bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrospun porous materials laden with tea tree oil and zinc nitrate exhibiting tailored physicochemical and in vitro apatite formation
Authors: Mani Mohan Prasath , Jaganathan Saravana Kumar , Md Khudzari Ahmad Zahran , bin Ismail Ahmad Fauzi , Faudzi Ahmad Athif Mohd , Tucker Nick
Published: November 2022

Scaffold designs must accommodate the complex regeneration processes of damaged bone tissues. We attempt to achieve this goal by developing a composite electrospun scaffold mimicking the structural and functional requirements of extra cellular matrix This study investigates the use of a novel bone tissue regeneration formulation of tea tree oil (TT) and zinc nitrate Zinc2 incorporated into a polyurethane (PU) nanofibres scaffold fabricated via the well-known electrospinning technique.The diameter of these nanocomposites fibres was smaller (PU/TT-495 ± 184 nm and PU/TT/(ZnNO3)2–409 ± 155 nm) than polyurethane (1099 ± 118 nm) on its own. Fourier transform infrared spectroscopy analysis revealed that the PU and the additives interact through hydrogen-bond formation. Measuring the wettability of the PU/TT indicated a hydrophobic nature (115 ± 2) which was reversed by the addition of (ZnNO3)2 to PU/TT (69° ± 2). TT and the addition of (ZnNO3)2 increased the tensile strength. Atomic force microscopy showed that the fibres of PU/TT (633 ± 297 nm) and PU/TT/(ZnNO3)2 (345 ± 147 nm)were smoother than the PU (854 ± 32 nm). The developed nanocomposites showed delayed blood clot activation and reduced toxicity as determined by anticoagulant studies. Further, bone-forming abilities quantified by in vitro calcium deposition studies indicated enhanced calcium deposition (PU/TT-5.6% and PU/TT/(ZnNO3)2–10.8%) in comparison to PU (2.4%). We have demonstrated that the attributes of these nanocomposites maybe successfully exploited for bone reconstruction.
Exploring behaviour change in general practice consultations: A realist approach
Authors: Advocat Jenny , Sturgiss Elizabeth , Ball Lauren , Williams Lauren T , Prathivadi Pallavi , Clark Alexander M
Published: November 2022

Objectives

While general practice involves supporting patients to modify their behaviour, General Practitioners (GPs) vary in their approach to behaviour change during consultations. We aimed to identify mechanisms supporting GPs to undertake successful behaviour change in consultations for people with T2DM by exploring (a) the role of GPs in behaviour change, (b) what happens in GP consultations that supports or impedes behaviour change and (c) how context moderates the behaviour change consultation.

Methods

Semi-structured interviews with academic clinicians ( n = 13), GPs ( n = 7) and patients with T2DM ( n = 16) across Australia. Data were analysed thematically using a realist evaluation approach.

Results

Perspectives about the role of GPs were highly variable, ranging from the provision of test results and information to a relational approach towards shared goals. A GP–patient relationship that includes collaboration, continuity and patient-driven care may contribute to a sense of successful change. Different patient and GP characteristics were perceived to moderate the effectiveness and experience of behaviour change consultations.

Discussion

When patient factors are recognised in consultations, a relational approach becomes possible and priorities around behaviour change, that might be missed in a transactional approach, can be identified. Therefore, GP skills for engaging patients are linked to a person-centred approach.
Common and serious ENT presentations in primary care
Authors: Hayois Loïc , Dunsmore Agata
Published: November 2022

Ear, nose and throat (ENT) conditions present in about 10% of all GP consultations. The most common presentations include otalgia, cough, rhinorrhoea and deafness. These presentations are caused typically by self-limiting infections, but a small proportion is caused by rare or serious conditions needing referral to secondary care for investigation and treatment. The aim of this article is to provide a brief review of the wide range of common ENT presentations and other more serious conditions that need to be considered and diagnosed in primary care. We aim to guide management decisions including appropriate referral when needed.
Perioperative Management of Obstructive Sleep Apnea in Patients With Syndromic Craniosynostosis Undergoing LeFort III Osteotomy With Distraction: A Case Series
Authors: Brown Kathryn W. , Edwards Shelley R. , Hoppe Ian C.
Published: November 2022

Study Design

Retrospective observational study.

