bluuebunny/crossref_metadata_2025 huggingface dataset:
The Best Choice of Oxygen Cost Prediction Equation for Computing Post-Stroke Walking Energy Expenditure Using an Accelerometer
Authors: Compagnat Maxence , Salle Jean-yves , Vinti Maria , Joste Romain , Daviet Jean Christophe
Published: February 2022

Background

The integration of oxygen cost into the accelerometer’s algorithms improves accuracy of total energy expenditure (TEE) values as post-stroke individuals walk. Recent work has shown that oxygen cost can be estimated from specific prediction equations for stroke patients.

Objective

The objective is to the validity of the different oxygen cost estimation equations available in the literature for calculating TEE using ActigraphGT3x as individuals with stroke sequelae walk.

Method

Individuals with stroke sequelae who were able to walk without human assistance were included. The TEE was calculated by multiplying the walking distance provided by an ActigraphGT3x worn on the healthy ankle and the patient’s oxygen cost estimated from the selected prediction equations. The TEE values from each equation were compared to the TEE values measured by indirect calorimetry. The validity of the prediction methods was evaluated by Bland–Altman analysis (mean bias (MB) and limits of agreement (LoA) values).

Results

We included 26 stroke patients (63.5 years). Among the selected equations, those of Compagnat and Polese obtained the best validity parameters for the ActigraphGT3x: MBCompagnat = 1.2 kcal, 95% LoACompagnat = [−12.0; 14.3] kcal and MBPolese = 3.5 kcal, 95% LoAPolese = [−9.2; 16.1] kcal. For comparison, the estimated TEE value according to the manufacturer’s algorithm reported MBManufacturer = −15 kcal, 95% LoAManufacturer = [−52.9; 22.8] kcal.

Conclusion

The Polese and Compagnat equations offer the best validity parameters in comparison with the criterion method. Using oxygen cost prediction equations is a promising approach to improving assessment of TEE by accelerometers in post-stroke individuals.
Nitrogen Critical Loads: Critical Reflections on Past Experiments, Ecological Endpoints, and Uncertainties
Authors: Briggs William M. , Hanekamp Jaap C.
Published: February 2022

Nitrogen Critical Loads (NCL), as purported ecological dose-response outcomes for nitrogen deposition from anthropogenic sources, play a central role in environmental policies around the world. In the Netherlands, these NCL are used to assess, via calculations using the model AERIUS, to what extent NCL are exceeded for different habitats as a result of different sources such as industry, agriculture, traffic. NCL are, however, not well defined, and are subject to hitherto unrecognized forms of uncertainty. We will address this with reference to a number of key studies that forms the basis for several NCL. We will subsequently propose amendments that could be applicable to future nitrogen studies and their enhanced relevancy in decision making.
Philanthropic tales: A critical analysis of how philanthropic citizenship is represented in children’s picture-books – problems and possibilities
Authors: Body Alison , Lacny Jayne
Published: February 2022

In this article we critically question how philanthropic citizenship is represented within children’s literature. Critical content analysis of over 100 western children’s picture-books reveals that the majority of children’s contemporary literature frames philanthropy as an individual act of personal responsibility which takes place in the private sphere, focusing on singular acts of kindness and generosity, overlooking connections between the cause and wider societal socioeconomic, political, environmental and/or social justice issues. Furthermore, many stories reinforce concerning traditional and stereotypical ideas of gender, race and power. Nonetheless, we also identify several books which notably seek to move beyond this, connecting acts of philanthropy to wider ideological, economic and political factors, placing a strong emphasis on social justice. In conclusion, we call for further research to explore how philanthropic stories are used within the home and classroom, and what children interpret as the ‘good philanthropic citizen’ through these stories.
Multifactorial analysis of football penalty kicks in the Portuguese First League: A replication study
Authors: Almeida Carlos Humberto , Volossovitch Anna
Published: February 2022

Although penalty-kick outcomes in football are thought to be affected by different factors, many of them have not been sufficiently analysed yet. This study sought to replicate and extend the findings of a previous multifactorial analysis of penalty kicks in Union of European Football Associations (UEFA) club competitions. For that purpose, we used a larger sample ( n = 833), collected from eight consecutive seasons of the Portuguese First League (from 2013–2014 to 2020–2021) and adding the variables season, team quality and the penalty taker's playing status (starter or substitute) to the analysis. Chi-square tests of independence only showed significant associations of performance-related factors ( shot horizontal and vertical directions, and goalkeeper's action) with penalty-kick outcome. Multinomial logistic regression model revealed significant increases in the odds of penalty kicks being saved when (1) shots were directed to the centre-left zones compared to the right zones (penalty taker's perspective), (2) shots were directed to the low zones of the goal and (3) goalkeepers dived to the correct side of the ball. In addition, the probability of missing the target or hitting the goalpost/crossbar significantly increased when shots aimed the high zones of the goal. Noteworthy, the risk of a penalty being saved when the shot was directed to the bottom zones of the goal outweighed the “miss factor” of shooting high. These findings enable coaches to develop optimal strategies for taking and saving penalty kicks, thus increasing the likelihood of both players to succeed in competitive matches, regardless of individual attributes and/or casual competitive circumstances.
Radiographic Comparison of Heterotopic Ossification After Primary Total Ankle Arthroplasty in Fourth-Generation Implants
Authors: Doyle Matthew D. , Mitchell Logan H. , Ishibashi Megan A. , Castellucci-Garza Francesca M. , Sherick Ryan M. , Rao Nilin M.
Published: February 2022

