bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-dose intranasal dexmedetomidine premedication improves epidural labor analgesia onset and reduces procedural pain on epidural puncture: a prospective randomized double-blind clinical study
Authors: Sun Hao , Ma Xiang , Wang Shengyou , Li Zhenzhen , Lu Yao , Zhu Haijuan
Published: May 2023

Background

Epidural labor analgesia is a safe and effective method of pain management during labor with the drawbacks of delayed onset and maternal distress during epidural puncture. This study aimed to determine whether pretreatment with intranasal low-dose dexmedetomidine effectively shortens the onset of analgesia and reduces procedural pain.

Methods

In this prospective, randomized double-blind trial, nulliparous patients were randomly assigned to either the intranasal dexmedetomidine group or the control group. The intranasal dexmedetomidine group received 0.5 μg/kg dexmedetomidine intranasally, and the control group received an equal volume of normal saline intranasally. Both groups were maintained with a programmed intermittent epidural bolus. The primary outcome was the onset time of analgesia and scores of pain related to the epidural puncture.

Results

Seventy-nine patients were enrolled, and 60 completed the study and were included in the analysis. The time to achieve adequate analgesia was significantly shorter in the intranasal dexmedetomidine group than in the control group (hazard ratio = 2.069; 95% CI, 2.187 to 3.606; P = 0.010). The visual analogue scale pain scores during epidural puncture in the intranasal dexmedetomidine group were also significantly lower than those in the control group (2.0 (1.8–2.5) vs. 3.5 (3.3–4.5), P ≤ 0.001, Table 2). Pretreatment with intranasal dexmedetomidine before epidural labor analgesia was associated with improved visual analogue scale pain scores and Ramsay scores, less consumption of analgesics and higher maternal satisfaction (P < 0.05). No differences were observed for labor and neonatal outcomes or the incidence of adverse effects between the two groups.

Conclusions

Pretreatment with intranasal dexmedetomidine before epidural labor analgesia yielded a faster onset of analgesia and decreased epidural puncture pain without increasing adverse effects. Pretreatment with intranasal dexmedetomidine may be a useful adjunct for the initiation of epidural analgesia, and further investigation should be encouraged to determine its utility more fully.

Trial registration

This trial was prospectively registered at Chictr.org.cn on 29/05/2020 with the registration number ChiCTR2000033356 (http://www.chictr.org.cn/listbycreater.aspx).
Risk stratification for predicting postoperative recurrence of gastric cancer by grade of venous invasion
Authors: Imai Yasuo , Kurata Yoshihiro , Ichinose Masanori
Published: May 2023

Background

Venous invasion (VI) in pathological examination of surgically resected gastric cancer (GC) may predict postoperative recurrence, but there are no objective criteria for VI grading.

Methods

157 GC patients (pathological stages I 82, II 34, and III 41) who underwent surgery with curative intent were analyzed. VI was graded in pathological examination by elastica van Gieson staining based on the number of VIs per glass slide as follows: v0, 0; v1, 1−3; v2, 4−6; and v3, ≥ 7. Filling-type invasion in veins with a minor axis of ≥ 1 mm increased the grade by 1. The association of VI grade with prognosis was statistically analyzed.

Results

Recurrence increased with VI grade (v0 1.5%, v1 29.6%, v2 41.7%, v3 78.6%). VI grade as well as pathological (p) tumor, node, metastasis (TNM) stage was a significant recurrence predictor by the multivariate Cox analysis. VI grade was implicated in hematogenous and peritoneal recurrences independent of pTNM stage but not in nodal recurrence. GC was then divided into two tiers, without indication of adjuvant chemotherapy (AC) (pStage I, pT1 and pT3N0) and with AC indication (pStages remaining II/III), based on the ACTS-GC trial, which is common in Japan and East Asia. VI grade was a significant recurrence predictor in both tiers. v2/v3 revealed a significantly worse recurrence-free survival (RFS) than v0/v1 in GC without AC indication. v0/v1 exhibited RFS rate exceeding 95% even after 5 years but that of v2/v3 fell around 70% within one year postoperatively, suggesting that AC may be considered for this tier with v2/v3. GC with AC indication exhibited dismal RFS according to the VI grade. RFS rate fell below 80% within one year postoperatively when VI was positive, while recurrence was not observed in v0, which was, however, rare in this tier (10.9%). Differentiation grade did not significantly affect postoperative prognosis in both tiers.

Conclusions

VI grade was a significant predictor of postoperative GC recurrence irrespective of the AC indication based on the ACTS-GC study and this VI grading system could be applied in future studies of adjuvant therapy in GC presently deemed without AC indication in Japan.
Relation of environmental factors with activity limitations and participation restrictions in older adults with diabetes mellitus over time: an international classification of functioning framework perspective
Authors: Tai Li Ai , Tsai Le Yu , Chiu Yi Chen
Published: May 2023

Background

Activity limitations and participation restrictions were observed in patients with diabetes, which may impact their quality of life. Environmental factors such as seasonal effects, resources and perceived stress may play important role in activity limitations and participation restrictions. In this study, a variant of International Classification of Functioning (ICF) model was used to clarify the associations of function/structure factors, personal factors and environmental factors with activity limitations and participation restrictions.

