bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence of iron deficiency Anaemia during pregnancy in Far North Queensland
Authors: Carter Edward , Lane Katie , Ryan Elizabeth , Jayaratnam Skandarupan
Published: November 2022

Introduction

The WHO estimates the incidence of iron deficiency anaemia in Australia is 25%. However there is considerable variation during pregnancy and in regional areas.

Objective

The aim of this investigation is to quantify the incidence of iron deficiency anaemia during pregnancy within Far North Queensland.

Design

This is a single‐centre retrospective cohort study. Cairns Hospital is the main referral centre for complex maternity care in Far North Queensland with an estimated population of 280‐000, which includes many people from rural and remote communities and a high proportion who identify as Aboriginal or Torres Strait Islander. This study included all births at the Cairns Hospital in 2018, a total of 2190 deliveries.

Findings

The study randomly sampled 551 mothers from the cohort, and the incidence of iron deficiency anaemia was 34.9%. 48.7% of women who identified as Aboriginal or Torres Strait Islander within the region were anaemic. This was significantly higher than an incidence of 28.9% for the rest of the population. Other risk factors include booking appointment after 28‐weeks, Asian ethnicity and age less than 25‐years. A BMI greater than 35 was protective

Discussion

This study will inform antenatal care providers within the region and improve obstetric outcomes by increasing awareness. Identifying risk factors will also facilitate prompt treatment and improve maternity care for vulnerable patient groups. On a broader level, the study provides new data to inform population health estimates both nationally and internationally.

Conclusion

The incidence of iron deficiency anaemia during pregnancy in Far North Queensland is significantly higher than previous estimates.
Women in urology: Gender differences in urologists' authorship in high impact journals
Authors: Demir Demirhan Örsan , Karagöz Mehmet Ali
Published: November 2022

Background

The number of women among medical doctors and surgeons continues to rise. However, urology remains one of the least preferred specialties by female physicians, resulting in the inadequate academic representation of female urologists. In this study we examined changes in the representation of female urologists in the journals European Urology (EU) and Journal of Urology (JOU) and investigated in which urology subspecialties female urologists focus their academic studies.

Methods

Original articles, reviews and case reports published in EU and JOU were included in the study. The analysis was limited to 4 years, starting with 2004 and continuing at 5‐year intervals until 2019.The publications were also classified according to urology subspecialty and geographic location.

Results

In total, 2708 articles were analysed. Overall, women accounted for 9.9% of first authors (267/2708) and 5.9% of senior authors (161/2708).The proportion of female first authors was 8.2% in 2004 and increased to 10.7% in 2009, 10.6% in 2014, and 11.6% in 2019 (P = 0.062). The proportion of female last authors was 7% in 2004 and 5.3%, 6.1%, and 2.5% in 2009, 2014, and 2019, respectively (P = 0.011). Women accounted for a significantly higher proportion of first authors than men in publications related to female and paediatric urology (P = 0.001 and P = 0.002, respectively).

Conclusions

The increasing number of women urologists worldwide is not reflected in the scientific authorship of female urologists. Multicenter studies focusing on the elimination of gender disparity in academic representation are needed in surgical branches such as urology.
Online activities for individuals with intellectual disabilities at a day centre in the wake of COVID‐19
Authors: Engwall Kristina
Published: November 2022

Accessible summary

Many day centres in Sweden closed during the COVID‐19 pandemic.

Some day centres provided online activities like FaceTime calls and short films instead.

This was to help people keep in touch.

Some people with intellectual disabilities also got involved in making films when lockdown lifted.

People with intellectual disabilities and staff learned a lot about doing things online and using technology. It would be good to keep this going.
Exploring effects of an early math intervention: The importance of parent–child interaction
Authors: Ribner Andrew , Silver Alex M. , Elliott Leanne , Libertus Melissa E.
Published: November 2022

We explore whether training parents' math skills or playing number games improves children's mathematical skills. Participants were 162 parent–child dyads; 88.3% were white and children (79 female) were 4 years (M = 46.88 months). Dyads were assigned to a number game, shape game, parent‐only approximate number system training, parent‐only general trivia, or a no‐training control condition and asked to play twice weekly for 8 weeks. Children in the number game condition gained over 15% SD on an assessment of mathematical skill than did those in the no‐training control. After 8 additional weeks without training, effects diminished; however, children of parents in the ANS condition underperformed those in the no‐treatment control, which was partially explained by changes in the home numeracy environment.
The concept of family: Perspectives of Spanish young people in foster care
Authors: Ie Judite
Published: November 2022

This article employs concepts from family sociology to explore how ‘family’ is conceptualised in 14 life narratives of young people in foster care in Spain. The article draws on a multi‐method approach with young people who are in long‐term non‐kinship foster care. Seven girls and seven boys aged 10 to 22 took part in the study. The empirical material reveals an interplay between biological preference and foster family affective practices in young people's narratives, illuminating a struggle to make sense of the concept of family in foster care. Most of the participants understand family as shared affective practices sustained through love, commitment, consistent care and reciprocity rather than blood ties. Some show a preference for biological connectivity, while others describe family as determined by rituals and family displays. The key practice implications highlight the importance helping young people positioning themselves in birth family relationships, and supporting their sense of family belonging.
A NR2E1‐interacting peptide of LSD1 inhibits the proliferation of brain tumour initiating cells
Authors: Hu Rong , Hameed Umar Farook Shahul , Sun Xiang , Moorthy Balakrishnan Shenbaga , Zhang Wen , Jeffrey Philip D. , Zhou Li , Ma Xin , Chen Fangjin , Pei Jianfeng , Giri Pankaj K. , Mou Yonggao , Swaminathan Kunchithapadam , Yuan Ping
Published: November 2022

Objectives

Elimination of brain tumour initiating cells (BTICs) is important for the good prognosis of malignant brain tumour treatment. To develop a novel strategy targeting BTICs, we studied NR2E1(TLX) involved self‐renewal mechanism of BTICs and explored the intervention means.

