP-10, MMP-13, and TIMP-2 were upregulated both in OSCC tissue and saliva of OSCC patients. Bioinformatic analysis revealed the correlation of these factors with patient survival and cancer functional states in head and neck cancer, indicating these factors as possible saliva-based non-invasive diagnostic/prognostic markers and therapeutic targets of OSCC.
High prevalence of myopia and low hyperopia reserve in 4411 Chinese primary school students and associated risk factors
Authors: Yue Yu , Liu Xianmao , Yi Shu , Liu Bo , Yi Hong , Li Hong
Published: May 2022

Purpose

To investigate the prevalence of myopia in Chinese primary school students and their ocular biometrics including axial length (AL), corneal radius of curvature (CRC) and spherical equivalent refraction (SER). To analyze their association with potential myopia risk factors, such as body mass index (BMI), cram school, time of outdoor activity and electronic screen use.

Methods

In this cross-sectional study of 4500 primary school students from 5 schools, participants underwent refraction using non-cycloplegic autorefractor and visual acuity testing. A follow-up study in the same schools was conducted in 2022. Myopia was defined as SER ≤ -0.50 diopter (D) and uncorrected visual acuity (UCVA) < 0.00 logMAR (6/6). Logistic regression models were used to determine factors associated with myopia.

Results

After excluding 389 participants, the overall prevalence of myopia was 33.6%. The prevalence of high myopia was 0.6%. The prevalence of myopia in girls was significantly higher than that in boys (37.6% vs. 30.0%, p < 0.001). The height, weight and BMI were significantly associated with AL (r = 0.471, r = 0.440, r = 0.276, p < 0.001, respectively). AL/CRC ratio was more highly correlated with SER than AL alone. Regression analysis showed that AL/CRC and hyperopia reserve were associated with myopia onset in the subsequent year (F = 201.557, p < 0.001; F = 68.934, p < 0.001). The cut point of hyperopia reserve for myopia in the subsequent year for grade 1 students was + 0.31D. Age (p < 0.001), parental myopia (p = 0.001) and lack of outdoor activity between classes (p = 0.049) were independently associated with higher prevalence rates of myopia.

Conclusion

The prevalence of myopia among Chinese schoolchildren is alarming high. Consistent with previous cross-sectional data, AL/CRC and hyperopia reserve could function as myopia detection indicators. The hyperopia reserve among children aged between 6 ~ 7 years was low. Healthcare providers need to raise parents’ awareness of the importance of regular eye examination and proper optical correction.
Barriers and facilitators influencing the implementation of the occupational health intervention ‘Dynamic Work’: a qualitative study
Authors: Mastenbroek Victoria J. E. Z. , Jelsma Judith G. M. , van der Ploeg Hidde P. , Stijnman Dominique P. M. , Huysmans Maaike A. , van der Beek Allard J. , van Nassau Femke
Published: May 2022

Background

Sedentary behavior is associated with an increased risk of morbidity and mortality. To reduce occupational sitting time of office workers, the multi-component intervention ‘Dynamic Work’ was implemented in a Dutch insurance company. Although the results showed no significant reductions in sitting time, associations were found between higher levels of implementation and reductions in sitting time. Building upon these findings, this qualitative study aimed to identify barriers and facilitators from an organizational perspective for the implementation of Dynamic Work. In addition, we explored differences in barriers and facilitators between departments with a low, middle and high level of implementation.

Methods

In total, eighteen semi-structured interviews were conducted with two Dynamic Work coordinators, three occupational physiotherapists who delivered the intervention, and thirteen department managers. All participants were purposively sampled. The data was coded in Atlas.ti and a thematic analysis was performed guided by The Integrated Checklist of Determinants (TICD).

Results

Implementation factors were related to the organization; working culture and financial support facilitated implementation. Factors related to the implementing department mainly hindered implementation, i.e. lack of information at start of the project, late delivery of Dynamic Work equipment, large group sizes, employee’s workload and work tasks, and an ongoing reorganization. The facilitating role of managers was experienced as both enabling and hindering. The pre-existing familiarity of the occupational physiotherapists with the departments and alignment amongst the three implementers facilitated implementation. Yet, the non-obligatory nature of the intervention as well as limited availability and technical problems of equipment did not support implementation.

