bluuebunny/crossref_metadata_2025 huggingface dataset:
Recruitment strategies and reach of a digital fall-prevention intervention for community-dwelling older adults
Authors: Pettersson Beatrice , Bajraktari Saranda , Skelton Dawn A , Zingmark Magnus , Rosendahl Erik , Lundin-Olsson Lillemor , Sandlund Marlene
Published: September 2022

Background

To have an impact on the population's health, preventive interventions have to reach a large proportion of the intended population. Digital solutions show potential for providing wider access to fall preventive exercise. However, there is a lack of knowledge about how to reach the target group. The aim of this study was to describe the recruitment process used in the Safe Step randomised controlled trial and the characteristics of the participants reached.

Methods

Several recruitment methods, both digital and non-digital, were adopted to reach the intended sample size. Sociodemographic parameters from the baseline questionnaire were used to describe participant characteristics. The characteristics were also compared to a representative sample of older adults in the Swedish population.

Results

In total, 1628 older adults were recruited. Social media proved to be the most successful recruitment strategy, through which 76% of the participants were recruited. The participants reached had a mean age of 75.9 years, lived in both urban and rural locations, were already frequent users of the Internet and applications (smartphone/tablet) (79.9%), had higher education (71.9%), and a large proportion were women (79.4%). In comparison with the general population participants in the Safe Step study were more highly educated ( p < 0.001), women in the study more frequently lived alone ( p < 0.001) and men more often reported poorer self-rated health ( p = 0.04). Within the study, men reported a faster deteriorating balance ( p = 0.003) and more prescribed medication ( p < 0.001) than women.

Conclusion

Recruitment via social media is a useful strategy for reaching older adults, especially women and frequent users of the Internet, for a fully self-managed and digital fall prevention exercise intervention. This study underlines that a range of interventions must be available to attract and suit older adults with different functional statuses and digital skills.
Grounding Creativity in Music Perception? A Multidisciplinary Conceptual Analysis
Authors: Schiavio Andrea , Moran Nikki , Antović Mihailo , van der Schyff Dylan
Published: September 2022

To what extent can we understand and account for music perception as a creative process? In this paper we draw on recent work in music, creativity, and the cognitive humanities to suggest that the fundamentally creative aspect of music perception is not yet satisfactorily examined in existing research. We briefly review the state of scholarship into both creativity and music perception, and identify key points of convergence, which are prominent in work that investigates the mutuality of action and perception, and the exploratory bases of the latter, among others. Inspired by a growing number of contributions in 4E music cognition research, we argue that listening to music can involve mechanisms of active bodily engagement, along with the imaginative exploration of novel possibilities for thought and action. We put forward the view that this approach is important because of the way in which it can bring to the analytical centre stage a creative dimension that may not otherwise be apparent. The contribution of this paper involves this presentation of a multidisciplinary framework for the study of music perception, highlighting the integration of perception and action, and foregrounding this conception of creative cognition as a central aspect of music perception.
Short traditional and long simplified: The paradox of contemporary traditional Taiwanese characters that consist of fewer strokes than their equivalent simplified forms
Authors: Messchendorp Edwin B
Published: September 2022

Traditional Chinese characters are usually written with at least as many strokes as simplified characters, but there are Chinese characters with fewer strokes in their Taiwanese traditional forms than in their Mainland Chinese simplified forms. This study lists these characters and gives the reasons for the differences between their traditional and simplified forms. These reasons will lead to the conclusion that there are motivations for orthographic choices in Mainland China and Taiwan that extend beyond the desire for standardization or simplification. These motivations have been explicitly expressed in texts dictating the rules for standard character forms, but are little known and rarely discussed. This study brings these motivations to the forefront and shows the effects they have had on orthographic policy, in particular where differing motivations between Mainland China and Taiwan have caused Taiwanese traditional characters to consist of fewer strokes than their simplified equivalents. The root cause underlying the different choices made by the Mainland Chinese script authorities and their Taiwanese counterparts post-1949 is a difference in ideology. In Mainland China, the script was a tool to be employed in such a way as to achieve a practical goal, namely mass literacy. Since achieving this goal was thought to require or at least be facilitated by simplifying the script, that course of action was taken. In Taiwan, however, the goal of script policy is to preserve the traditional way of writing characters. In practice, this means that unlike simplified characters, Taiwanese traditional characters are preferably made to structurally conform to their seal script forms in the Shuoˉwén Jieˇzì, leaving certain Taiwanese traditional characters with lower stroke counts than their equivalent simplified forms. Thus, Taiwanese and Mainland Chinese character forms are different because the Taiwanese and Mainland Chinese script authorities ultimately want different things from their scripts.
Unpacking correctional workers’ experiences with transgender prisoners in Nova Scotia, Canada
Authors: Johnston Matthew S , Coulling Ryan , Ricciardelli Rosemary
Published: September 2022

Empirical research on Canadian correctional workers’ successes, challenges, and attitudes towards accommodating gender diversity remains limited. Drawing on data garnered from two open-ended survey questions (n = 70) asking correctional workers in the community or institutions about their perspectives on working with trans populations, we explore how correctional workers in Nova Scotia, Canada accommodate or struggle to accommodate gender diversity in carceral settings. We found that respondents are generally mindful of issues pertaining to the safety and security of trans prisoners, usually espouse open-mindedness, and are generally able to work within correctional parameters to accommodate those with a diverse gender identity. Yet some respondents raised concerns and suspicion towards prisoners who present a safety risk to other prisoners and, in their view, may be manipulating human rights policies to cause harm to others. We take up these tensions critically and discuss the scholarly and practical implications of our findings, as well as possible avenues for future research.
Primary Repair of Medial Collateral Ligament Tears With Suture Augmentation
Authors: Yang Xiuyi A. , Vermeijden Harmen D. , Holuba Kurt , O’Brien Robert , DiFelice Gregory S.
Published: September 2022