Materials and Methods

NR2E1 and its interacting protein‐LSD1 in BTICs were studied by gene interference combined with cell growth, tumour sphere formation, co‐immunoprecipitation and chromatin immunoprecipitation assays. NR2E1 interacting peptide of LSD1 was identified by Amide Hydrogen/Deuterium Exchange and Mass Spectrometry (HDX‐MS) and analysed by in vitro functional assays. The in vivo function of the peptide was examined with intracranial mouse model by transplanting patient‐derived BTICs.

Results

We found NR2E1 recruits LSD1, a lysine demethylase, to demethylate mono‐ and di‐methylated histone 3 Lys4 (H3K4me/me2) at the Pten promoter and repress its expression, thereby promoting BTIC proliferation. Using Amide Hydrogen/Deuterium Exchange and Mass Spectrometry (HDX‐MS) method, we identified four LSD1 peptides that may interact with NR2E1. One of the peptides, LSD1‐197‐211 that locates at the LSD1 SWIRM domain, strongly inhibited BTIC proliferation by promoting Pten expression through interfering NR2E1 and LSD1 function. Furthermore, overexpression of this peptide in human BTICs can inhibit intracranial tumour formation.

Conclusion

Peptide LSD1‐197‐211 can repress BTICs by interfering the synergistic function of NR2E1 and LSD1 and may be a promising lead peptide for brain tumour therapy in future.
The vaccine hesitancy continuum among hesitant adopters of the COVID‐19 vaccine
Authors: Moore Ramey , Purvis Rachel S. , Willis Don E. , Worley Kyle C. , Hervey Devonte , Reece Sharon , Yeates Aimee , McElfish Pearl A.
Published: November 2022

Vaccination is a strategy for mitigating the impact of coronavirus disease 2019 (COVID‐19) at both the individual and population levels. Vaccine hesitancy is identified as a significant threat to global health by the World Health Organization (WHO). Vaccine hesitancy has been theorized as a continuum encompassing a range of attitudes, beliefs, emotional orientations, ideologies, and health‐seeking behaviors. Individuals who received the COVID‐19 vaccine but also indicated some level of hesitancy about vaccination, or “hesitant adopters,” remain an understudied group. This study uses a qualitative descriptive design to understand motivations to receive the COVID‐19 vaccine among hesitant adopters at various self‐reported levels of hesitancy. We conducted interviews with hesitant adopters (n = 49) to analyze the elements of vaccine hesitancy corresponding to reported levels of COVID‐19 vaccine hesitancy (i.e., “little hesitant,” “somewhat hesitant,” and “very hesitant”). Concerns about side effects are shared across the continuum but are articulated differently at each level of hesitancy. The “little hesitant” relate fears of side effects to their health and a lack of clear information to inform their health decision making, whereas the “very hesitant” articulate the risks of side effects within the frame of conspiracies related to the development, approval, and economics of the COVID‐19 vaccine. Additionally, conspiracy theories generally increase in salience across the continuum, with the “very hesitant” reporting conspiracy theories as the most salient element of vaccine hesitancy. This research presents opportunities for developing targeted interventions for different levels of vaccine hesitancy.
Reflectance confocal microscopy of facial neoplasms: Follicular involvement as a clue to diagnosis
Authors: Shahriari Neda , Grant‐Kels Jane M. , Rabinovitz Harold , Oliviero Margaret , Scope Alon
Published: November 2022

Background

Facial skin is characterized by high density of follicles. Facial neoplasms may present overlapping clinical and dermoscopic findings. Our goal was to evaluate and compare, via reflectance confocal microscopy (RCM), follicular involvement in facial neoplasms.

Methods

We retrospectively searched our image database, between January 2008 and December 2020, for all facial lesions with (1) a standardized set of clinical, dermoscopic, and RCM images, and (2) a biopsy‐proven diagnosis of lentigo maligna/lentigo maligna melanoma (LM/LMM, n = 39), basal cell carcinoma (BCC, n = 51), squamous cell carcinoma in situ (SCCIS, n = 5), actinic keratosis (AK, n = 11), and lichen‐planus‐like keratosis (LPLK, n = 18). Two readers jointly evaluated the RCM images for a set of predefined features of follicular involvement.

Results

Diffuse obliteration of follicles was frequent in BCC (88%), while follicular infiltration by refractile dendritic cells and/or by bright round nucleated cells was common in melanoma (90% and 44%, respectively). Extension of atypical keratinocytes down follicles was more prominent among SCCIS than AK (80% vs. 45%, p = 0.01). In most LPLK (89%), there was follicular sparing.

