bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on preparation technology of animal skin intrinsic multifunctional packaging material
Authors: Zhang Jiaxing , Long Zhongzhen , Chen Hui , Shan Zhihua
Published: May 2022

High-end leather packaging material safe, environmentally friendly, and has a good market prospect. It is an interesting technology to solve the intrinsic functionalization of skin collagen packaging materials. Nano-Hydroxyapatite (HA) precursors solution with a specific 1.67 calcium to phosphorus ratio (Ca/P) were infiltrated into the three-dimensional collagen network matrix (3DCM) in situ growth based on goat skin pretreated with glutaraldehyde and the HAG-3DCM was obtained. After compression, a transparent film HAG-3DCM-was formed. Structural and functional characterization showed that the HAG-3DCM-CM film has good comprehensive performance, such as the tensile strength increased to 67 mPa from 28 mPa, the bending resistance increased from 5 cycles to 50 cycles and the swelling degree from 55% to 12%. HA disperses and fixes the three-dimensional collagen network matrix (3DCM) fibers, improves its stability against humidity and heat, and the thermal conductivity changed from 0.72 W/(K•m) to 0.65 W/(K•m). HAG-3DCM has a relatively high limiting oxygen index of 26.5%. This study demonstrates a new approach for preparing animal skin packaging materials with new application value.
Proteomic alteration of endometrial tissues during secretion in polycystic ovary syndrome may affect endometrial receptivity
Authors: Li Jun , Jiang Xiaohua , Li Caihua , Che Huihui , Ling Lin , Wei Zhaolian
Published: May 2022

Embryo implantation is a complex developmental process that requires coordinated interactions among the embryo, endometrium, and the microenvironment of endometrium factors. Even though the impaired endometrial receptivity of patients with polycystic ovary syndrome (PCOS) is known, understanding of endometrial receptivity is limited. A proteomics study in three patients with PCOS and 3 fertile women was performed to understand the impaired endometrial receptivity in patients with PCOS during luteal phases. Through isobaric tags for relative and absolute quantitation (iTRAQ) analyses, we identified 232 unique proteins involved in the metabolism, inflammation, and cell adhesion molecules. Finally, our results suggested that energy metabolism can affect embryo implantation, whereas inflammation and cell adhesion molecules can affect both endometrial conversion and receptivity. Our results showed that endometrial receptive damage in patients with PCOS is not a single factor. It is caused by many proteins, pathways, systems, and abnormalities, which interact with each other and make endometrial receptive research more difficult.
Thermal gradient ring reveals different temperature-dependent behaviors in mice lacking thermosensitive TRP channels
Authors: Ujisawa Tomoyo , Sasajima Sachiko , Kashio Makiko , Tominaga Makoto
Published: May 2022

Transient receptor potential (TRP) channels are known as temperature receptors. Each channel has an activation temperature in vitro within the physiological temperature range. Mice deficient in specific TRP channels show abnormal thermal behaviors. However, the role of TRP channels in mouse thermal behavior is not fully understood. We measured thermal behavior using a new type of thermal gradient system, where mice can freely move around the ring floor, thereby avoiding the stereotypical habit that mice have of staying in a corner, as occurs in a rectangular system. With this system, we can also analyze various factors, such as “Spent time,” “Travel distance,” “Moving speed,” and “Acceleration,” to provide more accurate information about mouse behaviors. Further analysis using this system would lead to a better understanding of the molecular basis of thermal behaviors in mice, which could help us develop ways of making humans comfortable in different temperature conditions.
FragGeneScanRs: faster gene prediction for short reads
Authors: Van der Jeugt Felix , Dawyndt Peter , Mesuere Bart
Published: May 2022

Background

FragGeneScan is currently the most accurate and popular tool for gene prediction in short and error-prone reads, but its execution speed is insufficient for use on larger data sets. The parallelization which should have addressed this is inefficient. Its alternative implementation FragGeneScan+ is faster, but introduced a number of bugs related to memory management, race conditions and even output accuracy.

Results

This paper introduces FragGeneScanRs, a faster Rust implementation of the FragGeneScan gene prediction model. Its command line interface is backward compatible and adds extra features for more flexible usage. Its output is equivalent to the original FragGeneScan implementation.

Conclusions

Compared to the current C implementation, shotgun metagenomic reads are processed up to 22 times faster using a single thread, with better scaling for multithreaded execution. The Rust code of FragGeneScanRs is freely available from GitHub under the GPL-3.0 license with instructions for installation, usage and other documentation (https://github.com/unipept/FragGeneScanRs).
Toward a more accurate 3D atlas of C. elegans neurons
Authors: Skuhersky Michael , Wu Tailin , Yemini Eviatar , Nejatbakhsh Amin , Boyden Edward , Tegmark Max
Published: May 2022

Background

Determining cell identity in volumetric images of tagged neuronal nuclei is an ongoing challenge in contemporary neuroscience. Frequently, cell identity is determined by aligning and matching tags to an “atlas” of labeled neuronal positions and other identifying characteristics. Previous analyses of such C. elegans datasets have been hampered by the limited accuracy of such atlases, especially for neurons present in the ventral nerve cord, and also by time-consuming manual elements of the alignment process.

