bluuebunny/crossref_metadata_2025 huggingface dataset:
Benefits of Meniscal Repair in Selected Patients Aged 60 Years and Older
Authors: Husen Martin , Kennedy Nicholas I. , Till Sara , Reinholz Anna , Stuart Michael J. , Krych Aaron J. , Saris Daniel B.F.
Published: September 2022

Background:

Little is known about the benefits and outcomes of meniscal repair in patients older than 60 years.

Purpose:

To (1) report the clinical and radiographic outcomes of meniscal repair in patients aged ≥60 years and compare them with matched patients who underwent meniscectomy and (2) identify procedural failures.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

We included 32 knees in 32 patients aged ≥60 years (20 female, 12 male; mean age, 64.5 ± 4.6 years) who underwent meniscal repair surgery at a single medical institution between 2010 and 2020. Patients were matched according to age, sex, body mass index, and meniscal tear type with a comparison cohort who underwent meniscectomy (n = 49 patients [49 knees]; 32 female, 17 male). For all patients, demographic information, clinical history, physical examination findings, treatment details, and radiographic images were reviewed and analyzed. At final follow-up (mean, 42.2 months; range, 13-128 months), patients completed the 2000 International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee injury and Osteoarthritis Outcome Score (KOOS), and Lysholm score. Clinical failure was defined as revision surgery and/or progression to total knee arthroplasty (TKA). A matched-pairs t test was used to analyze differences between the 2 treatment groups, and Kaplan-Meier analysis was used to determine the rates of knee osteoarthritis and progression to TKA.

Results:

The majority of patients had a medial meniscal tear (72.8%), whereas the lateral meniscus was torn in 27.2% of cases. Most tears were located in the meniscal root (56.8%), followed by the posterior horn (34.6%) and midbody (8.6%). At final follow-up, all outcome scores were higher in the repair group compared with the meniscectomy group (IKDC, 78.9 ± 13.4 vs 56.0 ± 15.4; KOOS, 86.6 ± 11.9 vs 61.7 ± 16.2; Lysholm, 88.3 ± 13.3 vs 68.7 ± 15.2, respectively; P < .001 for all). Clinical failure was observed in 22% of patients in the repair group.

Conclusion:

All clinical outcome scores were higher in the meniscal repair group compared with the matched meniscectomy group at final follow-up. The clinical failure rate of the repair group was 22%. These findings support meniscal repair in selected patients aged ≥60 years.
Open Repair of Complete Proximal Hamstring Avulsions in Workers’ Compensation Patients
Authors: Johnson Emma E. , Brutico Joseph M. , Rangavajjula Lasya , Xia Yuwei , Paul Ryan W. , Otlans Peters , Arner Justin W. , Hammoud Sommer , Bradley James P. , Cohen Steven B.
Published: September 2022

Background:

Several studies have reported excellent results after surgical repair of proximal hamstring avulsions. However, the effect on these patients of receiving workers’ compensation has not yet been explored.

Hypothesis:

Workers’ compensation patients undergoing proximal hamstring repair of complete tears will have similar outcomes when compared with a matched control group of non–workers’ compensation patients.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Workers’ compensation patients who underwent complete proximal hamstring avulsion open repair between 2010 and 2019 were identified (WC group). A control group was matched by age (±3 years), sex, and body mass index (BMI; ±3). Demographics and patient-reported outcome measures were compared, including standard and custom Marx activity rating scale (MARS), standard and custom lower extremity functional scale (LEFS), and visual analog scale (VAS) for pain. Rate and time to return to work were recorded.

Results:

The WC group was composed of 20 patients (8 men, 12 women) with a mean age of 52.3 years and BMI of 32.4. The 20 matched controls (8 men, 12 women) who underwent repair had a mean age of 50.6 years and a mean BMI of 31.2. There was no difference between the groups regarding age ( P = .924), sex ( P > .999), or BMI ( P = .330). The WC group reported similar mean MARS (3.3 vs 5.4; P = .174), custom MARS (87.5 vs 97.0; P = .215), and VAS pain (3.3 vs 3.8; P = .698) scores compared with controls. However, the WC group had significantly lower standard LEFS (69.1 vs 94.1; P < .001) and custom LEFS (62.3 vs 87.9; P < .001) scores, returned to work at a lower rate (70.0% vs 94.1%; P = .039), and required more time to return to work after repair (4.3 vs 3.5 months; P = .029) compared with controls.

Conclusion:

Workers’ compensation patients who underwent open proximal hamstring repair for complete avulsions experienced inferior patient-reported outcomes, required more time to return to work, and returned to work at a lower rate than a matched control group.
Neurologic Complications of Extracorporeal Cardiopulmonary Resuscitation in Neonates and Infants
Authors: Schmaedick Maggie J. , Midura Devin , Gerall Claire D. , Garey Donna , Middlesworth William , Bain Jennifer M.
Published: September 2022