Conclusions

Evaluation of RCM criteria centering on the follicles can be useful in the differential diagnosis between common facial neoplasms.
Utility of transesophageal echocardiogram surveillance after watchman device placement
Authors: Wu Stephanie , Minhas Harjit , Shiota Takahiro , Siegel Robert J. , Rader Florian
Published: November 2022

Background

In atrial fibrillation patients undergoing left atrial appendage occlusion with a Watchman device, surveillance imaging with a transesophageal echocardiogram (TEE) is typically performed at 45 days and 1 year to evaluate for device‐related thrombus (DRT) and peri‐device leak (PDL) before the cessation of oral anticoagulation. The incidence of these complications is relatively low, and the ideal timing and duration of surveillance is unknown. We sought to evaluate the incidence of DRT and PDL after Watchman placement at 45 days and 1 year to determine the necessity of surveillance TEEs.

Methods

We retrospectively analyzed 361 patients who received a Watchman device between January 2016 and January 2020. Baseline clinical and echocardiographic data, post‐procedure antithrombotic therapy, and surveillance echocardiographic data were collected from the NCDR LAAO Registry. Nested backward variable elimination regression was performed to derive independent predictors of the composite outcome of DRT and PDL.

Results

A total of 286 patients who had post‐procedure TEEs were included in the analysis. At 45 days, 9 patients had DRT (3.2%) and 44 patients had PDL (15.0%). At 1 year, 5 patients had DRT (5.6%) and 8 patients had PDL (8.9%). All DRT at 45 days was treated with continued anticoagulation while no change in protocol occurred with PDL. All DRT at 1 year occurred in new patients without prior thrombus. A history of prior transient ischemic attack (TIA) and thromboembolism was significantly associated with DRT or PDL at 1 year.

Conclusions

We identified several patients with device‐related complications at 45 days and 1 year despite appropriate device sizing and adequate use of antithrombotic therapy. The incidence of DRT increased from 45 days to 1 year and occurred in patients without prior thrombus. These findings highlight the importance of surveillance imaging and suggest the potential need for extended surveillance in select patients.
Real‐world utility of early measurable residual disease assessments by multi‐parametric flow cytometry in adult patients with B‐lymphoblastic leukemia receiving Hyper‐CVAD induction chemotherapy
Authors: Nedumannil Rithin , Ritchie David , Bajel Ashish , Ng Ashley P. , Harrison Simon J. , Westerman David
Published: November 2022

Multi‐parametric flow cytometry (MFC) has a well‐established role in measurable residual disease (MRD) monitoring in patients with B‐lymphoblastic leukemia (B‐ALL). However, the optimal time‐point (TP) for early MRD testing and associated prognostic impact remain undefined in adult B‐ALL patients receiving Hyper‐CVAD induction chemotherapy. To evaluate the utility of MRD analysis after one cycle (TP1) in comparison to MRD analysis after two cycles (TP2) of induction treatment with Hyper‐CVAD chemotherapy, we studied 49 adult B‐ALL patients over a 10‐year period (2010–2020) who had available bone marrow samples for morphological and MFC MRD assessments at the two separate TPs. Median times to TP1 and TP2 relative to start of treatment were 21 and 45 days, respectively. When censored at transplant, achievement of MRD negativity at TP1 was not associated with a statistically significant improvement in either event‐free survival (EFS) (p = .426) or overall survival (OS) (p = .335) when compared to patients with MRD positivity. In contrast, achieving MRD negativity at TP2 was associated with a statistically significant improvement in both EFS (p = ·005) and OS (p = .047) over patients who remained MRD positive. Multivariate analysis demonstrated that KMT2A‐rearrangement and MRD positivity at TP2 were the only significant predictors of outcome, correlating with worse EFS and OS. Therefore, in the absence of residual morphologic disease, MRD analysis after one cycle of Hyper‐CVAD induction chemotherapy did not provide additional benefit with regard to risk stratification or correlation with survival outcomes when compared to MRD testing after two cycles of Hyper‐CVAD in adult B‐ALL patients.
Farming with forages can reconnect crop and livestock operations to enhance circularity and foster ecosystem services
Authors: Franzluebbers Alan J. , Martin Guillaume
Published: November 2022

Agriculture has undergone dramatic technological and cultural changes over the past century. Many would argue that the changes have been unquestionably positive with huge gains in productivity, reduced labour requirements, and alleviation of food insecurity for most people. However, the adoption of increasingly specialized and separated crop and livestock enterprises has also had widespread negative consequences resulting in (a) decline in biodiversity, (b) degradation of groundwater and surface waters with agrochemical pollutants, (c) poor soil health with monoculture crop production and frequent soil disturbance, (d) intensive greenhouse gas emissions from both specialized cropping systems relying on external inputs and concentrated animal feeding operations that accumulate wastes, and (e) general lack of ecological integrity among components of these specialized systems. Diversified agricultural systems using annual and perennial forages offer opportunities to elevate ecological synergies when crop and livestock operations are integrated. Integrated crop‐livestock systems can internalize nutrient cycling, provide cultural control of weeds, insects and diseases, and share resources in a circular‐based agroecosystem. Cover crops could be transitioned into nutritious annual forages for livestock grazing on currently specialized crop production farms with appropriate local incentives. Perennial forages in ley farming or in pasture‐crop rotations have historical relevance and are a proven practice for conserving nutrients, improving soil health and enhancing biodiversity. Redesigning contemporary agriculture with mixed‐use farming techniques could greatly reduce soil erosion, improve water quality, and invigorate soil health. We suggest that incorporating different types of forages across a diverse landscape can enhance agricultural sustainability and ecological integrity.
Passing as resistance through a Goffmanian approach: Normalized, defensive, strategic, and instrumental passing when LGBTQ+ individuals encounter institutions
Authors: Ozbilgin Mustafa F. , Erbil Cihat , Baykut Sibel , Kamasak Rifat
Published: November 2022