Background:

The medial collateral ligament (MCL) is considered to have superior healing and has classically been treated nonoperatively in low-grade MCL injuries. The MCL injury in the setting of concomitant anterior cruciate ligament (ACL) injury is usually treated with a delay of surgery to allow for nonoperative MCL treatment. Recent studies have shown that even with grade II MCL injury there may be residual laxity which may affect place greater strain on an ACL graft in the multi-ligamentous setting and can be corrected for with early primary repair of the MCL which also allows for early definitive treatment of concurrent ipsilateral ligamentous injuries.

Indications:

All patients are potential candidates given sufficient tissue quality for repair; however, this procedure is preferably performed acutely to avoid scarring, quadriceps strength loss, and allow for early intervention to any concurrent ipsilateral ligamentous knee injury. This technique may be performed on both proximal and distal MCL injuries with the same anchor positioning in either case.

Technique Description:

The torn superficial and deep MCL are sutured using a Bunnell-type pattern. The superficial proximal MCL is then fixed to its anatomic footprint using a suture anchor preloaded with an internal suture tape augmentation. A second small incision is made over the tibial insertion of the MCL and a passing suture is channeled from the distal to proximal incision under a skin bridge to retrieve the suture tape. The suture tape is then deployed with appropriate tensioning to the anatomic distal insertion point of the superficial MCL using a second suture anchor.

Results:

There is currently no published data regarding patient outcomes after MCL primary repair with suture augmentation. Our preliminary unpublished data with 49 patients treated with this technique and a variety of concomitant ligamentous injury with average follow-up of 1.7 years showed no MCL repair failures. Four patients experienced more than 10° of flexion range of motion loss, and 3 had residual valgus laxity of grade 1 at 0° and 30° of flexion.

Conclusion:

Primary MCL repair provides a minimally invasive treatment option for medial laxity, while the suture augmentation allows for early range of motion. Furthermore, this approach avoids delayed definitive surgical intervention of concomitant ligamentous injuries in the setting of combined multi-ligamentous injuries.
The von Willebrand factor–binding aptamer rondaptivon pegol as a treatment for severe and nonsevere hemophilia A
Authors: Ay Cihan , Kovacevic Katarina D. , Kraemmer Daniel , Schoergenhofer Christian , Gelbenegger Georg , Firbas Christa , Quehenberger Peter , Jilma-Stohlawetz Petra , Gilbert James C. , Zhu Shuhao , Beliveau Martin , Koenig Franz , Iorio Alfonso , Jilma Bernd , Derhaschnig Ulla , Pabinger Ingrid
Published: September 2022

Factor VIII (FVIII) circulates in a noncovalent complex with von Willebrand Factor (VWF), the latter determining FVIII half-life. The VWF-binding aptamer rondaptivon pegol (BT200) increases plasma levels of VWF/FVIII in healthy volunteers. This trial assessed its safety, pharmacokinetics, and pharmacodynamics in hemophilia A. Nineteen adult patients (ages 20-62 years, 4 women) with hemophilia A (8 mild, 2 moderate, and 9 severe) received subcutaneous injections of rondaptivon pegol. After an initial fixed dose of 3 mg on days 0 and 4, patients received weekly doses of 2 to 9 mg until day 28. Severe hemophilia A patients underwent sparse-sampling population pharmacokinetics individual profiling after the final dose of rondaptivon pegol. Adverse events, pharmacokinetics, and pharmacodynamics were assessed. FVIII activity and VWF levels were measured. All patients tolerated rondaptivon pegol well. The geometric mean half-life of rondaptivon pegol was 5.4 days and rondaptivon pegol significantly increased VWF levels. In severe hemophilia A, 6 doses of rondaptivon pegol increased the half-lives of 5 different FVIII products from a median of 10.4 hours to 31.1 hours (range, 20.8-56.0 hours). Median FVIII increased from 22% to 48% in mild hemophilia A and from 3% to 7.5% in moderate hemophilia A. Rondaptivon pegol is a first-in-class prohemostatic molecule that extended the half-life of substituted FVIII approximately 3-fold and increased endogenous FVIII levels approximately 2-fold in hemophilia patients. This trial was registered at www.clinicaltrials.gov as #NCT04677803.
Preventive treatment can reverse cognitive impairment in chronic migraine
Authors: González-Mingot Cristina , Gil-Sánchez Anna , Canudes-Solans Marc , Peralta-Moncusi Silvia , Solana-Moga Maria José , Brieva-Ruiz Luis
Published: September 2022

Objective

To study the impact of chronic migraine (CM) on the cognition and quality of life (QoL) of patients in the interictal period, and to analyse the degree of reversibility of any observed alterations following the use of preventive treatment.

Background

CM is a highly disabling disease, and migraineurs often have associated comorbidities, such as subjective memory problems, that are involved in the development of cognitive impairment. Our hypotheses are that patients suffering from chronic migraine experience objective cognitive alterations that are not only due to the pain that they suffer or their current emotional state. Furthermore, preventive treatment should be capable of reversing, or at least reducing, the impact of CM on the cognition and QoL of migraineurs.