Objective: Extracorporeal membrane oxygenation (ECMO) is a lifesaving measure for patients in cardiac or respiratory failure. Extracorporeal cardiopulmonary resuscitation (ECPR) is emergent ECMO cannulation during cardiac arrest. All ECMO patients are at high risk for neurologic complications, but the degree of risk of ECPR relative to ECMO without CPR in progress (non-ECPR ECMO) is not well documented in infants. The goal of the present study is to compare neurologic complication rates between infants who underwent ECPR and those who underwent non-ECPR ECMO. Methods: We performed a retrospective chart review on all patients admitted between 2009 and 2020 to the neonatal intensive care unit (NICU) in our quaternary children's hospital. We separated patients by ECPR vs. non-ECPR ECMO cannulation. We compared rates of death and used neuroimaging and video electroencephalogram (vEEG) to determine incidence of stroke, intracranial hemorrhage, and seizure. Chi-square and Fisher's exact tests were used to compare these categorical variables among groups.Results: A total of 181 infants were cannulated onto ECMO. Of these, 40 received ECPR, 56 received non-ECPR ECMO for a cardiac indication, and 85 received non-ECPR ECMO for a respiratory indication. After excluding patients currently admitted (n=1, ECPR), 180 patients were subjected to analysis. ECPR patients were less likely to survive to hospital discharge than patients who underwent non-ECPR ECMO for respiratory indications, and less likely to survive without any neurologic complication compared with infants who underwent non-ECPR ECMO for cardiac or respiratory indications. Interpretation: Significantly fewer ECPR patients survived without experiencing a neurologic complication, compared with non-ECPR ECMO patients.
Micropollutant transformation and toxicity: Electrochemical ozonation versus biological metabolism
Authors: Bröcker JHL , Stone W , Carstens A , Wolfaardt GM
Published: September 2022

Environmental water sources are constantly polluted by anthropogenic compounds, not always minimized by conventional water treatment methods to remove these compounds at the micro- and nano-range. The absolute concentrations of a suite of seven representative environmental micropollutants were compared pre- and post-treatment with both ozone and microbial biofilms, in terms of removal efficiencies and toxicity assays. Both synthetic micropollutant mixes and environmental water samples were evaluated. The study started with two representative micropollutants (carbamazepine, CBZ, and sulfamethoxazole, SMX), and broadened into a suite of pollutants, evaluating whole-sample eco-toxicological footprints. An ozone concentration of 4.24 ± 0.27 mg/L in tap water, resulted in an 87.9% and 96.5% removal of CBZ and SMX, respectively, within 1 min. Despite almost immediate removal of parent micropollutants by oxidation, endocrine disruption potential (anti-estrogenicity) of CBZ and SMX required up to 240 min of ozone treatment to show no assay effect. A broader suite of micropollutants in more complex environmental matrices showed scavenging of ozone (2.95 ± 0.17–0.25 ± 0.03 mg/L) and varying micropollutant recalcitrance to oxidation. Lower matrix pollution led to lower reduction in eco-toxicity. Microbial degradation of CBZ and SMX (56% and 70% versus 19% and 79%, respectively, in duplicate biofilms) by nutrient-limited biofilms showed less removal than ozonation, with marked variation due to the stochastic nature of biofilm sloughing. Microbial degradation of CBZ and SMX resulted in an increase of >90% in both estrogenicity and Aliivibrio inhibition. The results obtained from this study address a gap in understanding the removal efficiency of micropollutants, where the removal process often receives more attention than the comparative reduction of toxicological effects. This shift from a controlled laboratory environment to real-world scenarios also provided comparative insights into the removal of micropollutants and the eco-toxicity of the transformation by-products of each process.
Analyzing the impact of three-dimensional visibility value on shopping center retail unit rental prices
Authors: Khairunnisa Nur A , Gamal Ahmad
Published: September 2022

This research examines the effect of a three-dimensional visibility value variable on shopping experience and estimates the contribution to retail units’ rental prices for shopping centers. The visibility value in a three-dimensional scheme is measured by adding storefront area volume to existing two-dimensional calculations. This study utilized an explanatory research design and a quantitative analysis method—a STATA regression test—for 150 store units in Jakarta. All units are permanent physical stores, excluding food courts, anchor, and exhibitions. The results showed that visibility value has the positive effect of increasing the average initial rental price by 6% (IDR15,403). The findings of this research can be useful for shopping center managers when estimating rental rates for retail units and architects when considering the visibility factor when designing shopping centers.
Longitudinal Trajectories of PTSD Symptoms Predict Levels of Posttraumatic Growth in World Trade Center Responders
Authors: Kautz Marin M. , Collins Abigail , Schechter Clyde B. , Salim Ryan , Rodriguez Janice , Singh Ritika , Dasaro Christopher R. , Todd Andrew C. , Crane Michael , Moline Jacqueline M. , Udasin Iris G. , Harrison Denise J. , Luft Benjamin J. , Southwick Steven M. , Pietrzak Robert H. , Feder Adriana
Published: September 2022

Background

Prior research has indicated that posttraumatic growth (PTG) often co-occurs with symptoms of posttraumatic stress disorder (PTSD). However, it is yet unclear what longitudinal patterns of posttraumatic symptom levels may predict the development of PTG.

Methods

World Trade Center (WTC) rescue and recovery workers (2038 police and 2103 non-traditional responders) were assessed an average of 3, 6, 8, and 12 years post-9/11/2001. Responders’ WTC-related PTSD symptoms were characterized by No/Low Symptom, Worsening/Subtly Worsening, Steeply Worsening (only for non-traditional responders), Improving, and Chronic trajectories. PTSD symptom trajectories were examined as predictors of PTG, which was assessed using total scores on the Posttraumatic Growth Inventory-Short Form.