Heterotopic ossification (HO) is a known sequela in total ankle arthroplasty. The purpose of this study was to determine the radiographic incidence of HO in fourth-generation total ankle implants including the INFINITY, CADENCE, and VANTAGE. Radiographs were assessed for the incidence and location of HO in each implant using the modified Brooker classification. Seventy-one patients were included. There were 41 INFINITY, 16 CADENCE, and 14 VANTAGE implants. The average radiographic follow-up was 19.7 months. The incidence of HO was 69.0%. Overall, the HO was Class I in 31 cases (63.3%); Class II in 7 cases (14.3%); Class III in 10 cases (20.4%); and Class IV in 1 case (2.0%). For INFINITY; n = 33 patients (80.5%), CADENCE; n = 8 patients (50%); VANTAGE n = 8 patients (57.1%). When comparing INFINITY with CADENCE/VANTAGE, there was a statistically significant difference in presence of HO (P = 0.01). When comparing INFINITY with CADENCE, there was a statistically significant difference in presence of HO (P = 0.04). In the 33 cases of INFINITY with HO, 30 had neutral or posterior coverage, and in 4 cases, the prosthesis did not extend to the posterior tibial cortex (P = 0.005). This study demonstrates a continued high rate of HO with 3 fourth-generation ankle implants in the short term, although many were Class 1 and posterior. The INFINITY had a higher overall incidence of HO. Adequate posterior cortical coverage did not play a role in radiographic presence of HO. Further research is warranted with longer-term follow-up to determine the clinical and radiographic significance of HO.

Level of Evidence:

Level III: Retrospective comparative
Absolute Certainty and Political Ideology: A Systematic Test of Curvilinearity
Authors: Costello Thomas H. , Bowes Shauna M.
Published: February 2022

The present investigation examined curvilinear relations between political ideology, on the one hand, and absolute certainty and dogmatism, on the other, across six online samples ( N = 2,889). Ideological extremists were more likely than others to be absolutely certain: About one in three extremists reported being absolutely (i.e., 100%) certain of the correctness of their political beliefs, whereas about one in 15 non-extremists reported being absolutely certain. Although absolute political certainty was relatively symmetrical across the political left and right, conservatives tended to report greater domain-general dogmatism than liberals. Extremism effects for domain-general dogmatism were also present, however; and ideological asymmetries in dogmatism appeared to be driven by social, rather than economic, ideology. Taken together, these findings underscore the complexity of relations between absolute certainty, dogmatism, and ideology, ultimately challenging the sufficiency of contemporary psychological accounts of ideological (a)symmetries to describe our complex political reality.
How digital marketing can use a smart phone app to improve any business’s bottom line
Authors: Manko Barbara A
Published: February 2022

The marketing strategy of offering customer loyalty rewards has evolved with the use of technology. Instead of printing old-fashioned paper coupons, punch cards, and flyers to advertise special offers, customers can access their rewards through a customized app. The app functions as an all-in-one tool to attract customers, send offers, communicate specials, take orders, offer new products and services to existing customers, and so much more. During the restrictions of the COVID-19 lockdown, businesses found online communication soaring, with the ability to offer no-contact delivery of goods and services, and many businesses are keeping the technology they implemented during lock down because it is just good business. The use of application creation for digital marketing has the ability to supercharge sales by more effectively reaching the target audience and providing business analytics on users.
Latrine utilization and associated factors in East Gojjam Zone, North-West Ethiopia: A community-based cross-sectional study
Authors: Melesse Misganaw Fikrie , Aynalem Bewket Yeserah
Published: February 2022

Objective:

This research was aimed at assessing latrine utilization and associated factors in East Gojjam Zone, North West Ethiopia.

Methods:

A community-based cross-sectional study was conducted on households of East Gojjam Zone, from 1 February to 30 May 2021. Multistage cluster sampling technique was used to select 806 study participants into the study. Data were collected through pretested structured interview questionnaires and direct observation. Collected data were entered and cleaned using EPI info version 7.2 and analysed using SPSS version 23 software package. Bivariable and multivariable logistic regression was employed to assess association of the variables and controlling the effect of confounders, respectively. P value less than 0.05 was taken as statistically significant.

Results:

The overall latrine utilization in East Gojjam Zone was found to be 45.4% (95% confidence interval = 42.2–49.1). Occupation (adjusted odds ratio = 2.248, 95% confidence interval = 1.037–4.876), participating in model family training (adjusted odds ratio = 2.481, 95% confidence interval = 1.802–3.415), water availability (adjusted odds ratio = 2.456, 95% confidence interval = 1.514–3.983), and type of latrine (adjusted odds ratio = 2.013, 95% confidence interval 1.648–2.972) had statistically significant association with latrine utilization.