Methods

The cognition and QoL of 50 control subjects and 46 patients with CM were assessed using a battery of tests, prior to the use of preventive treatment based on botulinum toxin or oral drugs and after 3 months of this treatment.

Results

Compared with controls, patients with CM had lower scores on the assessment of cognitive performance (Rey-Osterrieth Complex Figure test [ROCF] (p<0.05), Trail Making Test [TMT] B) (p < 0.05) and QoL (p < 0.05). Three months after the use of preventive treatment, improvement was observed in all cognitive parameters (p < 0.05) and QoL (p < 0.05), except the ROCF copy task (p = 0.79). No statistically significant differences were observed when these outcomes were compared based on treatment.

Conclusions

This study confirms poor cognitive performance that is not explained by migraine pain itself, as it occurs in the interictal period, irrespective of the patient’s emotional status. Our findings show that these effects are reversible in some cases with preventive treatment of CM, reaffirming the important impact of this condition on the QoL of these patients, and the need to establish preventive treatment guidelines.
The portrayal of animal interactions in nature documentaries by David Attenborough and Bernhard Grzimek
Authors: McKay Calum J. , Sommer-Trembo Carolin , Sánchez-Villagra Marcelo R.
Published: September 2022

Millions of people across the world have been exposed to the wildlife documentaries of David Attenborough and Bernhard Grzimek, who have thus greatly influenced the public’s views on nature and biodiversity. We investigated the way organisms’ biology is portrayed in these documentaries, quantifying different types of animal interactions shown. We evaluated 1498 (Attenborough) and 391 (Grzimek) interactions within- and between-species from documentaries covering a wide range of environments and animal taxa, first aired between 1956 and 2019. We tested whether the relative frequencies of different interactions were influenced by temporal trends as well as by the presenters and their production teams who likely reflect the given Zeitgeist in the UK compared to the European mainland. For our categorisation of animal interactions, we contrasted interspecific versus intraspecific interactions and antagonistic versus cooperative behaviour. While Grzimek’s documentaries put a stronger emphasis on cooperation and Attenborough’s on antagonistic behaviour, the trends were not statistically significant. Furthermore, these patterns show no significant change over time, contrasting with the changing view among biologists that cooperation is more predominant than considered in the traditional understanding of nature as ‘red in tooth and claw’.
External ventricular drain placement is associated with lower mortality after intracerebral hemorrhage with intraventricular hemorrhage
Authors: Warren Andrew D. , Li Qi , Schwab Kristin , McKaig Brenna , Goldstein Alexa N. , Greenberg Steven M. , Viswanathan Anand , Anderson Christopher , Gurol M. Edip , Patel Aman , Goldstein Joshua N.
Published: September 2022

Background and aims

Many patients with intracerebral hemorrhage (ICH) develop intraventricular hemorrhage (IVH), which is associated with higher mortality and worse clinical outcome. External ventricular drains (EVDs) are often placed, but there is little data on how much patients benefit from this intervention. We explored the use, timing, and location of EVD in ICH patients and any association with clinical outcome.

Results

During the study period, 2870 patients presented with primary ICH, and 2486 were included in analyses. Overall, patients were 73 (± 13) years old; 54% were male, and 46% had associated IVH. An EVD was placed in 29% of patients with IVH and 4% of those without. IVH patients with EVD were younger (67 ± 13 vs 74 ± 13, p < 0.001), had larger IVH volumes (17 mL vs 8 mL, p < 0.001), and lower GCS scores (7 vs 10, p < 0.001), compared to those without EVD. Ninety-day mortality was available in 2486 (100%) patients, while 90-day mRS was available in 1673 (67.3%). In univariate analysis, EVD placement was associated with lower likelihood of 90-day mortality (53% vs 59%, p = 0.048) but higher likelihood of poor outcome (88% vs 85%, p < 0.001) in those for whom this was available. Those with poor outcomes underwent faster EVD placement (0.46 days vs. 0.96 days, p = 0.01). In multivariate analysis, EVD placement was associated with lower 90-day mortality (OR 0.19, 95% CI 0.053–0.657, p = 0.009), but not with lower odds of poor outcome (OR 1.64, 95% CI 0.508–5.309, p = 0.4). In multivariate analysis, days to EVD placement was associated with lower 90-day mortality (OR 0.69, 95% CI 0.49–0.96, p = 0.027).

Conclusion

IVH is relatively common after ICH. After controlling for potential confounds, EVD placement is associated with lower mortality, but not clearly with better neurologic outcome. In addition, more rapid EVD placement is associated with higher mortality, potentially reflecting early development of herniation or obstructive hydrocephalus.
Laparoscopic large adrenal mass resection: why we should be more careful?
Authors: Varyani Mohsen , Parvin Mahmood , Akbari Gilani Hamidreza
Published: September 2022

Background

Pheochromocytoma is a rare tumor originating from the adrenal medulla, and surgical removal is the main treatment. We report a case of large size pheochromocytoma that was removed laparoscopically without preoperative blockade of alfa adrenergic receptors.

Case presentation

A 58-y-old woman was referred to our center with incidentally found 7 cm right adrenal mass. She did not have any history of hypercatecholamine state, and 24 h urine test for catecholamine metabolites was in normal range; we thought there is no need for preoperative catecholamine blockade. She was scheduled for laparoscopic mass resection, and during the operation, there was no significant bleeding and no major hypertension or hypotension crisis. The final pathology report was pheochromocytoma.