Methods

This was a longitudinal design with 1 year follow-up. The Mini-Mental State Examination (MMSE), Geriatric Depression Scale- short form, Perceived Stress Scale, and Instrumental Activities of Daily Living assessments were measured at 3-month intervals for long-term follow-up in 110 patients with diabetes aged ≥ 65 years.

Results

Hierarchical linear regression models revealed that age (p = 0.001), perceived health status, MMSE scores (p < 0.01), and positive perceived stress (p < 0.001) were predictors of activity limitations (adjusted R2 = 53%). GDS-S (p < 0.05) and positive perceived stress (p < 0.01) were predictors of participation restrictions (adjusted R2 = 30%). Generalized estimating equation analysis indicated that seasonal effects, age, perceived health status, MMSE predicted the changes of slopes in activity limitations. Seasonal effects and GDS-S were predictors of the changes of slopes for participation restrictions (all p < 0.001).

Conclusions

The ICF can be used to identify the risk factors for activity limitations and participation restrictions in older adults with diabetes. Practitioners should provide individualized interventions with consideration of these risk factors.
Burden of HIV and treatment outcomes among TB patients in rural Kenya: a 9-year longitudinal study
Authors: Ngari Moses M. , Rashid Mohammed A. , Sanga Deche , Mathenge Hiram , Agoro Oscar , Mberia Jane K. , Katana Geoffrey G. , Vaillant Michel , Abdullahi Osman A.
Published: May 2023

Background

Although tuberculosis (TB) patients coinfected with HIV are at risk of poor treatment outcomes, there is paucity of data on changing trends of TB/HIV co-infection and their treatment outcomes. This study aims to estimate the burden of TB/HIV co-infection over time, describe the treatment available to TB/HIV patients and estimate the effect of TB/HIV co-infection on TB treatment outcomes.

Methods

This was a retrospective data analyses from TB surveillance in two counties in Kenya (Nyeri and Kilifi): 2012‒2020. All TB patients aged ≥ 18 years were included. The main exposure was HIV status categorised as infected, negative or unknown status. World Health Organization TB treatment outcomes were explored; cured, treatment complete, failed treatment, defaulted/lost-to-follow-up, died and transferred out. Time at risk was from date of starting TB treatment to six months later/date of the event and Cox proportion with shared frailties models were used to estimate effects of TB/HIV co-infection on TB treatment outcomes.

Results

The study includes 27,285 patients, median (IQR) 37 (29‒49) years old and 64% male. 23,986 (88%) were new TB cases and 91% were started on 2RHZE/4RH anti-TB regimen. Overall, 7879 (29%, 95% 28‒30%) were HIV infected. The proportion of HIV infected patient was 32% in 2012 and declined to 24% in 2020 (trend P-value = 0.01). Uptake of ARTs (95%) and cotrimoxazole prophylaxis (99%) was high. Overall, 84% patients completed six months TB treatment, 2084 (7.6%) died, 4.3% LTFU, 0.9% treatment failure and 2.8% transferred out. HIV status was associated with lower odds of completing TB treatment: infected Vs negative (aOR 0.56 (95%CI 0.52‒0.61) and unknown vs negative (aOR 0.57 (95%CI 0.44‒0.73). Both HIV infected and unknown status were associated with higher hazard of death: (aHR 2.40 (95%CI 2.18‒2.63) and 1.93 (95%CI 1.44‒2.56)) respectively and defaulting treatment/LTFU: aHR 1.16 (95%CI 1.01‒1.32) and 1.55 (95%CI 1.02‒2.35)) respectively. HIV status had no effect on hazard of transferring out and treatment failure.

Conclusion

The overall burden of TB/HIV coinfection was within previous pooled estimate. Our findings support the need for systematic HIV testing as those with unknown status had similar TB treatment outcomes as the HIV infected.
Long-term end-stage renal disease risks after living kidney donation: a systematic review and meta-analysis
Authors: Park Jun Young , Yang Won Jae , Doo Seung Whan , Park Jae Joon , Gwon Yong Nam , Kim Ki Min , Kim Jae Heon , Kim Do Kyung
Published: May 2023

Background

Recent studies have shown that donor nephrectomy can induce renal function impairment. However, few meta-analysis studies about this have proceeded. Therefore, the objective of this systematic review and meta-analysis including all data of recent research studies was to determine whether living donor nephrectomy (LDN) could induce renal function impairment.

Methods

By November 2020, comprehensive literature searches were performed on PubMed, Embase, and Cochrane databases. Inclusion criteria were: (1) observational studies with data about overall end-stage renal disease (ESRD) or chronic kidney disease (CKD) of living kidney donors, (2) control group consisted of people without donor nephrectomy, and (3) outcomes of studies included long-term end-stage renal disease risks after living kidney donation. Risk of Bias in Non-randomized Studies of interventions (ROBINS-I) assessment tool was used to evaluate our methodological quality.

Results

The qualitative review included 11 studies and the meta-analysis included 5 studies. In the meta-analysis, the integrated overall ESRD risk was 5.57 (95% CI: 2.03—15.30). Regarding the overall risk of bias using ROBINS-I assessment tool, 0 studies was rated as "Low", 7 studies were rated as "moderate", 2 studies were rated as "Serious", and two studies were rated as "Critical".