Conclusions

Various barriers and facilitators influenced the implementation of the Dynamic Work intervention, where the key role of the department manager, late delivery of dynamic work equipment and groups sizes varied between low and high implementing departments. These results can contribute to developing and improving implementation strategies in order to increase the effectiveness of future occupational health interventions.

Trial registration

The study protocol was registered on April 14, 2017 in the ClinicalTrials.gov Protocol Registration and Results System under registration number NCT03115645.
The alcohol industry, the tobacco industry, and excise taxes in the US 1986–89: new insights from the tobacco documents
Authors: Lesch Matthew , McCambridge Jim
Published: May 2022

Background

The UCSF Industry Documents Library has provided public health researchers with key insights into the organization of political activities in the tobacco industry. Much less is known about the alcohol industry. In the US, there is some existing evidence of cooperation between the two industries, particularly in areas where there are mutual interests and/or policy goals at stake. Efforts to raise excise taxes on tobacco and alcohol products are one such example.

Methods

We systematically searched the UCSF Industry Documents Library for data on alcohol industry actors and their political activities. Using content generated by alcohol and tobacco actors, we sought to identify new evidence of collaborations to shape excise tax policy debates in the US in the 1980s and 1990s.

Results

We uncover evidence of the alcohol industry’s efforts to shape excise tax policy debates, both at the national and state level. Excise taxes were defined by both alcohol and tobacco companies and related organisations as a key threat to profits. We show how the alcohol industry confronted this challenge in the late 1980s in the US, uncovering the range of monitoring, coordinating, and public-facing activities used to defeat proposed tax increases at both state and federal levels. The former draws particular attention to Oregon, where alcohol industry actors were not simply operating at the behest of the tobacco industry, but actively led a campaign to advance both brewing and tobacco interests.

Conclusions

The tobacco documents offer a key resource for studying economic interests beyond that of the tobacco industry, operating in collaboration with tobacco companies. Here, brewers advanced shared interests with tobacco, and these findings have implications for advancing understanding of alcohol and tobacco industry political strategies. The findings also suggest that financial documents from other public repositories could be used to generate new inferences about corporate political activities.
Experience of discrimination during COVID-19 pandemic: the impact of public health measures and psychological distress among refugees and other migrants in Europe
Authors: Marchi Mattia , Magarini Federica Maria , Chiarenza Antonio , Galeazzi Gian Maria , Paloma Virginia , Garrido Rocío , Ioannidi Elisabeth , Vassilikou Katerina , de Matos Margarida Gaspar , Gaspar Tania , Guedes Fabio Botelho , Primdahl Nina Langer , Skovdal Morten , Murphy Rebecca , Durbeej Natalie , Osman Fatumo , Watters Charles , van den Muijsenbergh Maria , Sturm Gesine , Oulahal Rachid , Padilla Beatriz , Willems Sara , Spiritus-Beerden Eva , Verelst An , Derluyn Ilse
Published: May 2022

Background

The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020).

Methods

Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items finalN = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2.

Results

In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200,p < 0.001) and PD (B = 0.455,p < 0.001). Moreover, PD was also associated with CARE (B = 0.094,p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417,p < 0.001; proportion mediated = 29.7%,p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132;p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection.

Conclusions

Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.
Evaluation of a single-shot of a high-density viscoelastic solution of hyaluronic acid in patients with symptomatic primary knee osteoarthritis: the no-dolor study
Authors: Calvet Joan , Khorsandi Danial , Tío Laura , Monfort Jordi
Published: May 2022

Background

Pronolis®HD mono 2.5% is a novel, one-shot, high-density sterile viscoelastic solution, recently available in Spain, which contains a high amount of intermediate molecular weight hyaluronic acid (HA), highly concentrated (120 mg in 4.8 mL solution: 2.5%). The objective of the study was to analyze the efficacy and safety of this treatment in symptomatic primary knee osteoarthritis (OA).

Methods

This observational, prospective, multicenter, single-cohort study involved 166 patients with knee OA treated with a single-shot of Pronolis®HD mono 2.5% and followed up as many as 24 weeks.