Passing and coming out are two divergent individual strategies historically associated with the LGBTQ+ community as they struggle to fit in with normative expectations at work and in life. While coming out has gradually become more common in organizations and national contexts that offer safeguards for LGBTQ+ individuals, passing remains an option where no such measures are available. Drawing on interviews with working‐class LGBTQ+ individuals in a country with an adversarial context, that is, Turkey, we identify how varieties of passing, defined as acting and appearing to fit with the dominant sexual orientation and gender identity norms, are used as strategies of coping with institutional norms. Working‐class LGBTQ+ individuals are an important group to study as many draw their pride, power, and identity from their engagement with work and the labor market. Transcending the monolithic accounts of passing, we illustrate four variants of passing (i.e., normalized, defensive, strategic, and instrumental passing) that LGBTQ+ individuals deploy at work. Reflecting on the field study findings, we explicate how and why LGBTQ+ individuals choose to pass at work in each case.
Association of factor expression levels with annual bleeding rate in people with haemophilia B
Authors: Burke Tom , Shaikh Anum , Ali Talaha M. , Li Nanxin , Konkle Barbara A. , Noone Declan , O'Mahony Brian , Pipe Steven , O'Hara Jamie
Published: November 2022

Introduction

Gene therapy clinical trials measure steady‐state clotting factor expression levels (FELs) to evaluate the modulation of the bleeding phenotype, aiming to offer consistent protection against breakthrough bleeding events. The link between FELs and bleeding risk in people with haemophilia B (PwHB) is not well understood.

Aim

We evaluated the association between FEL and ABR in PwHB.

Methods

This cross‐sectional study extended the CHESS burden of illness studies in Europe and the United States. Recruitment of additional adult males with haemophilia B supplemented the existing CHESS sample size of PwHB and FELs. PwHB receiving prophylaxis were excluded, as fluctuating FELs may have confounded the analysis. Demographic and clinical characteristics were reported descriptively. Any recorded baseline FEL was reported by the haemophilia‐treating physicians according to the medical records. Generalised linear models with log link explored the association between changes in FEL and ABR.

Results

The study included 407 PwHB and no inhibitors receiving on‐demand treatment. Mean age was 36.7 years; 56% from the EU, 44% from the United States. Mean baseline FEL was 9.95 IU/dl (SD, 10.47); mean ABR was 2.4 bleeds/year (SD, 2.64). After adjusting for covariates, the model showed that for every 1% increase in FEL the average ABR decreased by .08 (p < .001). Predicted number of bleeding events according to FEL showed a significant non‐linear relationship between FEL and ABR (p < .05).

Conclusion

This analysis showed a significant relationship between FEL and ABR, where increases in FEL were associated with decreases in ABR among men with HB in Europe and the US.
Masseter muscle contraction and cervical muscle sensitization by nerve growth factor cause mechanical hyperalgesia in masticatory muscle with activation of the trigemino‐lateral parabrachial nucleus system in female rats
Authors: Kubo Asako , Sugawara Shiori , Iwata Koichi , Yamaguchi Satoru , Mizumura Kazue
Published: November 2022

Objective

To establish a new rat model of craniofacial myalgia, and to clarify which central nervous system pathways are activated in the model.

Background

Craniofacial myalgia, represented by myogenous temporomandibular disorder and tension‐type headache with pericranial tenderness, is more common in female patients. The pain is thought to be a type of multifactorial disorder with several coexisting causes. To our knowledge, there are no models of craniofacial muscle hyperalgesia caused by multiple types of stimuli.

Methods

We injected nerve growth factor into the trapezius muscle of female and male rats and repeatedly stimulated the masseter muscle (MM) electrically for 10 days. We determined the mechanical head‐withdrawal threshold of MM and extent of phosphorylated extracellular signal‐related kinase 1/2 (pERK) immunoreactivity in various regions of the lower brainstem. We conducted retrograde tract‐tracing to determine the projection of mechanosensitive MM‐innervating secondary neurons to the lateral parabrachial nucleus. Finally, we administered morphine in rats to determine whether increases of pERK immunoreactivity were dependent on noxious inputs.

Results

In female rats, but not male rats, the mechanical head‐withdrawal threshold was decreased significantly from days 9 to 12. The number of pERK‐immunoreactive neurons in the brainstem was increased significantly in female rats in the group with both stimuli compared to rats in other groups with a single stimulus. Mechanosensitive MM‐innervating neurons in the brainstem projected to the parabrachial nucleus. Morphine administration blocked the increase in the number of pERK‐immunoreactive neurons in both the brainstem and parabrachial nucleus.