Conclusion

As the catecholamine release of pheochromocytoma may be periodic and inconsistent, the preoperative test should be repeated especially for large adrenal tumors.
Impact assessment of the loss of glyphosate within the EU: a literature review
Authors: Wynn Sarah , Webb Elise
Published: September 2022

Following the introduction of glyphosate in 1974, its efficacy against a vast range of weeds and its low price has established it as Europe’s most widely used herbicide. However, concerns about possible health and environmental impacts now threaten its continued approval for use. This review considers the contribution of glyphosate to European agriculture and the likely impacts on crop production if it were to be withdrawn. Without glyphosate, EU farmers could experience losses in wheat production of up to 24 Mt (worth €10.5 billion), 10.4 Mt in potatoes (worth €2 billion), and 4.7 Mt in grapes (worth €4.2 billion). Withdrawal of glyphosate would result in an increase in soil tillage, damaging the environment through soil structure degradation, increased risk of soil erosion, reduced soil biodiversity, and increased greenhouse gas emissions of 1.4–3.8 Mt CO2e per year across the EU through oxidation of organic matter. Increased machinery usage would require 15–44 L more fuel per hectare. Alternative weed control strategies are both less effective and more costly, often requiring additional labour at times of peak demand. They are also less effective at providing lasting control across a broad range of species and are inapplicable to conservation tillage practices.
Detecting antibody reactivities in Phage ImmunoPrecipitation Sequencing data
Authors: Chen Athena , Kammers Kai , Larman H Benjamin , Scharpf Robert B. , Ruczinski Ingo
Published: September 2022

Phage ImmunoPrecipitation Sequencing (PhIP-Seq) is a recently developed technology to assess antibody reactivity, quantifying antibody binding towards hundreds of thousands of candidate epitopes. The output from PhIP-Seq experiments are read count matrices, similar to RNA-Seq data; however some important differences do exist. In this manuscript we investigated whether the publicly available method edgeR (Robinson et al., Bioinformatics 26(1):139–140, 2010) for normalization and analysis of RNA-Seq data is also suitable for PhIP-Seq data. We find that edgeR is remarkably effective, but improvements can be made and introduce a Bayesian framework specifically tailored for data from PhIP-Seq experiments (Bayesian Enrichment Estimation in R, BEER).
Molecular characteristics of fluoroquinolone-resistant Escherichia coli isolated from suckling piglets with colibacillosis
Authors: Seo Kwangwon , Do Kyung-Hyo , Lee Wan-Kyu
Published: September 2022

Objectives

Colibacillosis is a frequent enteric disease in the pig industry that causes significant economic losses. The objective of this study was to investigate the molecular characteristics of fluoroquinolone (FQ)-resistantE. coliisolates from suckling piglets with colibacillosis.

Results

A total of 43 FQ-resistantE. coliisolates were tested in this study and all isolates showed multi-drug resistance (MDR) and mutations in quinolone resistance determining regions (gyrAorparC). Especially, FQ-resistantE. coliisolates with double mutations in bothgyrAandparCwere shown a high FQs minimum inhibitory concentration (≥ 64 mg/L for ciprofloxacin, ≥ 128 mg/L for enrofloxacin, and ≥ 256 mg/L for norfloxacin). Among 43 FQ-resistantE. coliisolates, 12 (27.9%) were showed plasmid-mediated quinolone resistance (PMQR) positiveE. coli. Prevalence of PMQR gene,aac(6’)-Ib-cr,qnrS, andqepA, were identified in 7, 3, and 2E. coliisolates, respectively. We identified the following in PMQR-positiveE. coliisolates: the tetracycline resistance genestetD(12 isolates, 100.0%),tetE(12 isolates, 100.0%),tetA(11 isolates, 91.7%), andtetB(1 isolate, 8.3%); β-lactamases–encodingblaCMY-2(10 isolates, 83.3%),blaTEM-1(7 isolates, 58.3%),blaOXA-1(7 isolates, 58.3%),blaSHV-1(3 isolates, 16.7%), andblaAAC-2(1 isolate, 8.3%); and the chloramphenicol resistance genes (10 isolates, 83.3%); the sulfonamide resistance genessul1(9 isolates, 75.0%) andsul2(10 isolates, 83.3%); the aminoglycoside modifying enzyme geneaac(3)-II(2 isolates, 16.7%). The F4 (7 isolates, 58.3%), LT:STb:EAST1 (5 isolates, 41.7%), and paa (3 isolates, 25.0%) were most common fimbrial antigen, combinations of toxin genes, and non-fimbrial adhesins genes, respectively. All PMQR-positiveE. colicarried class I integrons but only 4 isolates carried the gene cassette. The most prevalent plasmid replicon was FIB (9 isolates, 75.0%), followed by FIC, HI1, and N (7 isolates, 58.3%), respectively.

Conclusions

Because FQ-resistantE. colican serve as a reservoir of FQ resistant genetic determinants that can be transferred to pathogenic bacteria in humans or pigs, this represents a public health hazard.
Usability and acceptability of oral fluid hepatitis C self-testing among people who inject drugs in Coastal Kenya: a cross-sectional pilot study
Authors: Ivanova Reipold Elena , Fajardo Emmanuel , Juma Emily , Bukusi David , Bermudez Aza Elkin , Jamil Muhammad S. , Johnson Cheryl Case , Farquhar Carey , Easterbrook Philippa , Monroe-Wise Aliza
Published: September 2022

Background

People who inject drugs (PWID) are disproportionally affected by hepatitis C virus (HCV) infection and many remain undiagnosed. HCV self-testing (HCVST) may be an effective approach to increase testing uptake, but has rarely been used among PWID. We assessed the usability and acceptability of HCVST among PWID in Kenya.