Objective

The purpose of this publication is to address the absence of literature detailing respiratory management in patients with syndromic craniosynostosis and obstructive sleep apnea during the immediate postoperative interval following LeFort III advancement with placement of distraction hardware but prior to sufficient midface advancement.

Methods

After IRB approval, the investigators retrospectively selected candidates for inclusion in this case series. The sample was composed of four patients ranging from 10 to 19 years of age undergoing LeFort III midface advancement during a one-year span at a single tertiary care center. All operations were performed by a single surgeon. Three of the selected patients suffered significant obstructive sleep apnea necessitating the operation, as determined by polysomnography. One patient experienced persistent apnea postoperatively requiring prolonged ICU level care.

Results

Three of the four patients had severe OSA diagnosed by polysomnography with a median AHI of 28.3. Two of the three patients with preoperative OSA experienced no untoward respiratory compromise in the immediate postoperative period; one required nightly oxygen tent and the other required no supplemental oxygen. Patient 1 experienced significant postoperative respiratory distress with nightly apneic episodes and desaturations requiring supplemental oxygen and frequent stimulation.

Conclusions

The present study suggests that early involvement of sleep medicine and management of patient expectations is vital. Extremely close postoperative monitoring in the ICU is necessary. Future studies are needed to protocolize perioperative management of obstructive sleep apnea in patients undergoing LeFort III osteotomy prior to initiation and completion of midface advancement.
Socio-emotional Benefits Associated with Choir Participation for Older Adults Related to Both Activity Characteristics and Motivation Factors
Authors: Maury Susan , Vella-Brodrick Dianne , Davidson Jane , Rickard Nikki
Published: November 2022

Community choirs can contribute to health and wellbeing, but there is less clarity about the mechanisms through which choir participation promotes positive change, or whether mechanisms are shared with other leisure activities. This research explores two possible types of mechanism: Mechanisms relating to individual characteristics pertaining to mindset and motivation, including experiences of flow, competence, autonomy, and relatedness (Study 1); and mechanisms relating to the activity experience, which include music, movement, and social opportunities (Study 2). In Study 1, middle and older aged members of choirs, exercise groups and other kinds of social groups (N = 190) completed surveys on their experience of emotional wellbeing (operationalized as positive and negative affect scores), mental wellbeing, and social cohesion (outcomes) pertaining to their group activity as well as experiences of motivation, flow, and the components of Self-Determination Theory (potential mediators). Multiple regression analyses revealed that participation in Choir or Exercise groups predicted positive emotional wellbeing, but not social cohesion. Underlying mechanisms differed, with positive affect mediated by intrinsic motivation for choir members, and by intrinsic motivation, identified regulation, and flow for Exercise group members. Mental wellbeing was correlated only with exercise group participation and was mediated by flow. Study 2 used an experience sampling methodology conducted with a sub-group from Study 1 (N = 59), which asked daily questions about wellbeing (happiness, sense of social connection, and energy levels) and participation in activities (music engagement, exercise, and social activities) experienced in their everyday lives and not directly associated with any leisure group participation. Repeated-measures t-tests revealed that participants were more likely to report higher levels of social connection on days in which they participated in music activities than on days in which they did not engage in music activities. Engaging in exercise or social activities was also associated with a greater sense of social connection, as well as higher levels of happiness and energy. In sum, the activity characteristics and individual differences of motivation and mindset towards participation correlated with greater wellbeing, reflecting an ecological model of person-activity fit, with no indication of superior benefits associated with group singing. Findings are discussed in terms of social prescribing and other settings where social opportunities are organized.
‘Storylistening’ as a methodology for peacebuilding among young survivors of conflict and their communities in Colombia
Authors: Charles Mathew H , Fowler-Watt Karen
Published: November 2022