Conclusions

We established a model of craniofacial myalgia by combining trapezius and MM stimuli in female rats. We found mechanical hyperalgesia of the MM and activation of the pain pathway from the brainstem to parabrachial nucleus. The model reflects the characteristics of patients with craniofacial myalgia and might be helpful to clarify the pathogenic mechanisms underlying these disorders.
Positive postpartum well‐being: What works for women
Authors: Hannon Susan , Newnham Elizabeth , Hannon Kathleen , Wuytack Francesca , Johnson Louise , McEvoy Ellen , Daly Déirdre
Published: November 2022

Background

Women's experiences of pregnancy, birth and motherhood extend beyond healthcare provision and the immediate postpartum. Women's social, cultural and political environments shape the positive or negative effects of their experiences through this transition. However, there is limited research concerning the factors that women identify as being protective or promotive of maternal well‐being in the perinatal period and motherhood transition.

Objective

To explore women's views on the factors within healthcare, social, cultural, organizational, environmental and political domains that do or can work well in creating positive perinatal experiences.

Design, Setting and Participants

A qualitative descriptive study with embedded public and participant involvement (PPI). Participants were 24 women who were maternity care service users giving birth in Ireland.

Results

Three themes were developed. The first theme, ‘tone of care’, related to women's interactions with and attitudes of healthcare professionals in setting the tone for the care they experienced. The second theme, ‘postpartum presence and support’, concerned the professional postpartum supports and services that women found beneficial in the motherhood transition. The final theme, ‘flexibility for new families’ addresses social and organizational issues around parents returning to paid employment.

Discussion and Conclusion

Women suggested multiple avenues for promoting positive perinatal experiences for women giving birth in Ireland, which may be implemented at healthcare and policy levels. Women identified that maternal health education focuses on supporting informed decision‐making processes as a positive and worry‐alleviating resource. Additionally, women valued being met by healthcare professionals who regard women as the decision makers in their care experience. Exchanges in which healthcare professionals validate and encourage women in their mothering role and actively involve their partners as caregivers left lasting positive impressions. Extended and professional postpartum support was a common issue, and phone lines or drop‐in clinics were suggested as invaluable and affirming assets where women could access personalized support with healthcare professionals who had the knowledge and skills to genuinely approach women's concerns. Social and organizational considerations involved supporting parents to balance their responsibilities as new or growing families in the return to work.

Public or Patient Contribution

Maternity care service users were involved in the interviews and manuscript preparation.
Preferential corporate income tax treatment: Valuation in the market portfolio
Authors: Yoo Junwook
Published: November 2022

In the setting of the market portfolio, the impacts of preferential corporate income tax treatments through the valuational reduction for risk are opposite to and offset the impacts through the expected proceeds. This suggests that focusing on the absolute valuation of tax‐favored firms results in the undermeasurement of implicit taxes on returns on investments in tax‐favored firms and the relative valuation with reference to fully taxed (i.e., tax‐disfavored) benchmark firms be used. In addition, corporate income taxes imposed on entities and capital income taxes imposed on investors have opposite valuational effects through the endogenously derived market‐aggregate aversion to risk.
“Love for variety,” outside option and extensive margin of demand
Authors: Mukherjee Sovik , Mukherjee Vivekananda
Published: November 2022

The paper models a uniform‐price Bertrand‐price‐competition in a differentiated product oligopoly market, where the buyers' preference shows “love for variety.” The buyers differ from each other in their valuation of the differentiated product with a common outside option available to all. The model endogenously determines both the extensive and intensive margin of demand and the equilibrium number of varieties in the differentiated product market. It shows that in such a framework complementarity exists at the extensive margin of demand even in the presence of demand substitutability between the varieties. The results apply to the competition between brick and mortar shops and malls.
Daily moods, health routines and recovery among employees working in the retail and services sector: A diary study
Authors: Punna Mari , Sihvonen Sanna , Aunola Kaisa , Rönkä Anna
Published: November 2022

This study examined the quality and fluctuation of daily moods as well as health routines and means of recovery from work strain among employees (n = 38) working nonstandard, often unpredictable schedules in the retail and services sector in Finland. Data were collected via a background questionnaire and a one‐week mobile diary. The results indicated that the daily moods of employees were relatively positive but varied greatly from day to day. Hectic working days, unpredictable changes in work schedules, and compounded responsibilities at home and work were reported as causes of daily strain stemming from work. In contrast, more sleep and exercise were positively associated with daily mood and, therefore, are likely to enhance recovery from work related strain. Additional activities employees reported as useful in recovering from work strain included low‐effort leisure activities along with social activities with family and friends, as well as mastery experiences stemming from successful work experiences.
Dfree ultrasonic sensor in supporting quality of life and patient satisfaction with bladder dysfunction
Authors: Hofstetter Sebastian , Zilezinski Max , Wolf Anja , Behr Dominik , Paulicke Denny , Stoevesandt Dietrich , Schwarz Karsten , Schönburg Sandra , Jahn Patrick
Published: November 2022