Conclusion:

Latrine utilization in East Gojjam Zone was found to be low relative to other studies and the country’s plan. It is very far apart from the Ethiopian latrine coverage and utilization plan (100%). Occupational status, participated in the model family training, water availability, and type of toilet were significantly associated with toilet utilization. Encouraging private latrine construction with accessibility of water and all households participating in model family training may increase latrine utilization in East Gojjam Zone. Further observational study triangulated with qualitative research should be conducted to provide more strong evidence for further improvement of household latrine utilization status in East Gojjam Zone.
Efficacy of Supercapsular Percutaneously-Assisted Total Hip Arthroplasty in the Elderly With Femoral Neck Fractures: A Meta-analysis
Authors: Zhao Fulong , Xue Yang , Wang Xuefei , Zhan Yunjia
Published: February 2022

Introduction

Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach is a novel minimally invasive surgical technique for total hip arthroplasty (THA). This meta-analysis was conducted to evaluate the outcomes following THA via the SuperPATH approach in elderly patients with femoral neck fractures (FNFs), compared with those via traditional surgical approaches.

Methods

Eligible studies were retrieved through searching 7 electronic databases and manually screening related references. Objectives were surgical-related parameters, functional outcomes, and incidence of postoperative complications.

Results

9 comparative studies were included. Pooled results suggested that at the cost of longer operative time (WMD: 14.25, 95% CI: 3.25 to 25.25), the SuperPATH technique was superior to traditional approaches regarding incision length (WMD: −4.51, 95% CI: −6.46 to −2.56), intraoperative blood loss (WMD: −80.47, 95% CI: −122.36 to −38.57), and hospital stays (WMD: −3.35, 95% CI: −5.05 to −1.65). SuperPATH groups exhibited significantly increased Harris Hip Scores within 1 month after surgery (7d, WMD: 9.85, 95% CI: 6.40 to 13.30; 14d, WMD: 10.68, 95% CI: 8.29 to 13.08; 1 month, WMD: 6.17, 95% CI: 3.56 to 8.78) and had a reduced incidence of overall complications (OR: .19, 95% CI: .09 to .41). No significant differences were found between the 2 groups regarding postoperative pain relief.

Conclusion

Elderly patients with FNFs are potential candidates for THA treatment via the SuperPATH technique, which is associated with improved surgical outcomes, better short-term functional recovery, and lower risk of total complications as compared to traditional approaches. Additional studies are needed to further confirm our conclusions and validate the long-term efficacy of SuperPATH.
Operationalizing Organizational Capacity Assessment for Identifying Capability Gaps in the Indian Hospital Sector
Authors: A. N. Raghavendra , G. Vijayakumar , K. Adarsha
Published: February 2022

This study interprets the development and validation of the organizational capacity assessment tool, which is designed to evaluate the gaps in capabilities of hospitals across India. This assessment tool was tested on 300 managers working in hospitals across 16 states of India, with a majority coming from small-sized hospitals. The 40-item measure assessed six factors of organizational capabilities, namely, organizational foundation, organizational resources, organizational capacities, core task implementation, benefits and impacts, and external relations. Gaps in the capacities were identified. Internal consistency was evaluated using the Cronbach’s alpha. Confirmatory factor analysis supported the inclusion of the items in the questionnaire. In addition, structural equation modeling was conducted to evaluate the goodness of fit of the model demonstrating the relationships between the study variables. It was found that individual factors such as core task implementation and organizational foundation significantly influenced benefits and impacts as well as external relations. Similarly, organizational resources positively impacted evaluation capacity outcomes. In contrast, organizational capacity had no significant influence on either benefits and impacts or external relations. This study only validates the capacity assessment tool; however, it needs to be measured with varied types of work personnel within the healthcare sector as there is a huge diversity in the work force of this area. Based on this empirical study, many future research implications were suggested.
Reliability of a Novel Automatic Knee Arthrometer for Measuring Knee Laxity After Anterior Cruciate Ligament Ruptures
Authors: Niu Xingyue , Mai Hemuti , Wu Tong , Jiang Yanfang , Duan Xiaoning , Liu Mengzhen , Liu Jingyu , Ding Li , Ao Yingfang
Published: February 2022

Background:

The accuracy of existing devices for measuring knee laxity is adversely affected by examiner reliability.

Purpose:

To compare the accuracy of a novel automatic knee arthrometer (AKA) to that of the KT-2000 arthrometer for measuring knee laxity after anterior cruciate ligament (ACL) ruptures.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

We measured anterior displacement and the anterior displacement difference (ADD) at 134 N of anterior force in 221 healthy volunteers and 200 patients with ACL ruptures. All trials were performed by the same 2 examiners. We first analyzed the effects of examiner, side assessed, and device type using the intraclass correlation coefficient (ICC), t test, and F test. We then used the receiver operating characteristic curve to compare the diagnostic value of the measurements between devices.