Methods

We conducted a cross-sectional study nested within a cohort study between August and December 2020 on Kenya’s North Coast region. Participants were handed a prototype oral fluid HCVST kit and asked to conduct the test relying on the instructions for use. Usability was assessed by documenting errors made and difficulties faced by participants. Acceptability was assessed using an interviewer-administered semi-structured questionnaire.

Results

Among 150 participants, 19% were female and 65.3% had primary level education or lower. 71.3% made at least one error, 56.7% experienced some difficulty during at least one step, and the majority of participants (78%) required assistance during at least one step of the procedure. Most common errors occurred when placing the tube into the stand (18%), collecting the oral fluid sample (24%) and timing of reading results (53%). There was a strong association between presence of symptoms of opiate withdrawals and observed errors (94% vs 62%; p = 0.016) in a sub-group of 74 participants assessed. Inter-reader and inter-operator concordance were 97.7% (kappa: 0.92) and 99.2% (kappa: 0.95), respectively. Acceptability assessed by asking whether participants would choose to use HCVST prior to and after conducting HCVST was 98% and 95%, respectively.

Conclusions

We found a high acceptability of oral fluid HCVST among PWID. User errors were common and were associated with the presence of withdrawal symptoms among users. Despite errors, most participants were able to obtain and interpret results correctly. These findings suggest that this group of users may benefit from greater messaging and education including options to receive direct assistance when self-testing for HCV.
Prospective longitudinal evaluation of treatment-related toxicity and health-related quality of life during the first year of treatment for pediatric acute lymphoblastic leukemia
Authors: Schilstra Clarissa E. , McCleary Karen , Fardell Joanna E. , Donoghoe Mark W. , McCormack Emma , Kotecha Rishi S. , Lourenco Richard De Abreu , Ramachandran Shanti , Cockcroft Ruelleyn , Conyers Rachel , Cross Siobhan , Dalla-Pozza Luciano , Downie Peter , Revesz Tamas , Osborn Michael , Alvaro Frank , Wakefield Claire E. , Marshall Glenn M. , Mateos Marion K. , Trahair Toby N.
Published: September 2022

Background

Pediatric acute lymphoblastic leukemia (ALL) therapy is accompanied by treatment-related toxicities (TRTs) and impaired quality of life. In Australia and New Zealand, children with ALL are treated with either Children’s Oncology Group (COG) or international Berlin-Frankfurt-Munster (iBFM) Study Group-based therapy. We conducted a prospective registry study to document symptomatic TRTs (venous thrombosis, neurotoxicity, pancreatitis and bone toxicity), compare TRT outcomes to retrospective TRT data, and measure the impact of TRTs on children’s general and cancer-related health-related quality of life (HRQoL) and parents’ emotional well-being.

Methods

Parents of children with newly diagnosed ALL were invited to participate in the ASSET (Acute Lymphoblastic Leukaemia Subtypes and Side Effects from Treatment) study and a prospective, longitudinal HRQoL study. TRTs were reported prospectively and families completed questionnaires for general (Healthy Utility Index Mark 3) and cancer specific (Pediatric Quality of Life Inventory (PedsQL)-Cancer Module) health related quality of life as well the Emotion Thermometer to assess emotional well-being.

Results

Beginning in 2016, 260 pediatric patients with ALL were enrolled on the TRT registry with a median age at diagnosis of 59 months (range 1–213 months), 144 males (55.4%), majority with Pre-B cell immunophenotype, n = 226 (86.9%), 173 patients (66.5%) treated according to COG platform with relatively equal distribution across risk classification sub-groups. From 2018, 79 families participated in the HRQoL study through the first year of treatment. There were 74 TRT recorded, reflecting a 28.5% risk of developing a TRT. Individual TRT incidence was consistent with previous studies, being 7.7% for symptomatic VTE, 11.9% neurotoxicity, 5.4% bone toxicity and 5.0% pancreatitis. Children’s HRQoL was significantly lower than population norms throughout the first year of treatment. An improvement in general HRQoL, measured by the HUI3, contrasted with the lack of improvement in cancer-related HRQoL measured by the PedsQL Cancer Module over the first 12 months. There were no persisting differences in the HRQoL impact of COG compared to iBFM therapy.

Conclusions

It is feasible to prospectively monitor TRT incidence and longitudinal HRQoL impacts during ALL therapy. Early phases of ALL therapy, regardless of treatment platform, result in prolonged reductions in cancer-related HRQoL.
Acceptability of predictive testing for ischemic heart disease in those with a family history and the impact of results on behavioural intention and behaviour change: a systematic review
Authors: Wells Imogen , Simons Gwenda , Davenport Clare , Mallen Christian D. , Raza Karim , Falahee Marie
Published: September 2022

Background

Tests to predict the development of chronic diseases in those with a family history of the disease are becoming increasingly available and can identify those who may benefit most from preventive interventions. It is important to understand the acceptability of these predictive approaches to inform the development of tools to support decision making. Whilst data are lacking for many diseases, data are available for ischemic heart disease (IHD). Therefore, this study investigates the willingness of those with a family history of IHD to take a predictive test, and the effect of the test results on risk-related behaviours.