Conclusions

Our study showed that LDN increased ESRD risk in LDN patients. However, in our meta-analysis, variables in included studies were not uniform and the number of included studies was small. To have a definite conclusion, meta-analyses of well-planned and detailed studies need to be conducted in the future.
Antibiotic choice for Group B Streptococcus prophylaxis in mothers with reported penicillin allergy and associated newborn outcomes
Authors: Snider Josephine B. , Mithal Leena B. , Kwah Jason H. , Rhodes Nathaniel J. , Son Moeun
Published: May 2023

Objective

To evaluate the choice of antibiotic used for intrapartum Group B Streptococcus (GBS) prophylaxis in pregnant individuals with reported penicillin allergies compared to those without reported penicillin allergies and investigate whether there are associated differences in neonatal outcomes.

Study Design

This retrospective cohort study included mother-infant dyads of GBS positive pregnant individuals who labored and delivered newborns ≥ 35 weeks of gestation at a high-volume urban hospital (2005–2018). The type of antibiotic administered to the mothers for GBS prophylaxis (beta-lactam prophylaxis defined as penicillin-class drug or cefazolin; alternative prophylaxis defined as vancomycin or clindamycin) was compared between those with a penicillin allergy documented in their medical record versus those who did not. Neonatal outcomes included number of postnatal blood draws, antibiotic administration, neonatal intensive care unit (NICU) admission, bacteremia, and hospital length of stay and were compared between groups. Bivariable and multivariable analyses were performed.

Results

Of 11,334 mother-infant pairs, 1170 (10.3%) mothers had a penicillin allergy documented in their medical record. Of them, 49 (4.2%) received a penicillin, 259 (22.1%) received cefazolin, 449 (38.4%) received clindamycin, and 413 (35.3%) received vancomycin. Patients with a reported penicillin allergy were significantly more likely to receive alternative GBS prophylaxis compared to those without penicillin allergy (73.7% vs. 0.2%, p < 0.01). Neonates of patients who received alternative GBS prophylaxis were significantly more likely to undergo a postnatal lab draw compared to neonates of patients who received beta-lactam antibiotics (20.8% vs. 17.3%, OR 1.25 (95% CI 1.08–1.46)). This significant association persisted after adjusting for potential confounders (aOR 1.23, 95% CI 1.06–1.43). There were no other significant differences seen in other newborn outcomes.

Conclusion

Pregnant individuals who report a penicillin allergy were more likely to receive alternative antibiotics for GBS prophylaxis compared to those without a penicillin allergy. This was associated with an increased frequency of postnatal blood draws among neonates of mothers with a reported penicillin allergy.

Brief summary

Administration of alternative intrapartum antibiotic prophylaxis with vancomycin or clindamycin is common in individuals with self-reported penicillin allergy, and maternal alternative antibiotic administration may impact neonatal care, particularly via increased lab draws.
Association between the person-centered maternity care experience and mental health after delivery in urban and rural Dhading, Nepal: a cross-sectional study
Authors: Tomita Yuri , Kiriya Junko , Silwal Ram Chandra , Ong Ken Ing Cherng , Shibanuma Akira , Jimba Masamine
Published: May 2023

Background

Person-centered maternity care is a component of quality care, which includes effective communication, respect, and dignity. Supportive care has a positive effect on mothers’ perinatal experience. In contrast, negative childbirth experiences can cause psychological problems. However, the impact of person-centered maternity care experience on mothers’ mental health after delivery remains unknown. Therefore, in this study, we examined the association between person-centered maternity care experience at healthcare facilities and maternal mental health after delivery among Nepali women.

Methods

We conducted a cross-sectional study in urban and rural areas in Dhading District, Nepal. Participants were women who gave birth at public healthcare facilities, and their baby’s age was between 1 and 12 months. After purposively selecting the target areas, we recruited the women from July to August 2019 and interviewed them using questionnaires. We conducted multiple regression analyses to analyze the association between delivery care experience and depressive symptoms and the association between delivery care experience and mental well-being.

Results

In total, 595 women were included in the data analysis. The experience of better person-centered maternity care was associated with lower depressive symptom scores in urban (unstandardized coefficient [B]= − 0.09, p < 0.001) and rural areas (B= − 0.10, p < 0.001). Moreover, the experience of better person-centered maternity care was associated with higher mental well-being scores in both urban (B= 0.30, p < 0.001) and rural areas (B= 0.15, p = 0.017).

Conclusions

Person-centered maternity care was associated with lower depressive symptom scores and higher mental well-being, regardless of the setting in Nepal. Person-centered maternity care during childbirth can potentially improve mental health after delivery. Maternity care should be improved with more attention to person-centered maternity care aspects.
Dynamic changes of phenotype and function of natural killer cells in peripheral blood before and after thermal ablation of hepatitis B associated hepatocellular carcinoma and their correlation with tumor recurrence
Authors: Wang Hai-Yan , Cui Xiong-Wei , Zhang Yong-Hong , Chen Yu , Lu Ning-Ning , Bai Li , Duan Zhong-Ping
Published: May 2023

Background

Thermal therapy induces an immune response in patients with hepatocellular carcinoma (HCC), but the dynamic characteristics of the natural killer (NK) cell immune response post-thermal ablation remain unclear. We conducted a prospective longitudinal cohort study to observe the dynamic changes of phenotype and function of NK cells in peripheral blood before and after thermal ablation of hepatitis B-associated HCC and their correlation with tumor recurrence.