Results

We present a novel automated alignment method for sparse and incomplete point clouds of the sort resulting from typical C. elegans fluorescence microscopy datasets. This method involves a tunable learning parameter and a kernel that enforces biologically realistic deformation. We also present a pipeline for creating alignment atlases from datasets of the recently developed NeuroPAL transgene. In combination, these advances allow us to label neurons in volumetric images with confidence much higher than previous methods.

Conclusions

We release, to the best of our knowledge, the most complete full-body C. elegans 3D positional neuron atlas, incorporating positional variability derived from at least 7 animals per neuron, for the purposes of cell-type identity prediction for myriad applications (e.g., imaging neuronal activity, gene expression, and cell-fate).
miR-155 exerts posttranscriptional control of autoimmune regulator (Aire) and tissue-restricted antigen genes in medullary thymic epithelial cells
Authors: Tanaka Pedro Paranhos , Oliveira Ernna Hérida , Vieira-Machado Mayara Cristina , Duarte Max Jordan , Assis Amanda Freire , Bombonato-Prado Karina Fittipaldi , Passos Geraldo Aleixo
Published: May 2022

Background

The autoimmune regulator (Aire) gene is critical for the appropriate establishment of central immune tolerance. As one of the main controllers of promiscuous gene expression in the thymus, Aire promotes the expression of thousands of downstream tissue-restricted antigen (TRA) genes, cell adhesion genes and transcription factor genes in medullary thymic epithelial cells (mTECs). Despite the increasing knowledge about the role of Aire as an upstream transcriptional controller, little is known about the mechanisms by which this gene could be regulated.

Results

Here, we assessed the posttranscriptional control of Aire by miRNAs. The in silico miRNA-mRNA interaction analysis predicted thermodynamically stable hybridization between the 3’UTR of Aire mRNA and miR-155, which was confirmed to occur within the cellular milieu through a luciferase reporter assay. This finding enabled us to hypothesize that miR-155 might play a role as an intracellular posttranscriptional regulator of Aire mRNA. To test this hypothesis, we transfected a murine mTEC cell line with a miR-155 mimic in vitro, which reduced the mRNA and protein levels of Aire. Moreover, large-scale transcriptome analysis showed the modulation of 311 downstream mRNAs, which included 58 TRA mRNAs. Moreover, miR-155 mimic-transfected cells exhibited a decrease in their chemotaxis property compared with control thymocytes.

Conclusion

Overall, the results indicate that miR-155 may posttranscriptionally control Aire mRNA, reducing the respective Aire protein levels; consequently, the levels of mRNAs encode tissue-restricted antigens were affected. In addition, miR-155 regulated a crucial process by which mTECs allow thymocytes’ migration through chemotaxis.
A comparison of methods for multiple degree of freedom testing in repeated measures RNA-sequencing experiments
Authors: Wynn Elizabeth A. , Vestal Brian E. , Fingerlin Tasha E. , Moore Camille M.
Published: May 2022

Background

As the cost of RNA-sequencing decreases, complex study designs, including paired, longitudinal, and other correlated designs, become increasingly feasible. These studies often include multiple hypotheses and thus multiple degree of freedom tests, or tests that evaluate multiple hypotheses jointly, are often useful for filtering the gene list to a set of interesting features for further exploration while controlling the false discovery rate. Though there are several methods which have been proposed for analyzing correlated RNA-sequencing data, there has been little research evaluating and comparing the performance of multiple degree of freedom tests across methods.

Methods

We evaluated 11 different methods for modelling correlated RNA-sequencing data by performing a simulation study to compare the false discovery rate, power, and model convergence rate across several hypothesis tests and sample size scenarios. We also applied each method to a real longitudinal RNA-sequencing dataset.

Results

Linear mixed modelling using transformed data had the best false discovery rate control while maintaining relatively high power. However, this method had high model non-convergence, particularly at small sample sizes. No method had high power at the lowest sample size. We found a mix of conservative and anti-conservative behavior across the other methods, which was influenced by the sample size and the hypothesis being evaluated. The patterns observed in the simulation study were largely replicated in the analysis of a longitudinal study including data from intensive care unit patients experiencing cardiogenic or septic shock.

Conclusions

Multiple degree of freedom testing is a valuable tool in longitudinal and other correlated RNA-sequencing experiments. Of the methods that we investigated, linear mixed modelling had the best overall combination of power and false discovery rate control. Other methods may also be appropriate in some scenarios.
An approach to exploring patterns of imbalance and potential missingness in reports of the randomized baseline values for primary outcomes measurable at baseline in randomized controlled trials for meta-analyses
Authors: Park Eun-Gee , Hahn Seokyung
Published: May 2022

Background

This study evaluated the adequacy of randomization in randomized controlled trials by investigating baseline differences in the primary outcome when a meta-analysis employed an outcome whose baseline level was measurable.