Results

Across both occupational groups, being female, older, Hispanic, and experiencing more post-9/11 traumatic events were independently associated with self-reported PTG. Among police responders, a greater number of WTC exposures and supportive family members while working at the WTC site were linked to higher PTG. Among non-traditional responders, Black race/ethnicity, less education, fewer pre-9/11 traumatic events, and the presence of support while working at the WTC site were additionally linked to higher PTG. Only the moderate PTSD symptom trajectories (ie, worsening and improving) for police responders and all symptomatic trajectories for non-traditional responders were associated with higher levels of PTG.

Conclusions

Symptomatic 12-year trajectories of PTSD symptoms and certain sociodemographic characteristics, stressor exposures, and supportive resources were associated with PTG in traditional and non-traditional WTC responders. Results provide insight into subgroups of WTC responders who may benefit from PTG-promoting interventions, as well as potentially modifiable targets to help foster PTG in this population.
Temporal changes in cyclinD-CDK4/CDK6 and cyclinE-CDK2 pathways: implications for the mechanism of deficient decidualization in an immune-based mouse model of unexplained recurrent spontaneous abortion
Authors: Chang Zhuo , Kuang Hai-xue , Zhou Xueming , Zhu Hui , Zhang Yang , Fu Yin , Fu Qiang , Jiang Bei , Wang Wei , Jiang Sha , Ren Li , Ma Lei , Pan Xue , Feng Xiao-ling
Published: September 2022

Background

Deficient endometrial decidualization has been associated with URSA. However, the underlying mechanism is poorly understood. This study aimed to investigate the temporal cytokine changes and the involvement of CyclinD-CDK4/6 and CyclinE-CDK2 pathways in the regulation of the G1 phase of the cell cycle during decidualization in a murine model of URSA.

Methods

Serum and decidual tissues of mice were collected from GD4 to GD8. The embryo resorption and abortion rates were observed on GD8 and the decidual tissue status was assessed. In addition, PRL, Cyclin D, CDK6, CDK4, Cyclin E, CDK2 expression in mice were measured.

Results

URSA mice showed high embryo resorption rate and PRL, Cyclin D, Cyclin E CDK2, CDK4, CDK6 down-regulation during decidualization. The hyperactivated Cyclin D-CDK4/CDK6 and cyclin E/CDK2 pathways inhibit the decidualization process and leading to deficient decidualization.

Conclusion

Insufficient decidualization is an important mechanism of URSA. which is related to the decrease of Cyclin D、Cyclin E、 CDK2、CDK4 and CDK6 in decidualization process of URSA.
The labour market effects of the polish educational reform of 1999
Authors: Drucker Luca Flóra , Horn Dániel , Jakubowski Maciej
Published: September 2022

We estimate the effect of the 1999 education reform in Poland on employment and earnings. The 1999 education reform in Poland replaced the previous 8 years of general and 3/4/5 years of tracked secondary education with 9 years of general and 3/3/4 years of tracked upper-secondary education. The reform also introduced new curricula, national examinations, teacher standards, and a transparent financing scheme. Our identification strategy relies on a difference-in-differences approach using a quasi-panel of pooled year-of-survey and age-of-respondent observations from the Polish sample of the EU-SILC database. The results indicate that the reform has increased employment probability (by around 3 percentage points) and earnings (by around 4%).
Learning a confidence score and the latent space of a new supervised autoencoder for diagnosis and prognosis in clinical metabolomic studies
Authors: Chardin David , Gille Cyprien , Pourcher Thierry , Humbert Olivier , Barlaud Michel
Published: September 2022

Background

Presently, there is a wide variety of classification methods and deep neural network approaches in bioinformatics. Deep neural networks have proven their effectiveness for classification tasks, and have outperformed classical methods, but they suffer from a lack of interpretability. Therefore, these innovative methods are not appropriate for decision support systems in healthcare. Indeed, to allow clinicians to make informed and well thought out decisions, the algorithm should provide the main pieces of information used to compute the predicted diagnosis and/or prognosis, as well as a confidence score for this prediction.

Methods

Herein, we used a new supervised autoencoder (SAE) approach for classification of clinical metabolomic data. This new method has the advantage of providing a confidence score for each prediction thanks to a softmax classifier and a meaningful latent space visualization and to include a new efficient feature selection method, with a structured constraint, which allows for biologically interpretable results.

Results

Experimental results on three metabolomics datasets of clinical samples illustrate the effectiveness of our SAE and its confidence score. The supervised autoencoder provides an accurate localization of the patients in the latent space, and an efficient confidence score. Experiments show that the SAE outperforms classical methods (PLS-DA, Random Forests, SVM, and neural networks (NN)). Furthermore, the metabolites selected by the SAE were found to be biologically relevant.

Conclusion

In this paper, we describe a new efficient SAE method to support diagnostic or prognostic evaluation based on metabolomics analyses.
Complete chloroplast genome of the desert date (Balanites aegyptiaca (L.) Del. comparative analysis, and phylogenetic relationships among the members of Zygophyllaceae
Authors: AL-Juhani Widad S. , Alharbi Samah A. , Al Aboud Nora M. , Aljohani Ashwaq Y.
Published: September 2022

Background

Balanites aegyptiaca (L.) Delile, commonly known as desert date, is a thorny evergreen tree belonging to the family Zygophyllaceae and subfamily Tribuloideae that is widespread in arid and semiarid regions. This plant is an important source of food and medicines and plays an important role in conservation strategies for restoring degraded desert ecosystems.