Working on a participatory arts project with former child soldiers and young survivors of conflict in Colombia’s indigenous Nasa community led to the development of an alternative to the qualitative interview, which we call ‘story listening’. Storylistening is a methodology for peacebuilding that took shape within a narrative based culture and embraces the importance of acknowledging the everyday, as perceived and lived by young indigenous people. Within the context of conflict and reintegrating former child soldiers, storylistening emerged from a strong oral storytelling tradition to offer a dynamic and local approach to peacebuilding. This methodology shaped the production of an animated documentary, El árbol del amor (The Tree of Love), which explores the world of forced recruitment and child soldiering. The storylistening concept contains elements of auto/biography, in that it engages with memory and identity, where space and time are important. Based on Durkheimian notions of the socioemotional, storylistening shows how sharing emotions contributes to creating, maintaining and strengthening social bonds that can inspire change. It is an active process and has a shared impact on the ‘listener’ and the ‘teller’, whereas storytelling is an individual process that does not always carry the guarantee of being listened to. For the individual, storylistening offers the potential of catharsis, while for the community, it offers the opportunity for collective reflection. In the particular case of former child soldiers, storylistening engenders effective reintegration and more broadly fosters reconciliation, which underpins peacebuilding at the community level.
Are all CSR Activities in Your SNS Authentic? The Antecedents and Outcomes of Consumer Perceived Authenticity of CSR
Authors: Wang Chen , Kim Yeonggil , Kim Changhee
Published: November 2022

Although corporate social responsibility (CSR) activities appear active on social networking sites (SNS), consumers increasingly suspect their authenticity. Based on attribution theory, this study examines consumers’ responses to SNS-based corporate social responsibility (CSR) activities by analyzing the impact of their perceptions of CSR attributes on their perceived authenticity of CSR (CPACSR) and participation intention (PI). We conducted a between-subjects experiment on a sample of 480 Korean undergraduate students to test all the hypotheses. Our findings suggest that the three CSR attributes positively affect CPACSR, partially moderated by the type of message source and CSR activity. These findings suggest several opportunities for future research that may further benefit marketers in CSR marketing decisions.
It’s Okay to be Not Okay: An Analysis of Twitter Responses to Naomi Osaka’s Withdrawal due to Mental Health Concerns
Authors: Chen Zhijing , Kwak Dae Hee
Published: November 2022

An increasing number of athletes are speaking out on different social issues. There is also a growing acceptance and expectations of athletes utilizing their influence to push for social change. In recent years, some athletes have started disclosing their mental illness and raising awareness of mental health. This study investigates Twitter user data on Naomi Osaka’s withdrawal from the French Open due to her mental health concerns, as well as examines how different Twitter sources or handles (e.g., athlete vs. news media) further shape public responses. Both thematic analysis and sentiment analysis were conducted on Twitter data to identify emergent themes and audience sentiment towards the case. Findings reveal growing positive reception of athletes’ mental health disclosures, athletes’ behavior as a form of advocacy, and utilization of social media to amplify activism efforts. The results also extend the athlete activism literature by showing how message sources shape public reactions differently. Findings provide implications for athletes and relevant stakeholders to effectively navigate through the situation by creating and delivering messages to their target audiences.
Association of Thoracic MRI Findings With Specialty and Training
Authors: Linna Nathaniel B. , Zhang Steven , Farooqi Ali S. , Jia Lori , Huffman William , Casper David S. , Khalsa Amrit S.
Published: November 2022

Study Design

Retrospective

Objective

To compare the rate of positive pathology on thoracic MRI ordered by surgical spine specialists to those ordered by nonsurgical spine specialists.

Methods

Outpatient thoracic MRIs from January–March 2019 were evaluated from a single academic health care system. Studies without a known ordering provider, imaging report, or patients with known presence of malignancy, multiple sclerosis, recent trauma, or surgery were excluded (n = 320). Imaging studies were categorized by type of provider placing the order (resident, attending, or advanced practice practitioner) and department. MRIs were deemed positive if they showed relevant pathology that correlated with indication for exam as determined by a radiologist. One-sided chi-squared analysis was performed to determine statistical significance.