Methods

We retrieved Cochrane reviews published during one year. We calculated the proportion of studies that reported randomized baseline values for the primary outcome. The standardized mean difference (SMD) was used to assess baseline imbalance and heterogeneity. We explored ranking-ordered forest plots using a normal cumulative probability curve as a guideline representing well-performed randomized trials. When skewness was suggested, a funnel plot was drawn to assess whether there was a significant linear trend.

Results

In 10 of 18 meta-analyses, more than 25% of trials did not report randomized baseline values of the primary outcomes. Three meta-analyses indicated baseline imbalance (P < 0.1) and three showed substantial heterogeneity (I2 > 60%). Four meta-analyses with forest plots suggesting a skewed SMD distribution also showed a linear trend on their standard errors on the funnel plot.

Conclusions

If the primary outcome is measured at baseline, it is essential to explore the full scope of baseline imbalance among the trials. This could help understand patterns of bias, including missingness, for designing adjustment.
Using observational study data as an external control group for a clinical trial: an empirical comparison of methods to account for longitudinal missing data
Authors: Norvang Vibeke , Haavardsholm Espen A. , Tedeschi Sara K. , Lyu Houchen , Sexton Joseph , Mjaavatten Maria D. , Kvien Tore K. , Solomon Daniel H. , Yoshida Kazuki
Published: May 2022

Background

Observational data are increasingly being used to conduct external comparisons to clinical trials. In this study, we empirically examined whether different methodological approaches to longitudinal missing data affected study conclusions in this setting.

Methods

We used data from one clinical trial and one prospective observational study, both Norwegian multicenter studies including patients with recently diagnosed rheumatoid arthritis and implementing similar treatment strategies, but with different stringency. A binary disease remission status was defined at 6, 12, and 24 months in both studies. After identifying patterns of longitudinal missing outcome data, we evaluated the following five approaches to handle missingness: analyses of patients with complete follow-up data, multiple imputation (MI), inverse probability of censoring weighting (IPCW), and two combinations of MI and IPCW.

Results

We found a complex non-monotone missing data pattern in the observational study (N = 328), while missing data in the trial (N = 188) was monotone due to drop-out. In the observational study, only 39.0% of patients had complete outcome data, compared to 89.9% in the trial. All approaches to missing data indicated favorable outcomes of the treatment strategy in the trial and resulted in similar study conclusions. Variations in results across approaches were mainly due to variations in estimated outcomes for the observational data.

Conclusions

Five different approaches to handle longitudinal missing data resulted in similar conclusions in our example. However, the extent and complexity of missing observational data affected estimated comparative outcomes across approaches, highlighting the need for careful consideration of methods to account for missingness in this setting. Based on this empirical examination, we recommend using a prespecified advanced missing data approach to account for longitudinal missing data, and to conduct alternative approaches in sensitivity analyses.
Impact of rapid on-site evaluation on diagnostic accuracy of EUS-guided fine-needle aspiration of solid pancreatic lesions: experience from a single center
Authors: Guvendir Irem , Zemheri Itir Ebru , Ozdil Kamil
Published: May 2022

Background

The use of ROSE in EUS-FNA pancreatic lesions is still controversial in many centers. In this study, we aimed to demonstrate the contribution of ROSE to the diagnostic accuracy, as well as its assistance to the pathologist/cytopathologist.

Methods

162 EUS-FNA biopsies were included in the study. EUS-FNA cytology results were reported according to the six-tiered system of Papanicolaou Cytopathology Society and compared to their final diagnosis with histopathology and/or clinical follow-ups regarding malignancy. The diagnostic yield, the difference in diagnostic accuracy, and the contribution of ROSE to providing the pathologist with adequate tissue uptake (number of slides and cell blocks) for further examination were compared in the ROSE and non-ROSE patient groups.

Results

In the non-ROSE group, the diagnostic accuracy according to the final diagnoses was 96% and the sensitivity was 94.44%, specificity 100%, PPV 100%, NPV 87.50%; while diagnostic accuracy was 97.09%, sensitivity 97.47%, specificity 95.83%, PPV 98.77%, NPV 92% in patients with ROSE. There was no significant difference in diagnostic accuracy between those with and without ROSE (p: 0.078). In diagnostic cases, the number of passes, slides and cell blocks were significantly higher in patients with ROSE than those without ROSE (p: 0.003, p: 0.007, p: 0.012, respectively). ROSE was independently associated with diagnostic yield when evaluated by number of passes, slides, cell blocks in regression analysis (p: 0.001, OR: 5.07, confidence interval: 1.89–13.5).

Conclusion

ROSE may increase the acquisition of sufficient tissue, but it does not have an advantage in diagnostic accuracy. ROSE may raise the number of slides, which may assist the pathologist for the diagnosis. If the lesion is solid and/or contains a solid component, diagnostic yield is higher in patients where ROSE is available. Therefore, ROSE still maintains its applicability in terms of increasing the diagnostic efficiency and making the final diagnosis.
Parenting styles and health in mid- and late life: evidence from the China health and retirement longitudinal study
Authors: Ding Ruoxi , He Ping
Published: May 2022

Backgrounds

The impact of relationships in early childhood may be long-lasting and reaching to mid to late life. Limited studies have investigated the associations between parenting style and different aspects of well-being beyond adolescence. The current study aims to examine the association between parenting styles and multiple dimensions of functioning in mid-and later-life adults.