Results

In the present study, we sequenced the complete plastome of B. aegyptiaca. The chloroplast genome was 155,800 bp, with a typical four-region structure: a large single copy (LSC) region of 86,562 bp, a small single copy (SSC) region of 18,102 bp, and inverted repeat regions (IRa and IRb) of 25,568 bp each. The GC content was 35.5%. The chloroplast genome of B. aegyptiaca contains 107 genes, 75 of which coding proteins, 28 coding tRNA, and 4 coding rRNA.

We did not observe a large loss in plastid genes or a reduction in the genome size in B. aegyptiaca, as found previously in some species belonging to the family Zygophyllaceae. However, we noticed a divergence in the location of certain genes at the IR-LSC and IR-SSC boundaries and loss of ndh genes relative to other species. Furthermore, the phylogenetic tree constructed from the complete chloroplast genome data broadly supported the taxonomic classification of B. aegyptiaca as belonging to the Zygophyllaceae family. The plastome of B. aegyptiaca was found to be rich in single sequence repeats (SSRs), with a total of 240 SSRs.

Conclusions

The genomic data available from this study could be useful for developing molecular markers to evaluate population structure, investigate genetic variation, and improve production programs for B. aegyptiaca. Furthermore, the current data will support future investigation of the evolution of the family Zygophyllaceae.
Antioxidant activation, cell wall reinforcement, and reactive oxygen species regulation promote resistance to waterlogging stress in hot pepper (Capsicum annuum L.)
Authors: Gong Xuefeng , Xu Yi , Li Hong , Chen Xin , Song Zhanfeng
Published: September 2022

Background

Hot pepper (Capsicum annuumL.) is one of the world’s oldest domesticated crops. It has poor waterlogging tolerance, and flooding frequently results in plant death and yield reduction. Therefore, understanding the molecular mechanisms associated with pepper waterlogging tolerance is essential to grow new varieties with stronger tolerance.

Results

In this study, we discovered that after 5 days of flooding, the growth rate of waterlogging-tolerant pepper cultivars did not reduce to a large extent. Physiological data revealed that chlorophyll concentration was not significantly affected by flooding; however, stomatal conductance was altered considerably 0–5 days after flooding, and the net photosynthesis rate changed substantially 5–10 days after flooding. In addition, the root activity of waterlogging-tolerant varieties was substantially higher after flooding for 10 days than that of the control. This implies that the effect of flooding is associated with changes in the root environment, which ultimately affects photosynthesis. We evaluated changes in gene expression levels between two pepper types at the same time point and the same pepper variety at different time points after flooding stress treatment and performed a screening for multiple potential genes. These differentially expressed genes (DEGs) were further analyzed for functional enrichment, and the results revealed that antioxidase genes, cell wall synthesis pathway genes, and calcium ion regulation pathway genes might be associated with waterlogging tolerance. Other genes identified in peppers with waterlogging tolerance included those associated with lignin synthesis regulation, reactive oxygen species (ROS) regulation pathways, and others associated with stress resistance. Considerable changes in the expression levels of these genes were recorded 5 days after waterlogging, which was consistent with a considerable increase in oxidase content that was also noted on the fifth day after flooding. The quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) findings revealed that among the 20 selected DEGs, including genes such asmitogen-activated protein kinase 3 (MPK3)andcalcium-binding protein 4 (CML4),approximately 80% of the gene expression patterns were consistent with our RNA-seq dataset.

Conclusions

The findings of this study suggest that ROS modulation, increased antioxidase activity, lignin formation, and the expression of stress resistance genes help peppers with waterlogging tolerance resist flooding stress in the early stages. These findings provide a basis for further investigation of the molecular mechanisms responsible for waterlogging tolerance in pepper and may be a critical reference for the breeding of hot pepper.
Exercise interventions for older people with cognitive frailty—a scoping review
Authors: Li Xiaohua , Zhang Yan , Tian Yutong , Cheng Qingyun , Gao Yue , Gao Mengke
Published: September 2022

Background

As the global population ages, the issue of frailty in older people is gaining international attention. As one of the major subtypes of frailty, cognitive frailty is a heterogeneous clinical manifestation characterised by the co-existence of physical decline and cognitive impairment. The occurrence of cognitive frailty increases the risk of adverse health outcomes in older people, affecting their daily functioning and quality of life. However, cognitive frailty is a reversible state, and many interventions have been explored, with exercise interventions playing an important role in the non-pharmacological management of cognitive frailty. This study describes and summarises current exercise interventions for older people with cognitive frailty (including parameters such as mode, frequency and duration of exercise) and identifies the limitations of existing studies to inform future exercise interventions for older people with cognitive frailty.

Methods

Using a scoping review approach, Chinese and English literature published in PubMed, Web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Database, China Biomedical Literature Database (SinoMed) and Vipshop from April 2013, when the definition of cognitive frailty first appeared, to August 2021 was searched to select studies related to exercise interventions for this group, extract information from the included literature, and summarise and report the findings.

Results

Nine RCT trial studies and one quasi-experiment study were included, for a total of 10 articles. The exercise modalities involved walking, brisk walking, Otago exercise, resistance exercise, balance training, flexibility training and Baduanjin, etc.; the intensity of exercise was based on individualised guidance and graded exercise intensity; the frequency of exercise was mostly 3–4 times/week; the duration of exercise was mostly 30–60 min/time; compared to the control group, the included studies showed statistically significant improvements in cognitive function, frailty status, and depression with the exercise intervention.