Method

Medline, EMBASE, PsycINFO, LILACS and grey literature were searched. Primary research, including adult participants with a family history of IHD, and assessing a predictive test were included. Qualitative and quantitative outcomes measuring willingness to take a predictive test and the effect of test results on risk-related behaviours were also included. Data concerning study aims, participants, design, predictive test, intervention and findings were extracted. Study quality was assessed using the Standard Quality Assessment Criteria for Evaluating Research Papers from a Variety of Fields and a narrative synthesis undertaken.

Results

Five quantitative and two qualitative studies were included. These were conducted in the Netherlands (n = 1), Australia (n = 1), USA (n = 1) and the UK (n = 4). Methodological quality ranged from moderate to good. Three studies found that most relatives were willing to take a predictive test, reporting family history (n = 2) and general practitioner (GP) recommendation (n = 1) as determinants of interest. Studies assessing the effect of test results on behavioural intentions (n = 2) found increased intentions to engage in physical activity and smoking cessation, but not healthy eating in those at increased risk of developing IHD. In studies examining actual behaviour change (n = 2) most participants reported engaging in at least one preventive behaviour, particularly medication adherence.

Conclusion

The results suggests that predictive approaches are acceptable to those with a family history of IHD and have a positive impact on health behaviours. Further studies are needed to provide a comprehensive understanding of predictive approaches in IHD and other chronic conditions.
Inequalities in children’s exposure to alcohol outlets in Scotland: a GPS study
Authors: Caryl Fiona M. , Pearce Jamie , Mitchell Rich , Shortt Niamh K.
Published: September 2022

Background

Alcohol use is a leading cause of harm in young people and increases the risk of alcohol dependence in adulthood. Alcohol use is also a key driver of rising health inequalities. Quantifying inequalities in exposure to alcohol outlets within the activity spaces of pre-adolescent children—a vulnerable, formative development stage—may help understand alcohol use in later life.

Methods

GPS data were collected from a nationally representative sample of 10-and-11-year-old children (n = 688, 55% female). The proportion of children, and the proportion of each child’s GPS, exposed to alcohol outlets was compared across area-level income-deprivation quintiles, along with the relative proportion of exposure occurring within 500 m of each child’s home and school.

Results

Off-sales alcohol outlets accounted for 47% of children’s exposure, which was higher than expected given their availability (31% of alcohol outlets). The proportion of children exposed to alcohol outlets did not differ by area deprivation. However, the proportion of time children were exposed showed stark inequalities. Children living in the most deprived areas were almost five times more likely to be exposed to off-sales alcohol outlets than children in the least deprived areas (OR 4.83, 3.04–7.66; P < 0.001), and almost three times more likely to be exposed to on-sales alcohol outlets (OR 2.86, 1.11–7.43; P = 0.03). Children in deprived areas experienced 31% of their exposure to off-sales outlets within 500 m of their homes compared to 7% for children from less deprived areas. Children from all areas received 22—32% of their exposure within 500 m of schools, but the proportion of this from off-sales outlets increased with area deprivation.

Conclusions

Children have little control over what they are exposed to, so policies that reduce inequities in alcohol availability should be prioritised to ensure that all children have the opportunity to lead healthy lives.
Epidemiology of fractures in children with cerebral palsy: a Swedish population-based registry study
Authors: Linton Gustaf , Hägglund Gunnar , Czuba Tomasz , Alriksson-Schmidt Ann I.
Published: September 2022

Background

Children with cerebral palsy (CP) form a heterogeneous group and may have risk or protective factors for fractures compared with typically developing children. The fracture sites may also differ from those of children who do not have CP. We analyzed the fracture epidemiology in a total population of children with CP.

Methods

This was a retrospective registry study based on data from the Swedish Cerebral Palsy Follow-Up Program (CPUP) and the Swedish National Patient Register. All children in the CPUP born in 2000–2015 were included. The Gross Motor Function Classification System (GMFCS) level, reported fractures, fracture site, and epilepsy diagnosis were recorded up to 2018. Hazards and hazard ratios were calculated for first-time fractures.

Results

Of the 3,902 participants, 368 (9.4%) had at least one reported fracture. The cumulative risk of sustaining a fracture before age 16 years was 38.3% (95% confidence interval 33.9–42.4). The hazard for fracture was 7 times higher in children with epilepsy. The overall fracture incidence was not statistically significantly related to sex or GMFCS level. Fractures in the upper extremities were most prevalent in children with a lower GMFCS level, and femoral fractures were most prevalent in children at GMFCS level V. Most fractures occurred in early childhood and after 8 years of age.

Conclusions

Children with CP were at similar risk of sustaining fractures as typically developing children, but the risk was higher in children with comorbid epilepsy. Fractures occurred in children at GMFCS levels I–III at sites similar to those for typically developing children; fractures in the upper extremities were the most frequent. Children at GMFCS levels IV or V and those with epilepsy were more likely to have a fracture in the lower extremities, and the femur was the most frequent site.
Visceral fat area and body fat percentage measured by bioelectrical impedance analysis correlate with glycometabolism
Authors: Li Shuying , Li Shaoping , Ding Jie , Zhou Weihong
Published: September 2022

Background

Adiposity evaluated by body mass index (BMI) is associated with glycometabolism. The aim of the investigation was to explore the correlation of visceral fat area (VFA), body fat percentage (BFP), BMI and waist circumference (WC) with type 2 diabetes mellitus (T2DM) and pre-diabetes.