Methods

We used data from China Health and Retirement Longitudinal Study (CHARLS). Generalized Estimating Equation (GEE) was applied to examine the association between retrospective parenting styles/behaviors in childhood and health outcome.

Results

Compared with authoritative style, authoritarian style predicted worse self-rated health (coefficient = − 0.13, P < 0.001), cognitive function (− 0.23, P < 0.05) and depressive symptom (0.87, P < 0.001). Paternal affection was associated with more health outcome in mid- and late life than maternal affection. Only paternal affection was a significant predictor of mid- and late life health among male adults, while both paternal and maternal affection were strong predictors among female adults. Authoritative style was associated more positive health outcomes in mid- and late life among adults with literate parents than those with illiterate parents.

Conclusion

This study provides evidence for the link between parenting behaviors in early life stage and physical and psychological functioning in mid- to late adulthood. Authoritative style, and the memory of parental affection, particularly from father and educated parents, could have long-lasting positive influence on children’s physical and mental well-being, which further support the life-course perspective on human development.
Barriers and facilitators of appropriate antibiotic use in primary care institutions after an antibiotic quality improvement program – a nested qualitative study
Authors: Harbin Nicolay Jonassen , Lindbæk Morten , Romøren Maria
Published: May 2022

Background

Antibiotic prescribing by physicians in primary care institutions is common and affected by several factors. Diagnosis and treatment of infections in a nursing home (NH) resident is challenging, with the risk of both under- and overtreatment. Identifying barriers and facilitators of appropriate antibiotic prescribing in NHs and municipal acute care units (MACUs) is essential to ensure the most adequate antibiotic treatment possible and develop future antibiotic stewardship programs.

Methods

After implementing a one-year antibiotic quality improvement program, we conducted six semi-structured focus group interviews with physicians (n = 11) and nurses (n = 14) in 10 NHs and 3 MACUs located in the county of Østfold, Norway. We used a semi-structured interview guide covering multiple areas influencing antibiotic use to identify persistent barriers and facilitators of appropriate antibiotic prescribing after the intervention. The interviews were audio-recorded and transcribed verbatim. The content analysis was performed following the six phases of thematic analysis developed by Braun and Clarke.

Results

We identified thirteen themes containing barriers and facilitators of the appropriateness of antibiotic use in primary care institutions. The themes were grouped into four main levels: Barriers and facilitators 1) at the clinical level, 2) at the resident level, 3) at the next of kin level, and 4) at the organisational level. Unclear clinical presentation of symptoms and lack of diagnostic possibilities were described as essential barriers to appropriate antibiotic use. At the same time, increased availability of the permanent nursing home physician and early and frequent dialogue with the residents’ next of kin were emphasized as facilitators of appropriate antibiotic use. The influence of nurses in the decision-making process regarding infection diagnostics and treatment was by both professions described as profound.

Conclusions

Our qualitative study identified four main levels containing several barriers and facilitators of appropriate antibiotic prescribing in Norwegian NHs and MACUs. Diagnostic uncertainty, frequent dialogue with next of kin and organisational factors should be targeted in future antibiotic stewardship programs in primary care institutions. In addition, for such programs to be as effective as possible, nurses should be included on equal terms with physicians.
Prediction of drug resistance profile of multidrug-resistant Mycobacterium tuberculosis (MDR-MTB) isolates from newly diagnosed case by whole genome sequencing (WGS): a study from a high tuberculosis burden country
Authors: Sun Wenwen , Gui Xuwei , Wu Zheyuan , Zhang Yangyi , Yan Liping
Published: May 2022

Objectives

Our aim was to assess the ability of the Whole-genome sequencing (WGS) in predicting drug resistance profile of multidrug-resistant mycobacterium tuberculosis (MDR-MTB) from newly diagnosed cases in China.

Methods

We validated the Phenotypic drug Sensitivity Test (pDST) for 12 anti-tuberculosis drugs using the Bactec MGIT 960 system. We described the characteristics of the isolates enrolled and compared the pDST results with resistance profiles predicted by WGS.

Results

The pDST showed that of the 43 isolates enrolled, 25.6% were sensitive to rifabutin (RFB); 97.7%、97.7%、93.0% and 93.0% were sensitive to cycloserine (Cs), amikacin/kanamycin (Ak/Km), para-aminosalicylic acid (Pas) and ethionamide Eto), respectively; 18.6% were resistant to fluoroquinolones (FQs) or second-line injections. Genotype DST determined by WGS of Ak/Km、Eto and RFP reached high consistency to 97.7% compared with pDST, followed by moxifloxacin (Mfx) 95.3%, levofloxaci (Lfx) and Pas 93%, streptomycin (Sm) 90.3%. The genotype DST of RFB and EMB showed low consistency with the pDST of 67.2 and 79.1%. WGS also detected 27.9% isolates of pyrazinamide(PZA)-related drug-resistant mutation. No mutations associated with linezolid (Lzd), bedaquiline (Bdq) and clofazimine (Cfz) were detectd.