Bladder dysfunction is physically and mentally stressful. Long‐term catheterization is indicated as conservative therapy for chronic urinary retention as well as urinary incontinence; although an indwelling, transurethral catheter still represents a risk factor for ascending urinary tract infection and urosepsis. The primary outcome of this study was the impact of the DFree ultrasonic sensor on the subjectively perceived quality of life and satisfaction of patients. The secondary outcomes evaluated were usefulness, ease of use (user‐friendliness), quality of care, and self‐reported degree of autonomy. In this pilot study, 18 urological patients with various kind of bladder dysfunction were treated with an ultrasonic sensor for at least 12 h a day over a 3‐month period. Assessment was conducted using the Kings Health Questionnaire (KHQ) and the German version of the Client Satisfaction Questionnaire (ZUF‐8) (quantitative data) and guided interviews (qualitative data). Eighteen participants were included in this study. Participants highly appreciated the ideas and concepts of the device. A change in KHQ after treatment could not be statistically confirmed; however, the average value in ZUF‐8 showed satisfaction with Dfree. However, no significant improvement was observed in the quantitative data. During the interviews at the end of the testing phase, the participants provided positive feedback with specific suggestions to improve device usability. The application was described as helpful and easy to use. Data triangulation illustrates that an improvement in technical implementation could increase device usefulness. This would imply higher patient satisfaction when using the device for bladder dysfunction.
Effectiveness of virtual reality intervention on reducing the pain, anxiety and fear of needle‐related procedures in paediatric patients: A systematic review and meta‐analysis
Authors: Gao Yan , Xu Yiwei , Liu Naiquan , Fan Ling
Published: November 2022

Aims

To evaluate the effectiveness of virtual reality (VR) intervention in the management of pain, anxiety and fear in paediatric patients undergoing needle‐related procedures.

Design

A systematic review and meta‐analysis of randomized controlled trials (RCTs).

Data sources

A librarian‐designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI, and Wanfang databases was conducted to identify research articles in English or Chinese on RCTs up to February 28, 2022.

Review methods

Two researchers independently screened eligible articles. The Cochrane Handbook for Systematic Reviews was used to assess the risk of bias in the included studies. A fixed‐ or random‐effects meta‐analysis model was used to determine the pooled mean difference based on the results of the heterogeneity test.

Results

A total of 2269 articles were initially screened. The meta‐analysis included data from 27 studies representing 2224 participants. Compared with the non‐VR group, the VR intervention group significantly reduced pain, anxiety, and fear in paediatric patients who underwent puncture‐related procedures. Subgroup analysis showed that VR has advantages over conventional and other distraction methods.

Conclusion

Paediatric patients undergoing needle‐related procedures would benefit from VR interventions for pain, anxiety and fear management.

Impact

VR intervention has the potential to reduce pain, anxiety and fear in paediatric patients undergoing puncture‐related procedures. Future clinical interventions could incorporate VR into puncture procedures as an effective method to reduce negative emotions in children eligible for VR distractions.

Patient or Public Contribution

Our paper is a systematic review and meta‐analysis and such details don't apply to our work.
Post‐migration psychosocial experiences and challenges amongstLGBTQ+ forced migrants: A meta‐synthesis of qualitative reports
Authors: Gottvall Maria , Brunell Calle , Eldebo Anna , Johansson Metso Frida , Jirwe Maria , Carlsson Tommy
Published: November 2022

Aims

Synthesize qualitative research to illuminate the post‐migration psychosocial experiences amongst LGBTQ+ forced migrants.

Design

Meta‐synthesis of qualitative reports.

Data sources

Systematic searches in seven databases and manual screenings were performed in July 2021 (21,049 entries screened in total). The final sample included 29 English‐language reports containing empirical qualitative findings about post‐migration experiences and published 10 years prior to the searches, based on migrants as the primary source.

Review Methods

Methodological quality was appraised using the CASP and JBI checklists. Through a collaborative process involving nurse‐midwife researchers and experienced clinical professionals, reports were analysed with a two‐stage qualitative meta‐synthesis including an inductive qualitative content analysis.

Results

The methodological quality was high and the reports included 636 participants in total. Two themes were identified through the meta‐synthesis. The first theme illustrates the psychological distress and numerous challenges and stressors forced migrants face after arrival, including challenges encountered as an LGBTQ+ forced migrant, psychological reactions and manifestations, and practical issues related to resettlement and living conditions. The second theme highlights the resilience and strength they find through various internal processes and external resources, including resilience and strengthening resources, identity formation and establishing and maintaining social relationships.

Conclusion

After arrival in the host country, forced migrants identifying as LGBTQ+ face numerous societal and personal challenges whilst being at risk of experiencing significant psychological distress. These migrants utilize a wide range of resources that may strengthen their resilience. Peer support stands out as a highly appreciated and promising resource that needs further attention in experimental research.

Impact

Forced migrants identifying as LGBTQ+ need access to adequate and sufficient support. The findings emphasize several strength‐building resources that may inform nurses, midwives, researchers and other professionals when providing psychosocial support for these persons.

Patient or Public Contribution

No patient or public contribution.
Incidence of ablation‐induced esophageal lesions and gastroparesis in patients undergoing ablation index guided high power short duration atrial fibrillation ablation
Authors: List Stephan , Meinhardt Christian , Mueller Julian , Deneke Thomas , Barth Sebastian , Waechter Christian , Luesebrink Ulrich , Elsaesser Albrecht , Arlt Alexander , Halbfass Philipp
Published: November 2022

Introduction

Aim of this study was to evaluate the incidence of ablation‐induced endoscopically detected esophageal lesions (EDEL) and gastroparesis in patients undergoing high‐power short‐duration (HPSD) atrial fibrillation (AF) ablation using different target ablation index (AI) values.