Methods

Fifty-six patients clinically and pathologically confirmed with hepatitis B-associated HCC were selected for thermal ablation. Peripheral blood was collected on day 0, day 7, and month 1. NK cell subsets, receptors, and killing function were detected by flow cytometry, and the LDH levels were examined. Overall recurrence and associated variables were estimated using Kaplan–Meier, log-rank, and Cox proportional-hazards analyses.

Results

The frequency of CD3−CD56+ cells was increased on day 7 (P < 0.01) without significant differences between D0 and M1. NKG2D, NKp44, NKp30, CD159a, and CD158a expression was increased on M1 (all P < 0.05). The granzyme B and IFN-γ expression in NK cells were higher on M1 vs. D0 (P < 0.05). On day 7, the NK cell lysis activity of the target K562 cells was increased (P < 0.01) but decreased on M1 (P < 0.05). Survival analysis showed that CD158a expression and IFN-γ and perforin release on day 0 were associated with the risk of HCC recurrence. Cox regression analysis showed that the expression changes in CD56, NKp46, granzyme B, and perforin (D7-D0) induced by thermal ablation were associated with recurrence-free survival (RFS) of patients with HCC.

Conclusion

Thermal ablation increased the frequency and function of CD3−CD56+ NK cells in the peripheral blood of patients with HCC. These cells tended to be more differentiated and activated. Notably, expression levels of NK cell receptors NKp46, perforin, and granzyme B were associated with RFS.
Geographic Atrophy after Reabsorption of Pigment Epithelial Detachment (GARPED) study
Authors: Peng Enoch T. , Adrean Sean D.
Published: May 2023

Background

To describe the occurrence, rate of geographic atrophy (GA) expansion, and changes in visual acuity (VA) after reabsorption of subfoveal pigment epithelial detachments (PED).

Methods

Included patients had reabsorption of a PED followed by GA. Patients underwent clinical examination with SD-OCT. Images were classified by size with grading occurring post reabsorption. VA was recorded pre-reabsorption, post-reabsorption, and over time.

Results

The average age of the cohort, consisting of 22 eyes from 19 participants, was 86.9 years at reabsorption. Prior to reabsorption, the VA was 20/80 and then declined to 20/200 (p = 0.001) with an average follow-up time of 30.2 months. There was no significant VA change after the initial loss with reabsorption. The average initial lesion size of GA was 0.987 mm2 with an average growth rate of 0.274 mm/year.

Conclusions

This study longitudinally examined GA growth rate in patients with reabsorbed PEDs. These patients started with a drusenoid or serous PED, had a dramatic reduction in vision and GA that occurred in place of the PED. These GA lesions have a slower growth rate and a smaller area of onset compared to rates previously reported in the literature. They do not show significant VA change after reabsorption. As we have entered the era of GA therapy, these patients may not benefit from current treatments.
Identifying spatial clustering of diarrhoea among children under 5 years across 707 districts in India: a cross sectional study
Authors: Ghosh Koustav , Chakraborty Atreyee Sinha , SenGupta Shoummo
Published: May 2023

Background

Diarrhoea is one of the leading reasons for under-five child mortality and morbidity across the globe and especially in low- and middle-income countries like India. The present study aims to investigate and identify the spatial clustering and the factors associated with diarrhoea across 707 districts of different states in India.

Methods

This study used National Family Health Survey-4 & 5 (2015–16 & 2019–21) data in India. Spatial analysis software i.e., ArcGIS and GeoDa including Moran’s statistics have been applied to detect the spatial prevalence and auto-correlation of diarrhoea among neighbourhood districts. Bivariate analysis with a chi-square test and logistic regression has been performed to identify the factors associated with the morbidity condition.

Results

The result shows out of 2,23,785 children, 7.3 percent children suffer from diarrhoea in India. The prevalence is highest in Bihar (13.7%) and lowest in Lakshadweep (2.3%). Around 33 percent of districts have reported more than the national average level of diarrhoea prevalence. The study also found a medium to high level of autocorrelation with 0.41 Moran’s Index value and detected 69 hot-spots districts mostly from Maharashtra, Bihar, Odisha, and Gujarat. The study has also found, with an increase in children’s age as well as mother's age the prevalence of the disease decreases. The prevalence is more among male children than females. Underweight [OR = 1.08, 95% CI (1.03–1.13)] children have a greater risk of suffering from diarrhoeal diseases. The odds of children living in a pucca house [OR = 0.89, 95% CI (0.68–1.16)] are less likely to suffer from diarrhoea. On the other hand, rich economic status [OR = 0.91, 95% CI (0.86–0.97)], reduce the risk of such morbid conditions.