Conclusions

WGS has the potential to infer resistance profiles without time-consuming phenotypic methods, which could be provide a basis to formulate reasonable treatment in high TB burden areas.
Essential components of postnatal care – a systematic literature review and development of signal functions to guide monitoring and evaluation
Authors: McCauley Hannah , Lowe Kirsty , Furtado Nicholas , Mangiaterra Viviana , van den Broek Nynke
Published: May 2022

Background

Postnatal Care (PNC) is one of the healthcare-packages in the continuum of care for mothers and children that needs to be in place to reduce global maternal and perinatal mortality and morbidity. We sought to identify the essential components of PNC and develop signal functions to reflect these which can be used for the monitoring and evaluation of availability and quality of PNC.

Methods

Systematic review of the literature using MESH headings for databases (Cinahl, Cochrane, Global Health, Medline, PubMed, and Web of Science). Papers and reports on content of PNC published from 2000–2020 were included. Narrative synthesis of data and development of signal function through 7 consensus-building workshops with 184 stakeholders.

Results

Forty-Eight papers and reports are included in the systematic review from which 22 essential components of PNC were extracted and used to develop 14 signal functions. Signal functions are used in obstetrics to denote a list of interventions that address major causes of maternal and perinatal morbidity or mortality. For each signal function we identified the equipment, medication and consumables required for implementation. The prevention and management of infectious diseases (malaria, HIV, tuberculosis) are considered essential components of routine PNC depending on population disease burden or whether the population is considered at risk. Screening and management of pre-eclampsia, maternal anaemia and mental health are recommended universally. Promotion of and support of exclusive breastfeeding and uptake of a modern contraceptive method are also considered essential components of PNC. For the new-born baby, cord care, monitoring of growth and development, screening for congenital disease and commencing vaccinations are considered essential signal functions. Screening for gender-based violence (GBV) including intimate partner- violence (IPV) is recommended when counselling can be provided and/or a referral pathway is in place. Debriefing following birth (complicated or un-complicated) was agreed through consensus-building as an important component of PNC.

Conclusions

Signal functions were developed which can be used for monitoring and evaluation of content and quality of PNC. Country adaptation and validation is recommended and further work is needed to examine if the proposed signal functions can serve as a useful monitoring and evaluation tool.

Trial registration

The systematic review protocol was registered: PROSPERO 2018 CRD42018107054.
Five-year stability of posterior corneal surface after small incision lenticule extraction for high myopia
Authors: Zhao Yu , Lin Xue , Chen Zhuoyi , Zhou Xingtao
Published: May 2022

Background

To study the 5-year changes in the posterior corneal surface after small incision lenticule extraction (SMILE) for high myopia.

Methods

Eighty eyes received SMILE was included in this prospective study. They were allocated into two groups based on the spherical equivalent: high myopia (40eyes, -7.49 ± 0.70D) and moderate myopia (40eyes, -4.43 ± 0.87D). Certain points of posterior corneal elevation (the central point (PCE), thinnest point (PTE), maximal point (PME), and in various corneal areas) were evaluated using a Scheimpflug camera (Pentacam; Oculus GmbH, Germany) preoperatively and at 6 months and 5 years after surgery.

Results

All surgeries were completed uneventfully and no ectasia was developed throng the observation. The safety index and efficacy index were 1.14 and 1.03 in the high myopia group, and 1.16 and 1.06 in the moderate myopia group, respectively. Most of the calculated values in the high myopia group showed a slight increase at 6 months but decreased at 5 years. At 5 years postoperatively, the value of the PTE was significantly lower than at baseline in both groups (P ≤ 0.047); a statistical difference was also revealed in the PME in the moderate group with slight changes (10.15 ± 3.01 μm vs. 11.60 ± 4.33 μm, P = 0.002); no statistical significance was observed in other calculated values (P ≥ 0.067). Similarly, no significant linear correlation was noted between changes in all values and the residual bed thickness either (P ≥ 0.057).

Conclusions

SMILE causes no protrusion in posterior corneal surface for correction of high myopia at the follow-up visit of 5 years.
The association between long-distance migration and PTSD prevalence in Syrian refugees
Authors: Eiset Andreas Halgreen , Aoun Michaelangelo P. , Stougaard Monica , Gottlieb Annemarie Graa , Haddad Ramzi S. , Frydenberg Morten , Naja Wadih J.
Published: May 2022

Background

Refugees are forced migrants but there is a large variation in the distance that refugees cover and there is a paucity in the evidence of how this may affect refugees’ health and health care needs. Objective: We investigated the association between long-distance migration and post-traumatic stress disorder (PTSD), a serious psychiatric disorder associated with deteriorating mental and somatic health.

Methods

Included from 2016–2019 were adult Syrian refugees in Lebanon and Denmark that arrived up to 12 months prior to inclusion. PTSD was assessed using the Harvard Trauma Questionnaire and the estimate of association was obtained by multiply imputing missing data and adjusting for confounding by propensity score-weighting with covariates age, sex, socioeconomic status, trauma experience and general mental well-being, reporting the bootstrap 95-percentile confidence interval (95% CI). Additionally, a number of sensitivity analyses were performed.