Results:

In repeated measurements for a single healthy volunteer, there were no differences in the variance of the measurements between sides according to the AKA (standard deviation of right vs left knee for examiner A: 0.43 vs 0.58 mm, respectively [ P = .39]; for examiner B: 0.49 vs 0.77 mm, respectively [ P = .81]), while the KT-2000 measurements showed differences (standard deviation of right vs left knee for examiner A: 1.47 vs 0.80 mm, respectively [ P = .02]; for examiner B: 1.78 vs 0.91 mm, respectively [ P = .01]). The ADD assessed by the AKA was not significantly different between examiners A and B (0.50 vs 0.75 mm, respectively; P = .27; ICC = 0.83), but the KT-2000 showed a difference (1.07 vs 2.01 mm, respectively; P = .01; ICC = 0.55). The ADD of 20 healthy volunteers assessed by the AKA was less than that by the KT-2000 (0.98 vs 1.41 mm, respectively; P = .04). When comparing the diagnostic value of the 2 devices in the sample of 200 patients with ACL ruptures and 200 healthy controls, the area under the receiver operating characteristic curve for the AKA was larger than that for the KT-2000 (0.93 vs 0.87, respectively; P ≤ .01), and the threshold values were 1.75 and 2.73 mm, respectively.

Conclusion:

The AKA can be used to determine the degree of knee laxity in ACL injuries and to provide indications for treatment.
Enriching Clinical Encounters Through Qualitative Research
Authors: Hovey Richard B
Published: February 2022

Although many medical and dental journals publish qualitative research this does not mean they are being read by those who could directly benefit from their scholarly contributions. From clinician to the patient. This perspective on qualitative research for medical and dental education was written with the intention of introducing qualitative research to those who may be unaware of its possibilities and utility for clinical education. Its task is to inform others about life conditions they may not have experienced themselves other than in a biomedical context. As researchers, clinicians, and especially for students who read academic, medical, and clinical research papers which are appropriately discipline-and methodology-specific. We may find ourselves encultured to privileging one type of research methodology over others. For example, exclusively considering quantitative research methodologies as being more rigorous and trustworthy. This brief commentary may offer the opportunity for interested healthcare providers and researchers to expand their understanding of the purpose of qualitative research, its role and application in enhancing patient engagement, clinical practices, and person-centered research.
A Prospective Observational Study Assessing the Impacts of Health Literacy and Psychosocial Determinants of Health on 30-day Readmission Risk
Authors: Deshpande Ojas A , Tawfik John A , Namavar Aram A , Nguyen KimNgan P , Vangala Sitaram S , Romero Tahmineh , Parikh Neil N , Dowling Erin P
Published: February 2022

Our objective was to assess the utility of an assessment battery capturing health literacy (HL) and biopsychosocial determinants of health in predicting 30-day readmission in comparison to a currently well-adopted readmission risk calculator. We also sought to capture the distribution of inpatient HL, with emphasis on inadequate and marginal HL (an intermediate HL level). A prospective observational study was conducted to obtain HL and biopsychosocial data on general medicine inpatients admitted to the UCLA health system. Five hundred thirty-seven subjects were tracked prospectively for 30-day readmission after index hospitalization. HL was significantly better at predicting readmission compared to LACE + (Length, admission acuity, comorbidities, emergency room visits) alone ( P = .013). A multivariate model including education, insurance, and language comfort was a strong predictor of adequate HL ( P < .001). In conclusion, HL offered significant improvement in risk stratification in comparison to LACE + alone. Patients with marginal HL were high-risk, albeit difficult to characterize. Incorporating robust HL and biopsychosocial determinant assessments may allow hospital systems to allocate educational resources towards at-risk patients, thereby mitigating readmission risk.
Exploring Online Participation and Discussion in an Online Professional Learning Activity on Twitter
Authors: Zheng Binbin , Beck Dallaghan Gary , Gomez Michael , Holihan Stephen
Published: February 2022

BACKGROUND

Twitter offers opportunities to share resources, engage in online discussions, and network with other professionals. In medical education, Twitter is also being used for professional development. Little is known about the level of engagement in topical chats related to medical education. This study explores how medical educators participated and engaged in Twitter-facilitated discussion activity using #MedEdChat.

METHODS

All twitter chat transcripts using the hashtag #MedEdChat from Thursday night synchronous discussions were collected between January and December 2019. A total of 37 discussion topics were included. To answer the first research question about the overall participation, descriptive statistics were used to analyze the number of participants, posts, retweets, and interactions for each week's discussion. To answer the second question about types of discussion participants engaged in during weekly chats, a combination of top-down and bottom-up coding strategy was adopted with three categories: functional, social, and content.

RESULTS

This study identified five themes from #MedEdChat discussions: curriculum, faculty development, scholarship, assessment, and general medical education topics. All discussions had an average of 26 participants, with an average of 145 total posts, including 37 original posts, 52 retweets, and 56 interactions (mentions or replies using @). In terms of types of discussion, content-related tweets were most frequently posted, followed by functional and social tweets.

CONCLUSION

By identifying the patterns of participation and content of discussions, preliminary findings suggest implications for future study to further explore the social interactions and knowledge building processes among online participants in the Twitter-facilitated medical education online community.
Novel/Multidisciplinary Approach in Treating Morbidly Obese Patients with GERD
Authors: Ibrahim Mina Aziz , Heis Farah , Almagno Vincent , Amro Chris , Oleynikov Dmitry
Published: February 2022

Focus: Discuss indications for concurrent treatments; Dor/sleeve, Hill/sleeve, linx/sleeve, endoscopic/sleeve, etc. Indications for joint approach with GI?
The complex mechanism of Ti4+ incorporation into litidionite from the Somma–Vesuvius volcano, Italy
Authors: Balassone Giuseppina , Panikorovskii Taras L. , Pellino Annamaria , Bazai Ayya V. , Bocharov Vladimir N. , Krivovichev Sergey V. , Petti Carmela , Cappelletti Piergiulio , Mondillo Nicola
Published: February 2022