Methods

A total of 18,458 participates underwent physical examination in Nanjing Drum Tower Hospital from January 2018 to April 2022 was included in this study. Data were collected retrospectively. Regression analysis was used to evaluate the relationship of VFA, BFP, WC and BMI with diabetes status, fasting blood glucose (FBG) and glycohemoglobin (HbA1c).

Results

After fully adjusted for multiple covariates, VFA, BFP, WC and BMI in T2DM and pre-diabetes group exceeded compared with normal group. FBG was positively correlated with VFA, BFP, WC and BMI with βs of 2.221,0.306,0.606 and 0.175(p < 0.001). HbA1c was also positively correlated with the four indexes with βs of 2.645, 0.328, 0.685 and 0.255(p < 0.001). Subgroup analysis shown that FBG and HbA1c were positively correlated with VFA, BFP, BMI and WC in normal and pre-diabetes group (p < 0.001). FBG was negatively correlated with BMI in T2DM group (p = 0.023). In T2DM, there were non-linear relationships of HbA1c with VFA, BFP, WC and BMI with the inflection points for about 7%. Before the inflection point, HbA1c was positively correlated with obesity-related indicators, and it was reversed after the inflection point. In the individuals with excessive VFA and normal BMI, the risk for glycometabolism disorder exceed compared with normal VFA and normal BMI. Every per-standard deviation increasing in VFA, BFP, WC and BMI, the corresponding risk increasing of glycometabolism disorder was 16.4, 14.6, 22.6 and 22.2%.

Conclusion

The study demonstrated that in adults with T2DM or prediabetes, the VFA, BFP, WC and BMI were higher than with normal glycometabolism. In pre-diabetes and normal population, there were positive correlations of HbA1c and FBG with obesity-related indicators. In T2DM with poor glycemic control (HbA1c > 7%), there might be a trend of fat loss. VFA could negatively affect glycometabolism independently from BMI. The optimum to evaluate the risk of glycometabolism disorder was WC.
Development and validation of prediction models for gestational diabetes treatment modality using supervised machine learning: a population-based cohort study
Authors: Liao Lauren D. , Ferrara Assiamira , Greenberg Mara B. , Ngo Amanda L. , Feng Juanran , Zhang Zhenhua , Bradshaw Patrick T. , Hubbard Alan E. , Zhu Yeyi
Published: September 2022

Background

Gestational diabetes (GDM) is prevalent and benefits from timely and effective treatment, given the short window to impact glycemic control. Clinicians face major barriers to choosing effectively among treatment modalities [medical nutrition therapy (MNT) with or without pharmacologic treatment (antidiabetic oral agents and/or insulin)]. We investigated whether clinical data at varied stages of pregnancy can predict GDM treatment modality.

Methods

Among a population-based cohort of 30,474 pregnancies with GDM delivered at Kaiser Permanente Northern California in 2007–2017, we selected those in 2007–2016 as the discovery set and 2017 as the temporal/future validation set. Potential predictors were extracted from electronic health records at different timepoints (levels 1–4): (1) 1-year preconception to the last menstrual period, (2) the last menstrual period to GDM diagnosis, (3) at GDM diagnosis, and (4) 1 week after GDM diagnosis. We compared transparent and ensemble machine learning prediction methods, including least absolute shrinkage and selection operator (LASSO) regression and super learner, containing classification and regression tree, LASSO regression, random forest, and extreme gradient boosting algorithms, to predict risks for pharmacologic treatment beyond MNT.

Results

The super learner using levels 1–4 predictors had higher predictability [tenfold cross-validated C-statistic in discovery/validation set: 0.934 (95% CI: 0.931–0.936)/0.815 (0.800–0.829)], compared to levels 1, 1–2, and 1–3 (discovery/validation set C-statistic: 0.683–0.869/0.634–0.754). A simpler, more interpretable model, including timing of GDM diagnosis, diagnostic fasting glucose value, and the status and frequency of glycemic control at fasting during one-week post diagnosis, was developed using tenfold cross-validated logistic regression based on super learner-selected predictors. This model compared to the super learner had only a modest reduction in predictability [discovery/validation set C-statistic: 0.825 (0.820–0.830)/0.798 (95% CI: 0.783–0.813)].

Conclusions

Clinical data demonstrated reasonably high predictability for GDM treatment modality at the time of GDM diagnosis and high predictability at 1-week post GDM diagnosis. These population-based, clinically oriented models may support algorithm-based risk-stratification for treatment modality, inform timely treatment, and catalyze more effective management of GDM.
Nutritional inequalities among under-five children: a geospatial analysis of hotspots and cold spots in 73 low- and middle-income countries
Authors: Amir-ud-Din Rafi , Fawad Sakina , Naz Lubna , Zafar Sameen , Kumar Ramesh , Pongpanich Sathirakorn
Published: September 2022

Background

Child undernutrition is a severe health problem in the developing world, which affects children’s development in the long term. This study analyses the extent and patterns of under-five child undernutrition using Demographic and Health Surveys (DHS) for 73 low- and middle-income countries (LMICs).

Methods

First, we mapped the prevalence of undernutrition in the developing world. Second, using the LISA (a local indicator of spatial association) technique, we analyzed the geographical patterns in undernutrition to highlight the localized hotspots (regions with high undernutrition prevalence surrounded by similar other regions), cold spots (regions with low undernutrition prevalence surrounded by similar other regions), and outliers (regions with high undernutrition surrounded by low undernutrition and vice versa). Third, we used Moran’s I to find global patterns in child undernutrition.