Conclusion

The study recommends targeting the hot-spot districts with high prevalence areas, and district-level interventions by improving housing type and child nutrition status, which can help to prevent diarrhoeal diseases among children in India. Thus, the identification of hotspot districts and suggested policy interventions by the current study can help to prevent childhood mortality and morbidity, as well as to achieve the target given by Sustainable development Goals 3.2.
Chemo assist for children mobile health application to manage chemotherapy-related symptoms in acute leukemia in Indonesia: a user-centered design approach
Authors: Novrianda Dwi , Herini Elisabeth Siti , Haryanti Fitri , Supriyadi Eddy , Lazuardi Lutfan
Published: May 2023

Background

A mobile health (mHealth) application can encourage parents and pediatric patients to be involved in caring for their child’s health condition by providing the ability to identify and actively manage chemotherapy-related symptoms in their child. Several monitoring systems available today are diverse in features and system basis. This study aimed to develop and trial the Chemo Assist for Children (CAC) mHealth application for symptom management in children with acute lymphoblastic leukemia (ALL).

Methods

In this study, the development of the CAC application went through multiple phases and methods. Study phases included: (1) development of the application’s feature based on the need assessment, (2) creation of content of application based on literature review, (3) develop prototyping of CAC, (4) expert review and feedback on the application content, (5) usability testing by targeted end-user.

Results

Based on need assessment, it was determined that parents with leukemia children were interested in symptom management of chemotherapy and preferred mobile applications. Therefore, a mHealth application was designed to include features to identify symptoms and provide recommendation strategies to manage the symptom. Usability evaluation by end-user revealed that mHealth is a valid, accessible, and appropriate application for users.

Conclusions

The CAC mHealth application developed can meet the needs of technology users to identify symptoms and manage chemotherapy-related symptoms in children with ALL. The CAC mHealth application can accommodate data not recorded at out-of-hospital care, increase the independence of symptom management, and improve communication between parents of children with ALL and health workers.
Hoarseness as the first symptom in a patient with acute suppurative thyroiditis secondary to a pyriform sinus fistula: a case report
Authors: Otsuki Toshifumi , Onuma Ryoichi , Tonsho Kohei , Saito Dai , Sakai Hideyuki , Kamimura Miki , Watanabe Yohei , Kurihara Noriko , Ishida Eiichi , Kumaki Satoru
Published: May 2023

Background

Pyriform sinus fistulas (PSFs) are rare congenital anomalies of the third or fourth brachial pouch. Dyspnea is reportedly secondary to compression by a neck mass. However, hoarseness, as the first symptom of PSF, has not yet been reported.

Case presentation

This report describes an 11-year-old girl presenting with hoarseness as the first symptom of PSF. Hoarseness occurred 2 days prior to admission. On admission, she had fever, hoarseness, and an elastic soft mass on her left anterior neck. Contrast-enhanced computed tomography of the cervical region demonstrated an abscess partially infiltrating the thyroid gland and an air pocket near the pyriform sinus. Pharyngoscopy revealed swelling of the left arytenoid region, with purulent retention. The left vocal cord was swollen but not paralyzed. Additionally, the laboratory data indicated thyrotoxicosis. Suspecting a PSF infection, parenteral treatment with cefotaxime and dexamethasone was initiated. On the following day, the hoarseness disappeared, and the fever resolved. Four weeks after onset, the thyroid hormone levels returned to the normal range, and a barium esophagogram revealed residual contrast in the left pyriform sinus, leading to a diagnosis of PSF.

Conclusion

PSF presenting with hoarseness as the first symptom in patients should be considered.
COVID-19-associated impact and post-traumatic stress symptoms 39 days after pandemic in a sample of home-quarantined Chinese college students: the mediating effecting of past stressful events, psychological resilience, and social support
Authors: Zeng Fanmin , John Wong Chee Meng , Sun Xueli , Wang Yarong
Published: May 2023

Background

During the COVID-19 outbreak, most Chinese college students were home-quarantined to prevent the spread of the virus. COVID-19-associated impact has been shown to be a risk factor for the development of post-traumatic symptoms disorder (PTSD). However, little is known about the psychological processes that mediate this association. This study investigated the association between COVID-19-associated impact and PTSD and examined whether past stressful events, psychological resilience, and social support have mediating effects on this association.

Methods

The 12,397 valid responses from 31cities in China via an online survey assessed PTSD symptoms, past stressful events, psychological resilience, social support and social-demographic variables. AMOS was used to test the hypotheses of mediating effects.

Results

On the 39th day of the declared COVID-19 epidemic in China, 6.75% of the surveyed sample showed PTSD symptoms. A positive mediating effect of past stressful events was found between COVID-19-associated impact and PTSD, whereas psychological resilience and social support had negative mediating effects. The fit indices for the path model were found to be significant (β = 0.28, p < 0.001), COVID-19-associated impact indirectly affects the risk of PTSD through mediating pathways (past stressful events → psychological resilience → social support) on PTSD.

Conclusions

Attention should be paid to the effects of past stressful events of Chinese college students who were home-quarantined during the COVID-19 epidemic, and strategies should also be implemented to improve social support and develop psychological resilience.