For this study, the rare Cu-bearing silicate fumarolic assemblages from the Somma–Vesuvius volcano, Italy, characterised by the rare mineral litidionite, CuKNaSi4O10, were investigated. We report new data about Cu- and Ti-bearing phases found in these mineralisations, in which Ti-bearing litidionite occurs together with kamenevite, perovskite and rutile. Ti-bearing litidionite appears on the latest stages of partial crystallisation of Ti-bearing silica glass. Incorporation of Ti4+ into the litidionite crystal structure was investigated in detail. The Raman spectra of Ti-bearing litidionite contains an intense band at 597 cm−1 related to anti-symmetric bending vibrations of Si‒O bonds or overlapping stretching vibrations of Ti‒O bonds. The bands in the range 350‒500 cm−1 correspond to symmetric bending vibrations of O‒Si‒O bonds and overlapping stretching vibrations of Ti‒O bonds. The crystal structure of Ti-litidionite has been refined in the P$\bar{1}$ space group, a = 6.9699(7), b = 7.9953(10), c = 9.8227(10) Å, α = 105.186(9), β = 99.458(8) and γ = 114.489(10) to R1 = 0.064 for 1726 unique observed reflections. The refinement of the site-occupation factors confirmed the presence of Ti at a five-coordinated M site. The mean bond distance of 2.125 Å for the M site agrees with its refined occupancy (Ti0.32Cu0.30Ca0.29Fe0.09)1.00. The incorporation of Ti into the litidionite structure is accompanied by the complex heteropolyhedral substitution according to the scheme VTi4+ + VII–VIII□ + IVAl3+ ↔ VCu2+ + VII-VIII(Na,K)+ + IVSi4+. Two possible configurations for the phase with maximal TiO2 content (12.06 wt.% or 0.56 Ti apfu) CuTiK□Na2Si7AlO20 (Z = 1) or CuTiK2Na□Si7AlO20 (Z = 1) have been proposed.
Reduced learning bias towards the reward context in medication-naive first-episode schizophrenia patients
Authors: Cheng Xiaoyan , Wang Lingling , Lv Qinyu , Wu Haisu , Huang Xinxin , Yuan Jie , Sun Xirong , Zhao Xudong , Yan Chao , Yi Zhenghui
Published: February 2022

Background

Reinforcement learning has been proposed to contribute to the development of amotivation in individuals with schizophrenia (SZ). Accumulating evidence suggests dysfunctional learning in individuals with SZ in Go/NoGo learning and expected value representation. However, previous findings might have been confounded by the effects of antipsychotic exposure. Moreover, reinforcement learning also rely on the learning context. Few studies have examined the learning performance in reward and loss-avoidance context separately in medication-naïve individuals with first-episode SZ. This study aimed to explore the behaviour profile of reinforcement learning performance in medication-naïve individuals with first-episode SZ, including the contextual performance, the Go/NoGo learning and the expected value representation performance.

Methods

Twenty-nine medication-naïve individuals with first-episode SZ and 40 healthy controls (HCs) who have no significant difference in age and gender, completed the Gain and Loss Avoidance Task, a reinforcement learning task involving stimulus pairs presented in both the reward and loss-avoidance context. We assessed the group difference in accuracy in the reward and loss-avoidance context, the Go/NoGo learning and the expected value representation. The correlations between learning performance and the negative symptom severity were examined.

Results

Individuals with SZ showed significantly lower accuracy when learning under the reward than the loss-avoidance context as compared to HCs. The accuracies under the reward context (90%win- 10%win) in the Acquisition phase was significantly and negatively correlated with the Scale for the Assessment of Negative Symptoms (SANS) avolition scores in individuals with SZ. On the other hand, individuals with SZ showed spared ability of Go/NoGo learning and expected value representation.

Conclusions

Despite our small sample size and relatively modest findings, our results suggest possible reduced learning bias towards reward context among medication-naïve individuals with first-episode SZ. The reward learning performance was correlated with amotivation symptoms. This finding may facilitate our understanding of the underlying mechanism of negative symptoms. Reinforcement learning performance under the reward context may be important to better predict and prevent the development of schizophrenia patients’ negative symptom, especially amotivation.
The interplay between multisite pain and insomnia on the risk of anxiety and depression: the HUNT study
Authors: Marcuzzi Anna , Skarpsno Eivind Schjelderup , Nilsen Tom Ivar Lund , Mork Paul Jarle
Published: February 2022

Background

Chronic musculoskeletal pain and insomnia frequently co-occur and are known independent risk factors for anxiety and depression. However, the interplay between these two conditions on the risk of anxiety and depression has not been explored.

Methods

A population-based prospective study of 18,301 adults in the Norwegian HUNT Study without anxiety or depression at baseline (2006–2008). We calculated adjusted risk ratios (RRs) with 95% confidence intervals (CIs) for anxiety and/or depression at follow-up (2017–2019), associated with i) number of chronic pain sites, and ii) chronic pain and insomnia symptoms jointly.