Results

Included were 599 participants in Lebanon (mean age 35 years old, 73% being female) and 133 participants in Denmark (mean age 30 years old, 47% being female). After multiply imputing missing data and propensity score-weighted adjustment for confounding, migration to Denmark instead of Lebanon was associated with an increase in PTSD prevalence of 9 percentage point (95% CI [-1; 19] percentage point).

Conclusions

Long-distance migration may be associated with an increase in PTSD prevalence in refugees. The migration could be an important factor to consider when assessing refugees’ and asylum seekers’ health. Practitioners should consider “long-distance migration” in refugee health screenings and in particular when assessing the risk of post-traumatic stress disorder. Future research should be designed to ultimately lead to studies of relevant interventions to lower the risk of post-traumatic stress disorder in refugees.
The relationship between childhood maltreatment and mental health problems: coping strategies and social support act as mediators
Authors: Su Yingying , Meng Xiangfei , Yang Guang , D’Arcy Carl
Published: May 2022

Background

Childhood maltreatment significantly increases the risk of developing mental health problems in adolescence and adulthood. The present study examines if coping strategies and social support mediate the relationship between childhood maltreatment and mental health problems.

Methods

Data analyzed were from the 2012 Canadian Community Health Survey Mental Health (CCHS-MH, N = 25,113), a national population survey. A structured diagnostic interview, the World Health Organization version of Composite International Diagnostic Interview (WHO-CIDI), was used to assess mental health status. Multiple mediation analysis with structural equation modelling is used to test the mediating effects of coping skills and social support in the relationship between childhood maltreatment and mental health problems.

Results

Our findings demonstrate that both coping strategies and social support mediated the link between childhood maltreatment and major depressive episode (mediation proportion: 18.3%), generalized anxiety disorder (mediation proportion: 19.8%), and suicide ideation (mediation proportion: 15.9%). By and large, the study results showed that coping skills and social support had both direct and indirect effects on the studied mental health problems with coping skills having a stronger impact.

Conclusions

Personal resources play an important resilience role in the associations between maltreatment and mental disorders with positive coping strategies, an internal resource, having a stronger protective presence. This research reinforces the need for strengthening positive coping strategies as well as social support as preventive strategies to improve mental health for individuals who have experienced childhood maltreatment.
Socioeconomic and immigration status and COVID-19 testing in Toronto, Ontario: retrospective cross-sectional study
Authors: O’Neill Braden , Kalia Sumeet , Hum Susan , Gill Peter , Greiver Michelle , Kirubarajan Abirami , Eisen David , Ferguson Jacob , Dunn Sheila
Published: May 2022

Background

Preliminary evidence suggests that individuals living in lower income neighbourhoods are at higher risk of COVID-19 infection. The relationship between sociodemographic characteristics and COVID-19 risk warrants further study.

Methods

We explored the association between COVID-19 test positivity and patients’ socio-demographic variables, using neighborhood sociodemographic data collected retrospectively from two COVID-19 Assessment Centres in Toronto, ON.

Results

Eighty-three thousand four hundred forty three COVID-19 tests completed between April 5–September 30, 2020, were analyzed. Individuals living in neighbourhoods with the lowest income or highest concentration of immigrants were 3.4 (95% CI: 2.7 to 4.9) and 2.5 (95% CI: 1.8 to 3.7) times more likely to test positive for COVID-19 than those in highest income or lowest immigrant neighbourhoods, respectively. Testing was higher among individuals from higher income neighbourhoods, at lowest COVID-19 risk, compared with those from low-income neighbourhoods.

Conclusions

Targeted efforts are needed to improve testing availability in high-risk regions. These same strategies may also ensure equitable COVID-19 vaccine delivery.
Implementation of WHO guidelines on management of advanced HIV disease and its impact among TB co-infected patients in Tanzania: a retrospective follow-up study
Authors: Hassan Frank E. , Senkoro Mbazi , Mnyambwa Nicholaus P. , Wilfred Amani , Molloy Síle F. , Manisha Harrieth , Kivuyo Sokoine , Mfinanga Sayoki G.
Published: May 2022

Background

The commonest causes of mortality in people living with HIV (PLHIV) are preventable and the majority can be attributed to undiagnosed tuberculosis (TB). National HIV/AIDS control programs are encouraged to implement the WHO package of interventions to improve survival among PLHIV. We assessed the implementation of the WHO TB-related package of care for Advanced HIV Disease (AHD) and its impact on treatment outcomes among HIV/TB patients in Tanzania.

Methods

A retrospective cohort study was employed among HIV/AIDS patients on antiretroviral therapy from 21 public health facilities in three regions (Dar es Salaam, Coastal, and Morogoro) of Tanzania. Patients enrolled in care between January 2013- June 2017 (before the introduction of the WHO guidelines) and July 2017-Sept 2018 (during the implementation of the guidelines) were recruited. Data abstraction was done from patient hospital files using a structured questionnaire uploaded on a tablet.