Trial registration

The study was approved by the ethics committee of the Southwest Minzu University.
The relationship between home and community-based healthcare services utilization and depressive symptoms in older adults in rural China: a moderated mediation model
Authors: Huang Zishuo , Xu Tingke , Zhang Rujia , Zhang Xinxin , Wang Shanshan , Zhang Jiayun , Yang Qingren , Fu Yating , Gui Jia , Zhang Xiangyang , Chen Chun
Published: May 2023

Background

Studies have shown a close association between home and community-based healthcare services (HCBHS) utilization and depressive symptoms in older adults. However, no studies have explored the underlying mechanism of this relationship in rural China. This study was designed to evaluate the roles of instrumental activities of daily living (IADL) and marital status in the association between HCBHS utilization and depressive symptoms in Chinese rural older adults.

Methods

Data were obtained from the 2018 China Health and Retirement Longitudinal Study, and 5,981 rural respondents (≥ 60 years old) were included. Depression scores were calculated using the ten-item Center for Epidemiological Studies Depression Scale. Moderated mediation analysis was carried out applying Hayes’ PROCESS macro (Model 7).

Results

HCBHS utilization had a direct and negative effect on depressive symptoms. Furthermore, marital status moderated the association between HCBHS utilization and IADL, which belonged to the indirect influence of the first half on the association between HCBHS utilization and depressive symptoms. HCBHS utilization was associated with IADL in single but not in married respondents.

Conclusion

The results demonstrated that marital status moderated the indirect relationship between HCBHS utilization and depressive symptoms, with HCBHS utilization being negatively associated with IADL among single but not married respondents. The government should focus on rural older adults, especially those who are single and have poor IADL function, and improve the provision of HCBHS to alleviate depressive symptoms.
Are we equally at risk of changing smoking behavior during a public health crisis? Impact of educational level on smoking from the TEMPO cohort
Authors: Andersen Astrid Juhl , Hecker Irwin , Wallez Solène , Witteveen Anke , Lora Antonio , Mittendorfer-Rutz Ellenor , Corrao Giovanni , Walter Henrik , Haro Josep Maria , Sijbrandij Marit , Compagnoni Matteo Monzio , Felez-Nobrega Mireia , Kalisch Raffael , Bryant Richard , Melchior Maria , Mary-Krause Murielle
Published: May 2023

Background

The COVID-19 pandemic as a public health crisis has led to a significant increase in mental health difficulties. Smoking is strongly associated with mental health conditions, which is why the pandemic might have influenced the otherwise decline in smoking rates. Persons belonging to socioeconomically disadvantaged groups may be particularly affected, both because the pandemic has exacerbated existing social inequalities and because this group was more likely to smoke before the pandemic. We examined smoking prevalence in a French cohort study, focusing on differences between educational attainment. In addition, we examined the association between interpersonal changes in tobacco consumption and educational level from 2018 to 2021.

Methods

Using four assessments of smoking status available from 2009 to 2021, we estimated smoking prevalence over time, stratified by highest educational level in the TEMPO cohort and the difference was tested using chi2 test. We studied the association between interpersonal change in smoking status between 2018 and 2021 and educational attainment among 148 smokers, using multinomial logistic regression.

Results

Smoking prevalence was higher among those with low education. The difference between the two groups increased from 2020 to 2021 (4.8–9.4%, p < 0.001). Smokers with high educational level were more likely to decrease their tobacco consumption from 2018 to 2021 compared to low educated smokers (aOR = 2.72 [1.26;5.89]).

Conclusion

Current findings showed a widening of the social inequality gap in relation to smoking rates, underscoring the increased vulnerability of persons with low educational level to smoking and the likely inadequate focus on social inequalities in relation to tobacco control policies during the pandemic.
The effect of informal social support on the health of Chinese older adults: a cross-sectional study
Authors: Yang Ciran , Jia Changli , Yin Shicheng , Mao Zongfu , Cui Dan
Published: May 2023

Background

This study aimed to assess the effect of informal social support (ISS) on the health of Chinese older adults, identify channels of the association between the two, and assess the magnitude of this effect in different groups of older adults.

Methods

Based on the data from the 2018 China Longitudinal Aging Social Survey (CLASS), we first used both the Quality of Well-Being (QWB) scale and the analytic hierarchy process (AHP) method to construct the QWB score that can objectively measure the health status of Chinese older adults. Next, we conducted an econometric equation controlling for various high-dimensional fixed effects, estimated the effects using the Tobit model, and used various robustness check strategies and the propensity score matching (PSM) method to ensure reliability and deal with the potential endogeneity, respectively. Finally, we performed staging and grouping regression for mechanism and heterogeneity analysis.

Results

The mean QWB score of Chinese older adults was 0.778. ISS has a significant positive effect on the health of older adults (P < 0.001), and there were similar patterns of findings for the effects of SE (P < 0.001), PSS (P < 0.001), and ES (P < 0.001). Additionally, the health promotion effect is higher in older adults who are male (P < 0.001), under the age of 80 (P < 0.001), with agricultural household registration (P < 0.001), or with high income (P < 0.001) than in the control group.