Results

At follow-up, 2155 (11.8%) participants reported anxiety and/or depression. The number of pain sites was positively associated with risk of anxiety and/or depression (Ptrend, < 0.001). Compared to people without chronic pain and insomnia symptoms, people with ≥5 pain sites and no insomnia symptoms had a RR of 1.52 (95% CI: 1.28 to 1.81) for anxiety and/or depression, those with no chronic pain but with insomnia had a RR of 1.78 (95% CI: 1.33 to 2.38), whereas the RR among people with both ≥5 pain sites and insomnia was 2.42 (95% CI: 1.85 to 3.16). We observed no synergistic effect above additivity for the combination of ≥5 pain sites and insomnia on risk of anxiety and/or depression.

Conclusions

This study shows that people with multisite chronic pain who also suffer from insomnia are at a particularly high risk for anxiety and/or depression, suggesting that insomnia symptoms are important contributors to the association between multisite pain and common mental health problems.
Parent-adolescent agreement in reported moderate-to-vigorous intensity physical activity during the COVID-19 pandemic
Authors: Nagata Jason M. , Cortez Catherine A. , Iyer Puja , Dooley Erin E. , Ganson Kyle T. , Conroy Amy A. , Pettee Gabriel Kelley
Published: February 2022

Purpose

To describe the agreement between parent- and adolescent- reports of adolescent moderate-to-vigorous intensity physical activity (MVPA) and to determine sociodemographic factors associated with MVPA reporting differences during the COVID-19 pandemic.

Methods

We analyzed data collected in May 2020 from the Adolescent Brain Cognitive Development Study (ABCD, N = 4841), a U.S. prospective cohort study. We quantified past weekly adolescent MVPA levels as reported by the parent and adolescent (referent). Intra-class correlation coefficients (ICC) and Bland-Altman plots were used to examine the degree of agreement between parent- and adolescent- reports.

Results

When quantifying adolescent MVPA during the same recall period, median (p25, p75) MVPA (h∙wk.− 1) was 2.17 (0.00, 6.00) as reported by adolescents and 1.52 (0.29, 4.75) by parents with a mean difference of 4.89. Statistically significant differences in reports of MVPA were found in households with income > $75,000: on average, adolescents reported higher MVPA levels than their parents. Bland-Altman plots illustrated that, among adolescents reporting no or little MVPA, there was higher parent-adolescent agreement. However, among adolescents reporting high levels of MVPA, there was less agreement between the parent- and adolescent- reports.

Conclusions

Despite more time spent together at home during the pandemic, there was generally low agreement between parent- and adolescent- reports of adolescent MVPA. Future research could examine parent-adolescent agreement of MVPA within the context of device-based measures (e.g., accelerometers), determine reasons for differences in parent-adolescent reporting of MVPA, and inform interventions for improved parental involvement and monitoring of MVPA.
The differences of Slovenian and Italian daily practices experienced in the first wave of covid-19 pandemic
Authors: Pišot Saša , Šimunič Boštjan , Gentile Ambra , Bianco Antonino , Coco Gianluca Lo , Pišot Rado , Drid Patrik , Milovanović Ivana
Published: February 2022

Background

The COVID-19 pandemic situation with the lockdown of public life caused serious changes in people's everyday practices. The study evaluates the differences between Slovenia and Italy in health-related everyday practices induced by the restrictive measures during first wave of the COVID-19 pandemic.

Methods

The cross-sectional cohort study examined changes through an online survey conducted in nine European countries from April 15–28, 2020. The survey included questions from a simple activity inventory questionnaire (SIMPAQ), the European Health Interview Survey, and some other questions. To compare difference in changes between European countries we examined Italy with severe and its neighbour country Slovenia with low incidence and victims of COVID-19 epidemic. 956 valid responses from Italy (N = 511; 50% males) and Slovenia (N = 445; 26% males) were investigated.

Results

During the survey, there was a 4.7-fold higher incidence and 12.1-fold more deaths (per 100,000) in Italy than in Slovenia. Barring periods and measures were similar, the latter more stringent in Italy. We found more changes in Italy than in Slovenia: physical inactivity increased (Italy: + 65% vs. Slovenia: + 21%; p < 0.001), walking time decreased (Italy: -68% vs. Slovenia: -4.4%; p < 0.001); physical work increased by 38% in Slovenia (p < 0.001), and recreation time decreased by 37% in Italy (p < 0.001). Italians reported a decrease in quality of general health, fitness level, psychological well-being, quality of life and care for own health (p < 0.001); Slovenians showed a decline in psychological well-being and quality of life (p < 0.001) but generally had a higher concern for their own health (p = 0.005). In pooled participants, changes in eating habits (meal size and consumption of unhealthy food), age and physical inactivity were positively correlated with increases in body mass, while changes in general well-being and concern for health were negatively correlated.

Conclusion

The study shows that the negative impact of COVID -19 measures is greater in Italy where the pandemic COVID -19 was more prevalent than in Slovenia with low prevalence. Additional consideration should be given to the negative impact of COVID-19 measures on some health-related lifestyle variables when implementing further measures to mitigate the COVID-19 pandemic.
Adolescents’ proxy reports on obesity-related parenting practices: factorial validity and reliability across four behavioral domains
Authors: Fuligni Gabriel L. , Gonzalez Christopher J. , Figueroa Roger
Published: February 2022

Background

Adolescents’ energy balance behaviors are precursors to obesity shaped by the practices or strategies that many parents implement. Although key stakeholders to their families, adolescents are rarely considered to report on these obesity-related parenting practices. The aim of this study is to assess the factorial and predictive validity of adolescents’ proxy-report of parents’ obesity-related parenting across four behavioral domains.