Methods and Results

Consecutive patients undergoing AF ablation were included. Radiofrequency (RF) ablation was performed using HPSD ablation (50 W, target AI of 320 and 350 (group 1) and 380 (group 2) at posterior wall). Postablation endoscopy was performed in all patients. In total, 233 patients (66.8 ± 10 years; 52% male) were included consecutively (n = 137 patients in group 1 and n = 96 patients in group 2). Mean AI values und RF time at posterior wall was significantly higher and longer in group 2 compared to group 1 patients (413 ± 9 vs. 392 ± 19 AI, p < 0.01; 9.0 ± 0.8 s vs. 7.8 ± 0.7 s, p < 0.01). Esophageal endoscopy revealed esophageal lesions or gastroparesis in 43 of 233 patients (18.5%) in the total cohort (13.1% in group 1 and 26.0% in group 2; p = 0.02). Incidence of EDEL was 8.0% and 13.5% in group 1 and group 2, respectively. According to logistic analysis incidence of EDEL and/or gastroparesis was significantly lower in patients with a higher body mass index and higher in group 2 patients compared to group 1 patients.

Conclusion

The incidence of EDEL or gastroparesis in patients undergoing HPSD AF ablation was 18.5% in the total cohort. The risk of EDEL and gastroparesis was associated with a higher AI target value of 380 compared to 320 and 350 at posterior wall and was reversely associated with body mass index.
Asia‐Pacific guidelines for managing functional dyspepsia overlapping with other gastrointestinal symptoms
Authors: Gwee Kok‐Ann , Lee Yeong Yeh , Suzuki Hidekazu , Ghoshal Uday Chand , Holtmann Gerald , Bai Tao , Barbara Giovanni , Chen Min‐hu , Chua Andrew Seng Boon , Gibson Peter R , Hou Xiaohua , Liu Jinsong , Nakajima Atsushi , Pratap Nitesh , Sachdeva Sanjeev , Siah Kewin Tien Ho , Soh Alex Yu Sen , Sugano Kentaro , Tack Jan , Tan Victoria Ping Yi , Tang Xudong , Walker Marjorie , Wu Deng‐Chyang , Xiao Ying‐Lian , Zulkifli Khairil Khuzaini , Toh Clarissa
Published: November 2022

Contemporary systems for the diagnosis and management gastrointestinal symptoms not attributable to organic diseases (Functional GI Disorders, FGID, now renamed Disorders of Gut‐Brain Interaction, DGBI) seek to categorize patients into narrowly defined symptom‐based sub‐classes to enable targeted treatment of patient cohorts with similar underlying putative pathophysiology. However, an overlap of symptom categories frequently occurs and has a negative impact on treatment outcomes. There is a lack of guidance on their management. An Asian Pacific Association of Gastroenterology (APAGE) working group was set up to develop clinical practice guidelines for management of patients with functional dyspepsia (FD) who have an overlap with another functional gastrointestinal disorder: FD with gastroesophageal reflux (FD‐GERD), epigastric pain syndrome with irritable bowel syndrome (EPS‐IBS), postprandial distress syndrome with IBS (PDS‐IBS), and FD‐Constipation. We identified putative pathophysiology to provide a basis for treatment recommendations. A management algorithm is presented to guide primary and secondary care clinicians.
Epidemiology and prevalence of lean nonalcoholic fatty liver disease and associated cirrhosis, hepatocellular carcinoma, and cardiovascular outcomes in the United States: a population‐based study and review of literature
Authors: Almomani Ashraf , Kumar Prabhat , Onwuzo Somtochukwu , Boustany Antoine , Krishtopaytis Eduard , Hitawala Asif , Alshaikh Dana , Albakri Almaza , Hussein Leen , Hussein Ebrahim , Asaad Imad
Published: November 2022

Backgrounds

Nonalcoholic fatty liver disease (NAFLD) is linked to obesity and metabolic syndrome conditions. However, a subset of NAFLD patients express a normal or low body mass index (lean NAFLD [L‐NAFLD]). Our aim is to compare the prevalence of L‐NAFLD to the obesity‐associated NAFLD in the United States by assessing prevalence, potential risk factors, liver‐related complications, and coronary artery disease outcomes.

Methodology

A multicenter database (Explorys Inc.) of >70 million patients across the United States was screened. A cohort of patients with “nonalcoholic fatty liver” between 1999 and 2021 was identified. Two sub‐cohorts of NAFLD patients were identified: those with a body mass index (BMI) < 25 kg/m2 (L‐NAFLD) and those with a BMI > 30 kg/m2 (obesity‐associated NAFLD). We excluded patients with age <18 and those who have viral hepatitis, hemochromatosis, Wilson's disease, biliary cirrhosis, alcoholic liver disease, cystic fibrosis, alpha‐1‐antitrypsin deficiency, and autoimmune hepatitis. Multivariate analysis was performed to adjust for confounders.

Results

68 892 260 individuals were screened. NAFLD prevalence was four per 100 000, and L‐NAFLD prevalence was 0.6 per 100 000. Compared with those without, patients with L‐NAFLD tended to be older (OR 2.16), females (OR 1.28), and smokers (OR 4.67) and of Asian race (OR 2.12). L‐NAFLD patients were more likely to have acute coronary syndromes (OR 30.00) and metabolic syndrome (OR 2.31) despite the normal/low BMI. Esophageal varices and hepatocellular carcinoma risks were high in both cirrhosis patients.