Conclusion

There is a paucity of evidence on exercise interventions for older people with cognitive frailty. The evidence provided in this study suggests that exercise interventions may be beneficial for older people with cognitive frailty. However, the existing studies suffer from small sample sizes, short intervention periods, inadequate monitoring of the entire exercise process, and non-uniformity in the assessment of exercise effects. More randomized controlled trials should be conducted in the future to explore the most effective, low-cost and simple interventions to meet the needs of the older people with cognitive frailty.
Low prevalence of hepatitis B virus infection in HIV-uninfected pregnant women in Cape Town, South Africa: implications for oral pre-exposure prophylaxis roll out
Authors: Joseph Davey Dvora , Hsiao Nei-yuan , Wendy Spearman C. , Sonderup Mark , Hu Nai-Chung , Mashele Nyiko , Mvududu Rufaro , Myer Landon
Published: September 2022

Background

Oral daily preexposure prophylaxis (PrEP) using emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF) is recommended as standard of care for prevention in individuals at high risk for HIV infection, including pregnant and postpartum cisgender women. FTC/TDF is also active against hepatitis B virus (HBV); however, concern has been raised that providing PrEP to individuals infected with HBV could lead to hepatitis flares and liver injury, especially in the setting of suboptimal PrEP use.

Methods

We conducted a cross-sectional analysis of baseline data from the PrEP in pregnant and postpartum women (PrEP-PP) cohort study from February 2020–March 2022 in one antenatal care clinic in Cape Town, South Africa (SA) to evaluate: (1) the field performance of a point of care test (POCT) (Determine II, Abbott Inc., Japan) for diagnosis of hepatitis B surface antigen (HBsAg) in a maternity setting, (2) the prevalence of HBV in a cohort of pregnant women not living with HIV.

Results

We enrolled 1194 HIV sero-negative pregnant women at their first antenatal visit. Median age was 26 years (IQR = 22–31 years); 52% were born before 1995 (before universal HBV vaccination had started in South Africa). Median gestational age was 22 weeks (IQR = 16–30 weeks). There were 8 POCT and laboratory confirmed HBV cases among 1194 women. The overall prevalence of 0.67% (95% CI = 0.34–1.32%). In women born before 1995, 8 of 622 women were diagnosed with HBsAg; the prevalence was 1.29% (95% CI = 0.65–2.52%), and in women born in 1995 or after (n = 572); the prevalence was 0% (95% CI = 0.0–0.67%). We confirmed the test results in 99.8% of the rapid HBsAg (Determine II). Sensitivity was 100% (95% CI = 68–100%). Specificity was 100% (95% CI = 99.67–100%).

Conclusion

The prevalence of HBV was very low in pregnant women not living with HIV and was only in women born before the HBV vaccine was included in the Expanded Program of Immunization. The Determine II POCT HBsAg showed excellent performance against the laboratory assay. HBV screening should not be a barrier to starting PrEP in the context of high HIV risk communities.
Prevalence, trend and determinants of adolescent childbearing in Burundi: a multilevel analysis of the 1987 to 2016–17 Burundi Demographic and Health Surveys data
Authors: Nibaruta Jean Claude , Kamana Bella , Chahboune Mohamed , Chebabe Milouda , Elmadani Saad , Turman Jack E. , Guennouni Morad , Amor Hakima , Baali Abdellatif , Elkhoudri Noureddine
Published: September 2022

Background

Very little is known about factors influencing adolescent childbearing despite an upward trend in adolescent childbearing prevalence in Burundi, and its perceived implications on the rapid population growth and ill-health of young mothers and their babies. To adress this gap, this study aimed to examine the prevalence, trends and determinants of adolescent childbearing in Burundi.

Methods

Secondary analyses of the 1987, 2010 and 2016–17 Burundi Demographic and Health Surveys (BDHS) data were conducted using STATA. Weighted samples of 731 (1987 BDHS), 2359 (2010 BDHS) and 3859 (2016-17BDHS) adolescent girls aged 15–19 years old were used for descriptive and trend analyses. Both bivariable and multivariable two-level logistic regression analyses were performed to identify the main factors associated with adolescent childbearing using only the 2016–17 BDHS data.

Results

The prevalence of adolescent childbearing increased from 5.9% in 1987 to 8.3% in 2016/17. Factors such as adolescent girls aged 18–19 years old (aOR =5.85, 95% CI: 3.54–9.65, p <  0.001), adolescent illiteracy (aOR = 4.18, 95% CI: 1.88–9.30, p <  0.001), living in poor communities (aOR = 2.19, 95% CI: 1.03–4.64, p = 0.042), early marriage (aOR = 9.28, 95% CI: 3.11–27.65, p <  0.001), lack of knowledge of any contraceptive methods (aOR = 5.33, 95% CI: 1.48–19.16, p = 0.010), and non-use of modern contraceptive methods (aOR = 24.48, 95% CI: 9.80–61.14), p <  0.001) were associated with higher odds of adolescent childbearing. While factors such as living in the richest household index (aOR = 0.52, 95% IC: 0.45–0.87, p = 0.00), living in West region (aOR = 0.26, 95%CI: 0.08–0.86, p = 0.027) or in South region (aOR = 0.31, 95% CI: 0.10–0.96, p = 0.041) were associated with lower odds of adolescent childbearing.