Methods

This study used data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) study. This study tests whether adolescents’ proxy reports about their parents’ obesity-related parenting are significantly associated with parents’ responses on their own obesity-related parenting, as well as whether these reports are significantly associated to parent-adolescent energy balance behaviors. Factorial validity was assessed using linear regression and Confirmatory Factor Analysis (CFA), whereas predictive validity was assessed using Actor-Partner Interdependence Modeling (APIM).

Results

Regression results indicated that adolescents’ proxy report is significantly associated with parents’ report of their own parenting in all four domains (β = .59—.71; p < 0.05). CFA results indicated a final factor structure that loaded significantly onto hypothesized obesity-related parenting domains (β > .30) in both adolescents and parents. APIM results indicated that both parent- (β = .32; p < 0.05) and adolescent-(β = .21; p < 0.05) reported obesity parenting for fruit and vegetable consumption were associated with their own fruit and vegetable intake. In addition, adolescent-reported physical activity parenting was significantly associated with adolescent physical activity (β = 0.23; p < 0.05). Regarding partner effects, only parent-reported parenting for fruit and vegetable consumption were significantly associated with adolescent intake of fruit and vegetables (β = 0.15, p < 0.05) and adolescent-reported physical activity parenting was significantly associated with parental physical activity (β = 0.16, p < 0.05). Neither adolescent nor parent reported parenting were significantly associated with screen time or junk food intake outcomes. Each final obesity-related parenting scale had good internal consistency (a = .74-.85).

Conclusions

We found that adolescent- and parent-reported obesity-related parenting were significantly associated, while adolescent-reported parenting were more explanatory of fruit and vegetable intake and physical activity than parent-reported parenting. These findings suggest that adolescent proxy reports may be a valid source of information on obesity-related parenting.
The emotional side of post-traumatic stress reaction during COVID-19 pandemic: an Italian survey
Authors: Ferrante Gianluigi , Rossini Pierre Gilbert , Rousset Stefano , Ostacoli Luca , Piccinelli Cristiano , Carletto Sara , Giordano Livia
Published: February 2022

Background

Social restrictions due to COVID-19 might have had a significant impact on mental health. The aim of this study was to assess the prevalence of four emotional domains (nervousness, anger, numbness, physiological arousal) in a sample of citizens during the first pandemic wave in 2020, and their association with sociodemographic characteristics, housing conditions and lifestyle modifications.

Methods

A cross-sectional study based on a self-administered online questionnaire was set up to investigate emotions. Respondents were recruited through a non-probabilistic snowball sampling approach. The SPAN questionnaire was used to measure emotions in the interviewed population. The association between emotions and independent variables (gender, age, marital status, educational level, working condition, housing condition, COVID-19 positivity, sleep disturbance, increase in alcohol consumption and decrease in physical activity) was assessed through the multivariate Poisson regression.

Results

A total of 6,675 subjects were included in the analysis. Almost half of respondents (48.9%) experienced nervousness, 41.3% anger, 15.6% numbness and 18.8% physiological arousal. Females were more likely to face nervousness, anger and physiological arousal. For all the outcomes a decreasing trend was observed from younger to older. Singles were more likely to experience numbness compared to married people. Increase in alcohol consumption was associated with nervousness, anger and numbness. Decrease in physical activity was associated with nervousness, anger and physiological arousal. Restless sleep was the variable most associated with all emotional domains.

Conclusions

The first COVID-19 pandemic wave had a significant emotional impact on this sample, especially among younger people, singles and females. Even without reaching clinical relevance, these emotions could represent a form of psychological distress, which requires the implementation of preventive strategies, in particular regarding lifestyle care.
Tuberculosis contact tracing yield and associated factors in Uganda
Authors: Baluku Joseph Baruch , Nabwana Martin , Winters Muttamba , Bongomin Felix
Published: February 2022

Background

The yield of tuberculosis (TB) contact tracing is historically low in Uganda. We determined factors associated with a positive contact tracing yield at an urban public TB clinic in Kampala, Uganda.

Methods

We reviewed contact tracing registers of index TB cases registered between 2015 and 2020 at Kitebi Health Center, a primary level facility. Contacts who had symptoms of TB were designated as having presumptive TB. A contact investigation that yielded a new TB case was designated as a positive yield. We used logistic regression to determine factors associated with a positive yield of contact tracing.

Results

Of 778 index TB cases, 455 (58.5%) had a contact investigation conducted. Index cases with a telephone contact in the unit TB register (adjusted odds ratio (aOR) 1.66, 95% CI 1.02–1.97, p = 0.036) were more likely to have a contact investigation conducted than those who did not. Of 1350 contacts, 105 (7.8%) had presumptive TB. Of these, 73 (69.5%) were further evaluated for active TB and 29 contacts had active TB. The contact tracing yield for active TB was therefore 2.1% (29/1,350). The odds of a positive yield increased tenfold with each additional presumptive contact evaluated for active TB (aOR 10.1, 95% CI 2.95–34.66, p < 0.001). Also, retreatment index TB cases were more likely to yield a positive contact (aOR 7.69 95% CI 2.08–25.00, p = 0.002) than to new cases.