Conclusion

This is the largest study to assess L‐NAFLD prevalence in the United States. L‐NAFLD are at a significantly higher risk for acute coronary syndromes, esophageal varices, and hepatocellular carcinoma.
Pain as a risk factor for incident sarcopenia in community‐dwelling older adults: A 1‐year prospective cohort study
Authors: Lin Taiping , Huang Xiaotao , Guo Duan , Zhao Yanli , Song Quhong , Liang Rui , Jiang Tingting , Tu Xiangping , Deng Chuanyao , Yue Jirong
Published: November 2022

Background

Pain‐related muscle disuse and inflammatory reactions may increase the risk of sarcopenia among older adults with pain. Although several studies have examined the association between pain and sarcopenia, the findings are mixed. In the present study, we examined the association of pain as well as pain intensity and location with incident sarcopenia among community‐dwelling older adults and explored whether this association differed between men and women.

Methods

Pain characteristics, including the presence of pain, intensity (mild, moderate, and severe), and location (multisite, low back, joint, and chest), were self‐reported at baseline. Sarcopenia was identified according to the consensus of the Asin Working Group for Sarcopenia 2019 at baseline and 1 year later. Multivariable Poisson regression was used to determine the association of pain status, intensity, and location with incident sarcopenia, respectively.

Results

Eight hundred seventy‐three participants (67.1 ± 4.9 years, 524 female) who were free of sarcopenia at baseline were included, of which 64 (7.3%) developed sarcopenia in the follow‐up. The presence of pain was significantly associated with an increased risk of incident sarcopenia in older adults (adjusted RR = 1.83, 95% CI = 1.16–2.89), with a significant risk accumulation in incident sarcopenia upon higher pain intensity. Older adults with multisite pain, low back pain, or joint pain were more likely to develop sarcopenia. Although older men reported a lower prevalence and intensity of pain, their risk of sarcopenia during follow‐up was generally more pronounced than older women.

Conclusions

Older adults with pain had a significantly higher risk of incident sarcopenia, with a significant risk accumulation in sarcopenia development upon higher pain intensity and specific pain location. Additional attention is needed to identify older adults with pain and to implement timely pain interventions to prevent sarcopenia. High‐quality randomized controlled trials are warranted to verify the clinical significance of the present study.
Mental health of recipients after cadaveric liver transplantation: A perspective from positive psychology
Authors: Saiyu Gao , Shali Wen , Yanfang Lu , Jingping Zhang
Published: November 2022

Aims and Objectives

The aim of this study was to explore the mental health of transplant recipients, especially psychological integration and the donor‐recipient relationship.

Background

Psychological integration and the donor‐recipient relationship are unique psychological perception of recipients with transplantation, which have important effects on their mental health and recovery. However, few studies have focused on the feelings and attitudes of cadaveric liver transplant recipients.

Design

A qualitative descriptive design was used.

Methods

Individual semi‐structured interviews were conducted face‐to‐face with 30 recipients after liver transplantation. Qualitative content analysis was used and data saturation was achieved. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) were used.

Results

Three themes and eight subthemes were identified.

(1) Psychological integration—acknowledging the transplanted liver was a part of their own body and attaching great importance to the liver; (2) Attitudes towards the donor—gratitude to the donor, being inspired by the dedication of the donor and mourning the donor's misfortune; and (3) Living in the moment—health behaviours of self‐care, emotional regulation and positive attitude about life.

Conclusion

The psychological integration of recipients of cadaveric liver transplants is smooth, and the attitudes towards the donor are positive. From the perspective of positive psychology, we observed the important role of post‐traumatic growth of the recipient and positive emotions in promoting the recipient's health behaviours for self‐care, emotion regulation and attitudes towards life.

Relevance for Clinical Practice

Medical staff should help recipients to deal with these issues about the organ and its donor constructively and guide them to focus on postoperative inner growth and positive emotion.
A human rights based approach to the global children's rights crisis: A call to action
Authors: Levy Sheri R. , Migacheva Katya , Ramírez Luisa , Okorodudu Corahann , Cook Harold , Araujo‐Soares Vera , Minescu Anca , Livert David , Ragin Deborah Fish , Walker Peter
Published: November 2022

Children are not responsible for diseases, natural disasters, political conflicts, and wars; yet, children generally suffer the most. Although the UN Convention on the Rights of the Child (1989) is one of the most ratified world treaties, ample evidence of violations of children's rights exists in reports on the devastating effects of climate change, the COVID‐19 pandemic, and armed conflicts (e.g., Afghanistan, Haiti, Syria, Ukraine, Yemen) including abuse, abduction, becoming child soldiers, death, early marriages, family separation, loss of schooling, malnutrition, neglect, poverty, sexual violence, and trafficking, leading to traumatic short‐ and long‐term academic, emotional, psychological, and physical consequences. This article highlights a child‐rights based approach to the global crisis: (1) sounding an alarm for immediate and greater attention of governments to address children's rights violations and (2) calling multi‐disciplinary scholars to redouble their efforts toward freely sharing their findings, partnering with policy makers and stakeholders, collecting difficult to obtain data, and putting their knowledge into action in preventive and intervention measures to empower the implementation of children's protection and participation rights in the home, school, community, nation, and globally. The global multi‐faceted children's rights crisis requires urgent individual and collective action to make children's rights a global reality.