Conclusion

Our study found an upward trend in adolescent childbearing prevalence and there were significant variations in the odds of adolescent childbearing by some individual and community-level factors. School-and community-based intervention programs aimed at promoting girls’ education, improving socioeconomic status, knowledge and utilization of contraceptives and prevention of early marriage among adolescent girls is crucial to reduce adolescent childbearing in Burundi.
Characteristics of patients with advanced cancer preferring not to know prognosis: a multicenter survey study
Authors: van der Velden Naomi C. A. , van Laarhoven Hanneke W. M. , Burgers Sjaak A. , Hendriks Lizza E. L. , de Vos Filip Y. F. L. , Dingemans Anne-Marie C. , Jansen Joost , van Haarst Jan-Maarten W. , Dits Joyce , Smets Ellen MA , Henselmans Inge
Published: September 2022

Background

For some patients with advanced cancer not knowing prognosis is essential. Yet, in an era of informed decision-making, the potential protective function of unawareness is easily overlooked. We aimed to investigate 1) the proportion of advanced cancer patients preferring not to know prognosis; 2) the reasons underlying patients’ prognostic information preference; 3) the characteristics associated with patients’ prognostic information preference; and 4) the concordance between physicians’ perceived and patients’ actual prognostic information preference.

Methods

This is a cross-sectional study with structured surveys (PROSPECT). Medical and thoracic oncologists included patients (n = 524), from seven Dutch hospitals, with metastatic/inoperable cancer and an expected median overall survival of ≤ 12 months. For analysis, descriptive statistics and logistic regression models were used.

Results

Twenty-five to 31% of patients preferred not to know a general life expectancy estimate or the 5/2/1-year mortality risk. Compared to patients preferring to know prognosis, patients preferring unawareness more often reported optimism, avoidance and inability to comprehend information as reasons for wantinglimitedinformation; and less often reported expectations of others, anxiety, autonomy and a sense of control as reasons for wantingcompleteinformation. Females (p < .05), patients receiving a further line of systemic treatment (p < .01) and patients with strong fighting spirit (p < .001) were more likely to prefer not to know prognosis. Concordance between physicians’ perceived and patients’ actual prognostic information preference was poor (kappa = 0.07).

Conclusions

We encourage physicians to explore patients’ prognostic information preferences and the underlying reasons explicitly, enabling individually tailored communication. Future studies may investigate changes in patients’ prognostic information preferences over time and examine the impact of prognostic disclosure on patients who prefer unawareness.
Oleuropein inhibits invasion of squamous cell carcinoma of the head and neck through TGF-β1 signaling pathway
Authors: Xu Ting , Liu Xuan
Published: September 2022

Background

Squamous cell carcinoma of the head and neck (SCCHN) is globally the sixth most common cancer. TGF-β1 is a key regulator of cell proliferation and differentiation, and it induces the epithelial-mesenchymal transition (EMT) by activating Smad2 signaling in SCCHN cells. Previous studies have revealed that oleuropein (OL) can inhibit the EMT alterations and migration of cancer cells. The aim of this study was to examine the involvement of TGF-β1 signaling pathway in SCCHN and the effect of OL on it.

Methods

Through in vitro experiments at cellular level and in vivo evaluation in mouse xenograft tumor model, with morphological and Western blotting assays, we examined the effects of OL on TGF-β1-mediated signaling pathway in Tu686, CAL-27 and 686LN-M2 tumor cell lines.

Results

We found that OL reversed the TGF-β1-induced EMT, and changed the morphology of cells and the expression levels of epithelial and interstitial markers. Wound-healing and transwell invasion assays indicated that OL reversed the TGF-β1-promoted cell migration and invasion dramatically. The effects of OL were also verified in xenograft tumor model of mice, and the findings were identical to the in vitro assays.

Conclusion

This study demonstrated that OL inhibits the growth and metastasis of SCCHN by interfering with the TGF-β1 signaling pathway, and the findings are beneficial for the development of prevention and treatment strategy of SCCHN. Due to the low toxicity and less side effects, OL may be of potential value in the inhibition of metastasis of SCCHN and improve survival.
Diagnostic value of integrated 18F-FDG PET/MRI for staging of endometrial carcinoma: comparison with PET/CT
Authors: Yu Yang , Zhang Le , Sultana Bilkis , Wang Bo , Sun Hongzan
Published: September 2022

Purpose

To explore the diagnostic value of integrated positron emission tomography/magnetic resonance imaging (PET/MRI) for the staging of endometrial carcinoma and to investigate the associations between quantitative parameters derived from PET/MRI and clinicopathological characteristics of endometrial carcinoma.

Methods

Altogether, 57 patients with endometrial carcinoma who underwent PET/MRI and PET/computed tomography (PET/CT) preoperatively were included. Diagnostic performance of PET/MRI and PET/CT for staging was compared by three readers. Associations between PET/MRI quantitative parameters of primary tumor lesions and clinicopathological characteristics of endometrial carcinoma were analyzed. Histopathological results were used as the standard.

Results

The overall accuracy of the International Federation of Gynecology and Obstetrics (FIGO) staging for PET/MRI and PET/CT was 86.0% and 77.2%, respectively. PET/MRI had higher accuracy in diagnosing myometrial invasion and cervical invasion and an equivalent accuracy in diagnosing pelvic lymph node metastasis against PET/CT, although without significance. All PET/MRI quantitative parameters were significantly different between stage I and stage III tumors. Only SUVmax/ADCmin were significantly different between stage I and II tumors. No parameters were significantly different between stage II and III tumors. The SUVmax/ADCmin in the receiving operating characteristic (ROC) curve had a higher area under the ROC curve for differentiating stage I tumors and other stages of endometrial carcinoma.