Conclusion

ISS, including SE, PSS, and ES, had significant promotion effects on the health of older adults, especially on those who are male, under the age of 80, with agricultural household registration, or with high income. Meanwhile, these effects could be reflected through two channels: alleviating loneliness and improving the positive emotional status of older adults.
Evaluation of the Little Rock Green Schoolyard initiative: a quasi-experimental study protocol
Authors: Barenie Matthew J. , Howie Erin K. , Weber Kari A. , Thomsen Michael R.
Published: May 2023

Background

Evidence suggests that access to green schoolyards may facilitate vigorous play and lead to increased physical activity, which could lead to improved academic outcomes and reduce excess childhood weight gain. Greener schoolyards can also provide additional outdoor amenities that help the community at large. The Little Rock Green Schoolyard Initiative, a program aiming to promote outdoor learning and play in two of the city’s community schools, provides a natural experiment to evaluate the role of such interventions. This article presents the protocols and study plans that will be used to evaluate this community-led initiative on several outcomes including physical activity, sleep quality, use of schoolgrounds, and perceptions of the school environment. Administrative datasets will be used to assess exposure to green schoolyard improvements on academic achievement, attendance, and disciplinary referrals during elementary school.

Methods

Data will be gathered in two community schools where the green schoolyard improvements are taking place and in two demographically-matched comparison schools located elsewhere within the Little Rock School District. Data will be collected before, during, and after the green schoolyard improvements go into effect. Physical activity and sleep quality will be measured using actigraphy. Physical activity will also be assessed through direct playground observations during recess and outside of school hours. During the final year of the study, administrative data will be assembled and evaluated using difference-in-differences estimation and synthetic controls, two causal inference methods from the program evaluation literature.

Discussion

The study is designed to provide new insights into the design, implementation, and evaluation of playgrounds among schoolchildren, especially those who are at risk of developing severe obesity during their elementary school years. The research herein will develop empirical data, elucidate potential mechanisms, and practical experience for future study, policymaking, and health services.
Risk of dengue, Zika, and chikungunya transmission in the metropolitan area of Cucuta, Colombia: cross-sectional analysis, baseline for a cluster-randomised controlled trial of a novel vector tool for water containers
Authors: Carrillo Maria Angelica , Cardenas Rocio , Yañez Johanna , Petzold Max , Kroeger Axel
Published: May 2023

Background

Arbovirus diseases such as dengue, Zika, and chikungunya are a public health threat in tropical and subtropical areas. In the absence of a vaccine or specific treatment, vector management (in this case the control of the primary vector Aedes aegypti) is the best practice to prevent the three diseases. A good understanding of vector behaviour, ecology, human mobility and water use can help design effective vector control programmes. This study collected baseline information on these factors for identifying the arbovirus transmission risk and assessed the requirements for a large intervention trial in Colombia.

Methods

Baseline surveys were conducted in 5,997 households, randomly selected from 24 clusters (neighbourhoods with on average 2000 houses and 250 households inspected) in the metropolitan area of Cucuta, Colombia. The study established population characteristics including water management and mobility as well as larval-pupal indices which were estimated and compared in all clusters. Additionally, the study estimated disease incidence from two sources: self-reported dengue cases in the household survey and cases notified by the national surveillance system.

Results

In all 24 study clusters similar social and demographic characteristics were found but the entomological indicators and estimated disease incidence rates varied. The entomological indicators showed a high vector infestation: House Index = 25.1%, Container Index = 12.3% and Breteau Index = 29.6. Pupae per person Index (PPI) as an indicator of the transmission risk showed a large range from 0.22 to 2.04 indicating a high transmission risk in most clusters. The concrete ground tanks for laundry –mostly outdoors and uncovered- were the containers with the highest production of Ae. aegypti as 86.3% of all 17,613 pupae were identified in these containers. Also, the annual incidence of dengue was high: 841.6 self-reported cases per 100,000 inhabitants and the dengue incidence notified by the National surveillance system was 1,013.4 cases per 100,000 in 2019. Only 2.2% of the households used container water for drinking. 40.3% of the study population travelled during the day (when Aedes mosquitoes bite) outside their clusters.

Conclusions

The production of Ae. aegypti mosquitoes occurred almost exclusively in concrete ground tanks for laundry (lavadero), the primary intervention target. The baseline study provides necessary evidence for the design and implementation of a cluster randomized intervention trial in Colombia.
Positive maternal mental health in pregnant women and its association with obstetric and psychosocial factors
Authors: Monterrosa-Castro Álvaro , Romero-Martínez Shairine , Monterrosa-Blanco Angélica
Published: May 2023

Objective

To estimate the frequency of Positive Maternal Mental Health (PMMH) interpretation levels in pregnant women who attended prenatal consultation and to identify their association with obstetric and psychosocial factors.

Methods

A cross-sectional study that included pregnant women who attended prenatal care at 12 or more weeks of gestation. The following scales were applied: Positive Mental Health Questionnaire (PMHQ), Goldberg Anxiety and Depression Scale, and Jong Gierveld Loneliness Scale.