Results

Compared with baseline, the score of the Western Ontario and McMaster Universities Arthritis Osteoarthritis Index (WOMAC) pain subscale reduced at the 12-week visit (primary endpoint, median: 9 interquartile range [IQR]: 7–11 versus median: 4; IQR: 2–6; p < 0.001). The percentage of patients achieving > 50% improvement in the pain subscale increased progressively from 37.9% (at 2 weeks) to 66.0% (at 24 weeks). Similarly, WOMAC scores for pain on walking, stiffness subscale, and functional capacity subscale showed significant reductions at the 12-week visit which were maintained up to the 24-week visit. The EuroQol visual analog scale score increased after 12 weeks (median: 60 versus 70). The need for rescue medication (analgesics/nonsteroidal anti-inflammatory drugs) also decreased in all post-injection visits. Three patients (1.6%) reported local adverse events (joint swelling) of mild intensity.

Conclusions

In conclusion, a single intra-articular injection of the high-density viscoelastic gel of HA was associated with pain reduction and relief of other symptoms in patients with knee OA.

Trial registration

ClinicalTrial# NCT04196764
Non-infectious granulomatous disorders of the upper lip: clinicopathological analysis of 11 patients
Authors: Lafuente-Ibáñez de Mendoza Irene , Vigarios Emmanuelle , Herbault-Barres Béatrice , Alberdi-Navarro Javier , Sibaud Vincent , Maret Delphine , Aguirre-Urizar José Manuel
Published: May 2022

Background

Non-infectious granulomatous disorders of the upper lip represent a special chapter of oral and maxillofacial pathology. In this work we report a case-series of this process, to analyse its main clinicopathological features and find differential data that allow us improve its diagnosis and understand its pathogenesis.

Methods

We present 11 cases of non-infectious granulomatous disorders of the upper lip, 8 women and 3 men with an age range of 29–84 years, who have been attended at the Oral Medicine Department of the IUCT (France) and the Oral Medicine Unit of the UPV/EHU (Spain). All clinicopathological data were collected in a specific protocol.

Results

We recognized 4 different subtypes of non-infectious granulomatous disorders of the upper lip: (1) associated with Crohn’s disease (1 case), (2) associated with foreign body (2 cases), (3) associated with gingivitis lichenoid-like (4 cases), (4) idiopathic (4 cases).

Conclusions

Clinicopathological differences were identified between these subtypes. A good differential diagnosis is necessary in all cases to rule out the presence of local or systemic etiopathogenic factors.
The relationship between attitudes to homelessness and perceptions of caring behaviours: a cross-sectional study among women experiencing homelessness, nurses and nursing students
Authors: Gaber Sophie Nadia , Rosenblad Andreas Karlsson , Mattsson Elisabet , Klarare Anna
Published: May 2022

Background

Women experiencing homelessness have complex and multifaceted healthcare needs and yet they are an underserved population across healthcare services. Nurses are trained to perform an integral role in the provision of equitable healthcare and their attitudes towards homelessness may therefore influence the care that women experiencing homelessness receive. This study aimed to examine correlations between attitudes towards homelessness and caring behaviours, and to test if these correlations differed between the groups of women experiencing homelessness, registered nurses, and nursing students.

Methods

A cross-sectional design using convenience sampling was used to recruit women experiencing homelessness (n = 37), registered nurses (n = 90), and nursing students (n = 138) in Stockholm, Sweden between August 2019 and December 2020. The participants answered two questionnaires: the Attitudes Toward Homelessness Inventory and the Caring Behaviours Inventory-24. Correlations between ordinal variables were calculated using Spearman’s rank correlation ρ. Tests of equality between two independent correlations were performed using a Z-test applied to Fisher’s z-transformed correlations. An advisory board of women with lived experience of homelessness supported the interpretation of the results.

Results

Weak, negative correlations were identified between the Attitudes Toward Homelessness Inventory and Caring Behaviours Inventory-24. The Attitudes Toward Homelessness Inventory mean total scores (SD) were 4.1 (0.6), 4.2 (0.6), 4.1 (0.5) points for the women experiencing homelessness, registered nurse, and nursing student groups, respectively, with the corresponding scores for the Caring Behaviours Inventory-24 being 4.1 (1.1), 5.2 (0.5), 4.8 (0.7) points, respectively.

Conclusions

To promote equitable health for women experiencing homelessness, healthcare providers and nurse educators should consider the role of stigmatising attitudes in relation to caring behaviours.