Results

Data from 2624 patients records were collected. Overall, 50% of patients with HIV had AHD with 7.8% of these co-infected with TB. Among AHD participants, 58.3% were female, 80.7% were from urban areas and 40.0% visited care and treatment centres as self-referrals. Implementation of the WHO AHD package of care was very low, ranging from 0% for Urine LF-LAM test done among patients with symptoms and signs of TB to 39.7% AHD concurrent with TB patients whose ART initiation was deferred for 2 weeks. Overall, the Proportion of AHD patients diagnosed with TB was 4.8%, Of which sputum Xpert as the first test for TB diagnosis was 4.4%. Five patients (0.6%) were documented to have received IPT at enrolment. Tailored counselling to ensure optimal adherence to ART for viral suppression was given to 12.1%.

AHD patients co-infected with TB were retained in care more before the introduction of WHO AHD guideline (82.1%) compared to the period after the introduction of the guideline (53.9%) (p = 0.008). Clinical failure at 6 months among AHD patients was 10.6% before the guideline and 11.4% after the guideline. Immunological failure was observed in 1 patient (9.1%) before the guideline and 1 patient (7.1%) after the guideline. After the introduction of the guideline, mortality was 5.9% and no mortality was observed before the guideline. All the differences were not statistically significant.

Conclusions

Implementation of the TB related WHO packages of care for AHD is very low. Except for TB diagnosis, other parameters did not improve with the introduction of the guidelines. More research is recommended to ascertain the effectiveness of guidelines as well as an understanding of the mechanisms involved.
The effectiveness of percutaneous endoscopic decompression compared with open decompression and fusion for lumbar spinal stenosis: protocol for a multicenter, prospective, cohort study
Authors: Zhai Shuheng , Zhao Wenkui , Zhu Bin , Huang Xin , Liang Chen , Hai Bao , Ding Lixiang , Zhu Hongwei , Wang Xianhai , Wei Feng , Chu Hongling , Liu Xiaoguang
Published: May 2022

Background

Lumbar spinal stenosis (LSS) is one of the most frequent indications for spine surgery. Open decompression and fusion surgery was the most common treatment and used to be regarded as the golden standard treatment for LSS. In recent years, percutaneous endoscopic decompression surgery was also used for LSS. However, the effectiveness and safety of percutaneous endoscopic decompression in the treatment of LSS have not been supported by high-level evidence. Our aim is to 1) compare the effectiveness of percutaneous endoscopic decompression surgery and open decompression and fusion for the treatment of LSS. 2) Investigate the prognosis risk factors for LSS. 3) Evaluate the influence of percutaneous endoscopic decompression for the stability of operative level, and degeneration of adjacent level.

Methods

It’s a prospective, multicenter cohort study. The study is performed at 4 centers in Beijing. This study plans to enroll 600 LSS patients (300 patients in the percutaneous endoscopic decompression group, and 300 patients in the open decompression and fusion group). The demographic variables, healthcare variables, symptom related variables, clinical assessment (Visual analogue score (VAS), Oswestry disability index (ODI), Japanese Orthopaedic Association score (JOA)), and radiological assessment (dynamic X-ray, CT, MRI) will be collected at baseline visit. Patients will follow up at 3, 6, 12 months. The primary outcome is the difference of improvement of ODI between baseline and 12-month follow-up between the two groups. The secondary outcome is the score changes of preoperative and postoperative VAS, the recovery rate of JOA, MacNab criteria, patient satisfaction, degeneration grade of adjacent level, ROM of operative level and adjacent level, complication rate.

Discussion

In this study, we propose to conduct a prospective registry study to address the major controversies of LSS decompression under percutaneous spinal endoscopy, and investigate the clinical efficacy and safety of percutaneous endoscopic decompression and open decompression in the treatment of LSS.

Trial registration

This study has been registered on clinicaltrials.gov in January 15, 2020 (NCT04254757). (SPIRIT 2a).
Slower upper extremity function in older adults with hyperkyphosis negatively impacts the 6-min walk test
Authors: Fukuoka Yoshimi , Katzman Wendy B. , Gladin Amy , Lane Nancy E. , Kado Deborah M. , Oh Yoo Jung
Published: May 2022

Background

Approximately 30% to 40% of older adults have hyperkyphosis, defined as excessive curvature of the thoracic spine. Hyperkyphosis is associated with increased morbidity and mortality. This study aimed to determine whether hyperkyphosis (Cobb’s angle) and upper extremity tasks were independently associated with the 6-min walk test (6MWT) in community-dwelling older adults with hyperkyphosis.

Methods

In this cross-sectional study, we studied 71 women and 28 men aged 60–87 from the study of hyperkyphosis, exercise, and function trial (SHEAF) who had kyphosis, 3 timed upper extremity tasks and the 6MWT assessed at their baseline visit. We used standing lateral spine radiographs and a standardized protocol for thoracic kyphosis (T4-T12) to measure Cobb angle of kyphosis. In addition, 3 activity of daily living (ADL) extremity tests (putting on and removing a laboratory coat, picking up a penny from the floor, and lifting a 7-lb. book to a shelf) were used.