Conclusions

PET/MRI had a higher accuracy for the staging of endometrial carcinoma, mainly for FIGO stage I tumors compared to PET/CT. PET/MRI quantitative parameters, especially SUVmax/ADCmin, were associated with tumor stage and other clinicopathological characteristics. Hence, PET/MRI may be a valuable imaging diagnostic tool for preoperative staging of endometrial carcinoma.
Delayed diagnosis of complex glycerol kinase deficiency in a Chinese male infant: a case report
Authors: Tao Na , Liu Xiaomei , Chen Yueqi , Sun Meiyuan , Xu Fang , Su Yanfang
Published: September 2022

Background

Xp21 contiguous gene deletion syndrome is a rare genetic metabolic disorder with poor prognosis in infants, involving deletions of one or more genes in Xp21. When deletions of adrenal hypoplasia (AHC), Duchenne muscular dystrophy (DMD), and chronic granulomatosis (CGD) loci are included, complex glycerol kinase deficiency (CGKD) can be diagnosed. We present a case of CGKD that was initially misdiagnosed and died during treatment in our hospital in terms of improving our understanding of the clinical features and diagnosis of this disease, as well as highlighting the need for more precise dosing of corticosteroid replacement therapy.

Case presentation

A 48-day-old full-term male infant was transferred to our medical center with global growth delay and persistent vomiting. Routine laboratory tests revealed hyperkalemia, hyponatremia, and a high level of creatine kinase. The initial diagnosis was adrenal cortical hyperplasia (ACH), then revised to adrenocortical insufficiency with a normal level of ACTH detected. After supplementing the routine lipid test and urinary glycerol test, CGKD was diagnosed clinically due to positive triglyceridemia and urinary glycerol, and the follow-up gene screening further confirmed the diagnosis. The boy kept thriving after corticosteroid replacement and salt supplementation. While levels of serum ACTH and cortisol decreased and remained low after corticosteroid replacement was administered. The patient died of acute type 2 respiratory failure and hypoglycemia after an acute upper respiratory tract infection, which may be the result of adrenal crisis after infection. Infants with CGKD have a poor prognosis, so physicians should administer regular follow-ups, and parents counseling during treatment to improve the survival of patients.

Conclusions

Overall, CGKD, although rare, cannot be easily excluded in children with persistent vomiting. Extensive blood tests can help to detect abnormal indicators. Adrenal crisis needs to be avoided as much as possible during corticosteroid replacement therapy.
Factors associated with self-medication of antibiotics by caregivers in pediatric patients attending the emergency department: a case-control study
Authors: Cruz Jhon Camacho , Perez Carolina Zambrano , Cabrera Maria Carolina Sánchez , Lopez Estefania Robledo , Hoyos Pablo Vásquez , Rojas Rojas Diana , Montaña Andrea Ortiz
Published: September 2022

Introduction

Antibiotic self-medication is a common practice in pediatric caregivers in low-income countries with limited resources and represents a public health problem. Our study sought to determine what factors are associated with this practice, including differences in knowledge or attitudes of caregivers who attend a pediatric emergency service.

Methods

Case-control study based on surveys of caregivers of pediatric patients brought to the emergency room with clinical symptoms suggestive of acute infection. Cases were defined as those caregivers who reported self-medication of antibiotics for the current illness and controls where those who did not report self-medication. Information was collected through a self-administered questionnaire that inquired about demographic and family characteristics, attitudes and knowledge toward self-medication of antibiotics. Data were compared using logistic regression and are presented with odd ratios and confidence intervals.

Results

A total of 728 caregivers, 182 cases and 546 controls were included. We found that higher parental education, both in mothers (OR 0.56, 95% CI 0.40-0.79) and fathers (OR 0.62, 95% CI 0.43-0.89) was associated with less self-medication. Attitudes such as always requesting antibiotics from their doctors (OR 3.92, 95% CI 1.59-9.66), frequently buying antibiotics without a prescription (OR 23.66, 95% CI 11.76-47.59) and giving advice on antibiotics among family members (OR 2.90, 95% CI 1.75-4.82) resulted in an increased likelihood of self-medication. There was also a higher probability of antibiotic self-medication in older children (OR 1.13, 95% CI 1.09-1.17), those with a greater number of siblings (OR 1.25, 95% CI 1.09-1.43) and in those cases that received antibiotics within the last 3 months (OR 6.27, 95% CI 4.35-9.04). Overall knowledge of risk of antibiotic self-medication was low.

Conclusions

Some patient and family characteristics such as age, number of siblings, recent antibiotic usage and inappropriate attitudes are strongly related to antibiotic self-medication. These findings will inform future interventions to reduce self-medication in children.
Facilitators and barriers to participation in health mothers’ groups in improving maternal and child health and nutrition in Nepal : A mixed-methods study
Authors: Acharya Ajay , Chang Chia-Lun , Chen Mario , Weissman Amy
Published: September 2022

Background

In Nepal, Health Mother’s Groups (HMG) are women’s group-based programmes for improving maternal and child health. However, they remain underutilised with only 27% of reproductive-aged women participating in an HMG meeting in 2016. This study aimed to understand the facilitators and barriers to HMG meeting participation.