Results

We find that South Asia has the highest under-five child undernutrition rates. The intra-country nutritional inequalities are highest in Burundi (stunting), Kenya (wasting), and Madagascar (underweight). The local indicator of spatial association (LISA) analysis suggests that South Asia, Middle East and North Africa (MENA) region, and Sub-Saharan Africa are undernutrition hotspots and Europe and Central Asia and Latin America, and the Caribbean are undernutrition cold spots (regions with low undernutrition surrounded by similar other regions). Getis Ord-Gi* estimates generally support LISA analysis. Moran’s I and Geary’s C gave similar results about the global patterns of undernutrition. Geographically weighted regressions suggest that several socioeconomic indicators significantly explain child undernutrition.

Conclusions

We found a significant within and across country variation in stunting, wasting and underweight rates among the under-five children’s population. The geospatial analysis also suggested that stunting, wasting, and underweight patterns exhibit clear regional patterns, underscoring the need for coordinated interventions at the regional level.
Circ-CSNK1G1 promotes cell proliferation, migration, invasion and glycolysis metabolism during triple-negative breast cancer progression by modulating the miR-28-5p/LDHA pathway
Authors: Zan Xiaochen , Li Wenfang , Wang Geng , Yuan Jie , Ai Yongbiao , Huang Jun , Li Zhi
Published: September 2022

Background

Circular RNAs (circRNAs) play a vital role in cancer progression. However, there are still numerous circRNAs that have not been functionally explored. Our study aimed to disclose the role of circ-CSNK1G1 in triple-negative breast cancer (TNBC).

Methods

The expression of circ-CSNK1G1, miR-28-5p and lactate dehydrogenase A (LDHA) mRNA was measured by quantitative real-time polymerase chain reaction (qPCR), and the expression of LDHA protein was measured by western blot. Cell proliferation was assessed using MTT assay and colony formation assay. Cell apoptosis was monitored using flow cytometry assay. Cell migration and cell invasion were investigated using transwell assay. Glycolysis progression was assessed according to glucose consumption, lactate production and ATP/ADP ratio. Tumor formation assay in nude mice was conducted to verify the role of circ-CSNK1G1 in vivo. The interplays between miR-28-5p and circ-CSNK1G1 or LDHA were confirmed by dual-luciferase reporter assay.

Results

Circ-CSNK1G1 was upregulated in TNBC tissues and cells. Circ-CSNK1G1 knockdown suppressed cancer cell proliferation, migration, invasion and glycolysis energy metabolism, promoted cell apoptosis in vitro, and blocked tumor growth in vivo. Mechanism analysis showed that circ-CSNK1G1 positively regulated LDHA expression by suppressing miR-28-5p. Rescue experiments presented that circ-CSNK1G1 played functions by targeting miR-28-5p, and miR-28-5p participated in TNBC progression by degrading LDHA.

Conclusion

Circ-CSNK1G1 promotes cell proliferation, migration, invasion and glycolysis metabolism during TNBC development by regulating the miR-28-5p/LDHA pathway.
Building capacity for integrated knowledge translation: a description of what we can learn from trainees’ experiences during the COVID-19 pandemic
Authors: Medeiros Priscilla , Laur Celia , Nguyen Tram , Gilfoyle Meghan , Conway Aislinn , Giroux Emily , Hoekstra Femke , Legasto Jean Michelle , Ramage Emily , Tittlemier Brenda , Wood Brianne , Steinwender Sandy ,   IKT Research Network Trainee Group, Moser Cheryl , MacKenzie Nicole , Ormel Ilja , Degen Charly
Published: September 2022

The use of collaborative health research approaches, such as integrated knowledge translation (IKT), was challenged during the COVID-19 pandemic due to physical distancing measures and transition to virtual platforms. As IKT trainees (i.e. graduate students, postdoctoral scholars) within the Integrated Knowledge Translation Research Network (IKTRN), we experienced several changes and adaptations to our daily routine, work and research environments due to the rapid transition to virtual platforms. While there was an increased capacity to communicate at local, national and international levels, gaps in equitable access to training and partnership opportunities at universities and organizations have emerged. This essay explores the experiences and reflections of 16 IKTRN trainees during the first 2 years of the COVID-19 pandemic at the micro (individual), meso (organizational) and macro (system) levels. The micro level, or individual experiences, focuses on topics of self-care (taking care of oneself for physical and mental well-being), maintaining research activities and productivity, and leisure (social engagement and taking time for oneself), while conducting IKT research during the pandemic. At the meso level, the role of programmes and organizations explores whether and how institutions were able to adapt and continue research and/or partnerships during the pandemic. At the macro level, we discuss implications for policies to support IKT trainees and research, during and beyond emergency situations. Themes were identified that intersected across all levels, which included (i) equitable access to training and partnerships; (ii) capacity for reflexivity; (iii) embracing changing opportunities; and (iv) strengthening collaborative relationships. These intersecting themes represent ways of encouraging sustainable and equitable improvements towards establishing and maintaining collaborative health research approaches. This essay is a summary of our collective experiences and aims to provide suggestions on how organizations and universities can support future trainees conducting collaborative research. Thus, we hope to inform more equitable and sustainable collaborative health research approaches and training in the post-pandemic era.