Results

The mean ± SD age was 70.1 ± 6.1 years. The mean ± SD Cobb angle of kyphosis was 57.4 ± 12.5 degrees. On average ± SD, the participants walked 504.8 ± 84.2 m in 6 min and took 2.4 ± 2.2 prescription medications. The mean ± SD height was 164.7 ± 8.5 cm, weight was 68.7 ± 13.1 kg, and BMI was 25.2 ± 4.0 kg/m2. Multivariate regression revealed that age, height, upper extremity book lift task, and the number of prescribed medications were significant predictors of performance on the 6MWT (p < 0.05).

Conclusions

While kyphosis was not associated with the 6MWT, timed tests of upper extremity function indicated that upper body dynamics can affect walking performance. In addition, sociodemographic factors and the number of prescribed medications were significant contributing factors to the 6MWT in older adults with mild to moderate hyperkyphosis. These results illustrate multifactorial influences on physical performance and the need for an integrated and targeted approach in helping older hyperkyphotic adults maintain healthy physical functioning as they age.
Inverse PCR-based detection reveal novel mobile genetic elements and their associated genes in the human oral metagenome
Authors: Tansirichaiya Supathep , Winje Endre , Wigand Johannes , Al-Haroni Mohammed
Published: May 2022

The human oral cavity is one of the hotspots harboring multiple mobile genetic elements (MGEs), which are segments of DNA that can move either within bacterial genomes or between bacterial cells that can facilitate the spreading of genetic materials, including antimicrobial resistance genes. It is, therefore, important to investigate genes associated with the MGEs as they have a high probability of dissemination within the bacterial population under selective pressure from human activities. As one-third of oral bacteria are not yet culturable in the laboratory condition, therefore, in this work, it is aimed to detect and identify the genetic contexts of MGEs in the oral cavity through an inverse PCR (IPCR)-based approach on the oral metagenomic. The human oral metagenome was extracted from saliva samples collected from healthy individuals in Tromsø, Norway. The extracted DNA was partially digested with the HindIII restriction enzyme and self-circularized by ligation. DNA primers targeting each MGE were designed to amplify outwards from the MGEs and used for the IPCR on the circularized DNA products. The IPCR amplicons were cloned into a pCR-XL-2-TOP vector, screened, and sequenced. Out of 40 IPCR amplicons, we confirmed and verified the genetic contexts of 11 samples amplified with primers targeting integron gene cassettes (GCs), IS431 composite transposons, and Tn916 conjugative transposons (tet(M) and xis-int). Novel integron GCs, MGEs, and variants of Tn916 conjugative transposons were identified, which is the first report using the IPCR technique to detect the genetic contexts of MGEs in the oral metagenomic DNA.
Patient perspectives on delays in cervical cancer screening and follow-up care in Botswana: a mixed methods study
Authors: Rendle Katharine A. , Ramogola-Masire Doreen , Monare Barati , Ogden Shannon N. , Toneff Hannah K. , Saia Chelsea A. , Wainwright Jocelyn V. , Friebel-Klingner Tara M. , Bazzett-Matabele Lisa , Bhatia Rohini , Bonner Natalie , Ralefala Tlotlo B. , Vuylsteke Peter , Luckett Rebecca , Grover Surbhi
Published: May 2022

Background

Delays in screening and timely diagnosis contribute significantly to global disparities in cervical cancer mortality in Botswana and other low- and middle-income countries, particularly those with high rates of HIV. Little is known about the modifiable factors shaping these delays from the perspectives of women themselves and how these perspectives may differ between those living with and without HIV.

Methods

From March–May 2019, we conducted a concurrent, mixed methods study of women receiving treatment for cervical cancer at a multidisciplinary oncology clinic in Botswana. Enrolled participants completed a one-time, concurrent semi-structured interview and structured questionnaire assessing patient characteristics, screening and HIV-related beliefs and knowledge, and barriers and facilitators to screening and follow-up care. Qualitative data were analyzed using directed content analysis guided by the Model of Pathways to Treatment and triangulated with quantitative questionnaire data to identify areas of convergence and divergence. Fisher’s exact tests were used to explore associations between questionnaire data (e.g., screening knowledge) and HIV status.

Results

Forty-two women enrolled in the study, 64% of whom were living with HIV and 26% were diagnosed with stage III cervical cancer. Median age was 45 years (IQR 54–67) in those living with HIV and 64 years (IQR 42–53) in those living without. Overall screening rates before symptomatic disease were low (24%). Median time from most proximal screen to diagnosis was 52 median days (IQR 15–176), with no significant differences by HIV status. General screening knowledge was higher among those living with HIV versus those without (100% vs 73%; p < 0.05), but knowledge about HPV and other risk factors was low in both groups. Similar to questionnaire results, qualitative results indicate limited awareness of the need to be screened prior to symptoms as a central barrier to timely screening. Some participants also noted that delays in the receipt of screening results and fear also contributed to treatment delays. However, many participants also described myriad sources of social and tangible support that helped them to overcome some of these challenges.

Conclusion

Interventions focused on increasing routine screening and supporting timely awareness and access to care are needed to reduce global disparities in cervical cancer.