Methods

We conducted a convergent mixed-methods study using cross-sectional quantitative data from the 2016 Nepal Demographic and Health Survey and primary data collected via 35 in-depth interviews and eight focus group discussions with 1000-day women and their family members, female community health volunteers (FCHVs) and health facility staff in two geographies of Nepal, Kaligandaki and Chapakot. Quantitative data were analysed using logistic regression and qualitative data using deductive coding. The results were triangulated and thematically organised according to the socio-ecological model (SEM).

Results

Facilitators and barriers emerged across individual, interpersonal and community levels of the SEM. In the survey, women with more children under five years of age, living in a male-headed household, or in rural areas had increased odds of HMG participation (p < 0.05) while belonging to the Janajati caste was associated with lower odds of participation (p < 0.05). Qualitative data helped to explain the findings. For instance, the quantitative analysis found women’s education level associated with HMG participation (p < 0.05) while the qualitative analysis showed different ways women’s education level could facilitate or hinder participation. Qualitative interviews further revealed that participation was facilitated by women’s interest in acquiring new knowledge, having advanced awareness of the meeting schedule and venue, and engagement with health workers or non-government organisation staff. Participation was hindered by the lack of meeting structure and work obligations during the agricultural season.

Conclusions

To improve women’s participation in HMGs in Nepal, it is necessary to address factors at the SEM’s individual, interpersonal, and community levels, such as enhancing FCHV literacy, providing advance notice of the meeting schedule, upgrading the meeting venues and reducing women’s workload through family support, particularly during agricultural season. These improvements are essential for strengthening effective implementation of HMG meetings and similar women’s group-based platforms, and for ultimately improving maternal and child health in Nepal.
A cluster randomized controlled trial of an after-school playground curriculum intervention to improve children’s physical, social, and emotional health: study protocol for the PLAYground project
Authors: Poulos Allison , Kulinna Pamela Hodges
Published: September 2022

Background

The public health benefits of physical activity for children are well known including contributions to metabolic and cardiorespiratory health. Along with physical benefits, engaging in physical activity can support the social and emotional health of youth and promote health and well-being into adulthood. This cluster-randomized controlled trial assesses the impact of an after-school curriculum aimed at improving physically active and inclusive play to promote physical, social, and emotional health. A secondary focus is on the implementation (appropriateness, feasibility, fidelity, sustainability) of the curriculum.

Methods

The PLAYground (Play and Learning Activities for Youth) project utilizes a social-ecological approach, targeting personal, behavioral, and environmental conditions, and Social Cognitive Theory (SCT) to study how a playground curriculum impacts children’s health. All elementary schools with an existing after-school program in a large, public school district in Mesa, Arizona will be eligible to participate. Seven schools will be allocated to the intervention arm in year one using random sampling stratified by school-income. In year two, the seven control schools will receive the intervention. Intervention schools will implement the research-based PlayOn!® playground curriculum to promote active and inclusive play. After-school staff will be trained to teach activities that address social and emotional skills (e.g., conflict resolution) through physical activity. Participating students will be trained as peer leaders to extend the playground activities to the recess setting. This trial will assess between-group differences in physical activity, social and emotional health indicators, and number of health and behavior incidents among students attending intervention schools and control schools. Implementation outcomes will also be assessed among program facilitators at each school site.

Discussion

Enhancement of physical activity opportunities at schools has the potential for high impact and reach due to practicality. Enhancements can also improve quality pedagogy and curricula in after-school settings. Results of this project can inform practical strategies to improve existing after-school programs to prepare leaders (adults and children) to facilitate physical activity, positive social interactions, and emotional well-being.

Trial registration

ClinicalTrials.gov, NCT ID NCT05470621, Registered July 22, 2022,
The public health impact of loneliness during the COVID-19 pandemic
Authors: Allen James , Darlington Oliver , Hughes Karen , Bellis Mark A.
Published: September 2022

Background

Social distancing measures have been effective in mitigating the spread of COVID-19; however, they have imposed a significant burden on population mental health and well-being. This study aimed to identify factors associated with loneliness during the COVID-19 pandemic, and to describe the relationship between loneliness and the risk of worsening health outcomes and behaviours.

Methods

Data for 8,960 adults were drawn from a national cross-sectional survey undertaken in Wales between January and June 2021. Participants self-reported changes to health and behaviour since the start of the pandemic. Logistic regression was used to identify factors associated with loneliness, and the impact of loneliness on self-reported changes in physical health, physical fitness, mental health, weight, alcohol consumption and social relations in comparison with pre-pandemic experiences.

Results

Groups most at risk of loneliness were those aged < 35 years, women (odds ratio [95% confidence interval]: 1.86 [1.70–2.05]), those with chronic health conditions (1.43 [1.29–1.58]) and the unemployed (2.18 [1.76–2.70]). Loneliness was a strong predictor of worsening health outcomes and behaviours, with those reporting often feeling lonely being at increased odds of worsening physical health (3.29 [2.80–3.86]), physical fitness (2.22 [1.90–2.60]), mental health (8.33 [6.95–9.99]), weight (1.39 [1.19–1.62]), alcohol consumption (1.37 [1.12,-1.66]) and social relations (2.45 [2.07–2.89]) during the pandemic.

Conclusion

This study established an association between loneliness and self-reported worsening health during the pandemic, and identified factors increasing the risk of loneliness. The effect that social control measures have on loneliness should influence the design of future public health policy.