Conclusion

TB contact tracing should aim to evaluate all contacts with presumptive TB and contacts of retreatment cases to maximise the yield of contact tracing.
Does MIS-TLIF or TLIF result in better pedicle screw placement accuracy and clinical outcomes with navigation guidance?
Authors: Liu Jia Bin , Wu Jun Long , Zuo Rui , Li Chang Qing , Zhang Chao , Zhou Yue
Published: February 2022

Background

Although previous studies have suggested that navigation can improve the accuracy of pedicle screw placement, few studies have compared navigation-assisted transforaminal lumbar interbody fusion (TLIF) and navigation-assisted minimally invasive TLIF (MIS-TLIF). The entry point of pedicle screw insertion in navigation-assisted MIS-TLIF (NM-TLIF) may deviate from the planned entry point due to an uneven bone surface, which may result in misplacement. The purpose of this study was to explore the pedicle screw accuracy and clinical consequences of MIS-TLIF and TLIF, both under O-arm navigation, to determine which surgical method is better.

Methods

A retrospective study of 54 patients who underwent single-segment NM-TLIF or navigation-assisted TLIF (N-TLIF) was conducted. In addition to the patients’ demographic characteristics, intraoperative indicators and complications, the Oswestry Disability Index (ODI) and visual analog scale (VAS) score were recorded and analyzed preoperatively and at the 1-, 6-, and 12-month and final postoperative follow-ups. The clinical qualitative accuracy and absolute quantitative accuracy of pedicle screw placement were assessed by postoperative CT. Multifidus muscle injury was evaluated by T2-weighted MRI.

Results

Compared with N-TLIF, NM-TLIF was more advantageous in terms of the incision length, intraoperative blood loss, drainage volume, time to ambulation, length of hospital stay, blood transfusion rate and analgesia rate (P < 0.05). The ODI and VAS scores for low back pain were better than those of N-TLIF at 1 month and 6 months post-surgery (P < 0.05). There was no significant difference in the clinical qualitative screw placement accuracy (97.3% vs. 96.2%, P > 0.05). The absolute quantitative accuracy results showed that the axial translational error, sagittal translational error, and sagittal angle error in the NM-TLIF group were significantly greater than those in the N-TLIF group (P < 0.05). The mean T2-weighted signal intensity of the multifidus muscle in the NM-TLIF group was significantly lower than that in the N-TLIF group (P < 0.05).

Conclusions

Compared with N-TLIF, NM-TLIF has the advantages of being less invasive, yielding similar or better screw placement accuracy and achieving better symptom relief in the midterm postoperative recovery period. However, more attention should be given to real-time adjustment for pedicle insertion in NM-TLIF rather than just following the entry point and trajectory of the intraoperative plan.
Frailty index is useful for predicting postoperative morbidity in older patients undergoing gastrointestinal surgery: a prospective cohort study
Authors: Gu Chaoyang , Lu Anqing , Lei Chen , Wu Qingbin , Zhang Xubing , Wei Mingtian , Wang Ziqiang
Published: February 2022

Background

Many assessment tools have been used to identify frail surgical patients. This study was designed to explore the prediction value of the frailty index (FI) for postoperative morbidity in older patients undergoing elective gastrointestinal surgery.

Methods

Between January 2019 and September 2020, we conducted a prospective study in our hospital, and patients aged over 65 years were enrolled. The FI assessment was conducted by two specialist nurses based on the 38-item scale, and patients were considered frail if the FI score was ≥ 0.25. The primary outcome was 30-day postoperative morbidity. Univariable and multivariable analyses were used to find the risk factors related to postoperative morbidity.

Results

A total of 246 consecutive patients were enrolled, for whom the median age was 72.0 [interquartile range (IQR): 67.0–77.0] years old, and 175 (71.1%) were male. Of these, 47 (19.1%) were frail. Patients with frailty were associated with older age (p < 0.001), higher American Society of Anesthesiologists (ASA) grade (p = 0.006), lower body mass index (p = 0.001), lower albumin (p = 0.003) and haemoglobin (p < 0.001) levels, increased blood loss (p = 0.034), increased risk of postoperative morbidity (p < 0.001), increased median length of stay (p = 0.017), and increased median postoperative hospital stay (p = 0.003). Multivariable analysis revealed that ASA grade [odds ratio (OR): 2.59, 95% confidence interval (CI) 1.19–5.64, p = 0.016], FI score (OR 7.68, 95% CI 3.19–18.48, p < 0.001) and surgical complexity (OR 22.83, 95% CI 5.46–95.51, p < 0.001) were independent predictors of 30-day postoperative morbidity. However, for patients with major surgery, FI score was the only independent predictor (OR 8.67, 95% CI 3.23–23.25, p < 0.001).

Conclusion

Frailty was associated with adverse perioperative outcomes, and the 38-item FI scale was a useful frailty screening tool for older patients undergoing elective gastrointestinal surgery. For patients with major surgery, frailty was a more reliable predictor of postoperative 30-day morbidity than age and ASA grade.