Results

702 pregnant women were evaluated; 634 (90.3%) had flourishing PMMH, and 68 (9.7%) had non-flourishing PMMH. Among the latter, all were at an intermediate level, and none were languishing. Flourishing PMMH was more frequent in adults (91.2%) compared to adolescents (75.0%) and in women with higher education (93.0%) than in those with basic education (83.9%). The PMHQ factors and global score correlated positively with maternal age and negatively with anxiety, depression, emotional, social, and general loneliness. Associated with a higher frequency of non-flourishing PMMH were general loneliness OR:6.32[CI95%:3.38–11.82], social loneliness OR:5.98[CI95%:3.42–10.42], adolescence OR:3.47[CI95%:1.61–7.45], emotional loneliness OR:3.12[1.83–5.32], anxiety OR:2.14[CI95%:1.27–3.60], and depression OR:1.88[CI95%:1.09–3.25]. Less frequently: work occupation outside the home OR:0.41[CI95%:0.24–0.68], technical/technological studies OR:0.22[CI95%:0.08–0.60] and university OR:0.27[CI95%:0.10–0.71]. Preconception consultation, desired pregnancy, cesarean section, and fetal or neonatal death were not associated. In the adjusted model: general loneliness OR:3.02[CI95%:1.10–8.31], social loneliness OR:2.82[CI95%:1.38–5.79] and anxiety OR:1.93[CI95%:1.02–3.67], retained statistical significance.

Conclusion

Nine out of ten pregnant women had flourishing PMMH, and none had languishing PMMH. None of the obstetric factors were associated with non-flourishing PMMH but with general loneliness, social loneliness, and anxiety.
Prevalence and variability of HIV/AIDS-associated neurocognitive impairments in Africa: a systematic review and meta-analysis
Authors: Mekuriaw Birhanie , Belayneh Zelalem , Teshome Worku , Akalu Yonas
Published: May 2023

Abstracts

Background

HIV/AIDS-associated neurocognitive impairments negatively affect treatment adherence, viral load suppression, CD4 count, functionality, and the overall quality of life of people with seropositive status. However, huge variability is observed across primary studies regarding the prevalence and determinants of neurocognitive impairment in people with HIV/AIDS. This systematic review and meta-analysis sought to determine the pooled prevalence of neurocognitive impairment and identify factors contributing to variations in its estimate among people living with HIV/AIDS in Africa.

Methods

A comprehensive literature search of scientific databases (Medline/PubMed, SCOPUS, Web of Science, PsycINFO, and EMBASE) was performed from inception onward. Google and Google Scholar were also searched for grey literature. Research articles available until July 15, 2022 were included. We used STATA-version 14 statistical software for analysis. A random effect model was executed to pool the reported prevalence of neurocognitive impairments. Subgroup analysis was done to show variations in the prevalence of neurocognitive impairments and factors that might contribute to these variations.

Results

A literature search resulted in 8,047 articles. After the removal of duplications and thorough evaluation, a total of 49 studies were included in the meta-analysis. The prevalence of HIV/AIDS-associated neurocognitive impairments was highly variable across studies, ranging from 14% to 88%, yielding the pooled prevalence of HIV/AIDS-associated neurocognitive impairment to be 46.34% [95% CI (40.32, 52.36)] and I2 = 98.5% with a P-value of 0.001.

Conclusions

A large proportion of people living with HIV/AIDS in Africa have HIV/AIDS-associated neurocognitive impairment. This illustrates the need to establish practical approaches to early identification and effective control of HIV/AIDS-associated neurocognitive impairments. However, there were variabilities in the reported prevalence of HIV/AIDS-associated neurocognitive impairments across studies. This further demonstrates the need to have consistent measurement approaches.

Trial registration

PROSPERO 2022, “CRD42020166572”.
Evaluating the effect of educational intervention based on the health belief model on the lifestyle related to premenstrual syndrome and reduction of its symptoms among the first-grade high school girls
Authors: Khalilzadeh Parisa , Amirzadeh-iranagh Jamileh , Khalkhali Hamid Reza , Maheri Mina
Published: May 2023

Introduction

A healthy lifestyle can reduce the rate and symptoms of premenstrual syndrome. Thus, the present study evaluates the effect of educational intervention based on the Health Belief Model on the lifestyle related to premenstrual syndrome and reduction of its symptoms among the first-grade high school girls.

Methods

This quasi-experimental study was conducted on 80 first-grade high school girls. They were divided into two intervention and control groups (40 people in each group). The data collection tools included the participants’ demographic information questionnaire, premenstrual symptoms screening tool, and a researcher-made questionnaire based on the constructs of the health belief model about PMS and the behaviors reducing its symptoms. Data were collected in two phases (before and three months after the educational intervention) via WhatsApp. Educational sessions were held in the form of four 45-min sessions for intervention group subjects regarding PMS and the behaviors that reduce its symptoms during one month via WhatsApp.

Results

According to the results of this study, the mean scores of knowledge about PMS and health belief model constructs (including perceived susceptibility), perceived severity, perceived benefits, perceived self-efficacy, cues to action, lifestyle/behaviors that reduce PMS symptoms) and the percentage of people who did not have PMS symptoms or had a mild type of PMS increased significantly after implementing the educational intervention in the intervention group compared to before the intervention and compared to the control group. Also, the perceived barriers construct score PMS decreased significantly.

Conclusions

The health belief model education focused on a healthy lifestyle was effective in reducing PMS symptoms. It is recommended to use the educational intervention designed in this study, along with other health care in schools and during puberty as an easy, low-cost, and effective intervention.