Results

Overall, our data demonstrated 17.2% of studies with positive pathology. Compared to nonspecialty clinicians, subspecialists showed 35/184 (19.0%) positivity rate versus the non-specialist with 20/136 (14.7%) positivity rate (P = .156). Posthoc analysis demonstrated that surgical specialists who order thoracic MRIs yield significantly higher positivity rates at 19/79 (24.0%) compared to nonsurgical specialists at 36/241 (14.9%) (P < .05). Overall, neurosurgery demonstrated the highest rate of positive thoracic MRIs at 14/40 (35.0%). Comparison between the rate of positivity between physicians and advanced practitioners was insignificant (P > .05).

Conclusions

Clinical diagnosis of symptomatic thoracic spine degenerative disease requires an expert physical exam combined with careful attention to radiology findings. Although the percent of relevant pathology on thoracic MRI is low, our data suggests evaluation by a surgical specialist should precede ordering a thoracic spine MRI.
Factors influencing the use of herbal medications during pregnancy at Public Health Center, Indonesia
Authors: Elba Fardila , Hilmanto Dani , Poddar Sandeep
Published: November 2022

Introduction:

There has been an increase in the usage of herbal remedies, particularly among pregnant women, across the globe. The prevalence of herbal medicine use during pregnancy ranged from 54.3% to 96.6% in the region studied, indicating a rising trend in the use of herbal medicine during pregnancy. Cold and flu symptoms and stomach problems were the most prevalent reasons people turned to this drug.

Materials and methods:

This study’s samples were pregnant women in the working area of Ciwaruga Public Health Center, which has eight villages. The samples were taken using a proportional simple random sampling technique until 96 respondents were obtained. The percentage of moms who took herbal medication was the primary outcome variable, and participants were chosen for the research using a systematic sampling procedure. A digital database was used to store quantitative data that had been coded.

Results:

The factors significantly associated with the use of herbal medicines during pregnancy were perception (OR 2.18; CI 1.02–4.66), having ever used herbal medicines during a previous pregnancy (OR 3.87; CI 1.46–10.25), and healthy reproductive is other reasons (OR 7.98; CI 4.45–14.30).

Conclusion:

Pregnant women in the Ciwaruga Public Health Center area often turn to herbal remedies, which may indicate a lack of access to mainstream medical treatment. They believe that herbal medications are useful and that using them during a prior pregnancy is linked.
SLAP Repair Versus Biceps Tenodesis in Patients Younger Than 40 Years: A Cost-Effectiveness Analysis
Authors: Sandler Alexis B. , Childs Benjamin R. , Scanaliato John P. , Dunn John C. , Parnes Nata
Published: November 2022

Background:

The surgical management of type II superior labrum anterior and posterior (SLAP) tears in patients younger than 40 years is controversial, but growing evidence suggests comparable outcomes between primary SLAP repair and primary biceps tenodesis, with lower rates of reoperations after primary biceps tenodesis. Given the relatively similar patient-reported outcomes, cost-effectiveness analyses of direct and indirect costs associated with the two procedures propound a valuable comparative technique.

Hypothesis:

In this value-based comparison of SLAP repair versus biceps tenodesis, we hypothesized that biceps tenodesis would be more cost-effective than SLAP repair in patients younger than 40 years.

Study Design:

Economic and decision analysis; Level of evidence, 4.

Methods:

A 1-month Markov cycle was simulated to reflect 10 years of health outcomes. Health states were selected based on outcomes that are especially important in assessing indirect costs for a younger, active patient population: return-to-sport rates, which demonstrate a return to baseline function, and reoperation rates. Transition state probabilities were obtained through an index systematic review and meta-analysis comparing labral repair and biceps tenodesis for the treatment of type II SLAP lesions in patients younger than 40 years. Health state utility and cost values were obtained from accepted values denoted in existing literature.

Results:

Both primary SLAP repair and primary biceps tenodesis yielded an average expected 8.1 quality-adjusted life years over the 10-year period. The average cost (in 2021 US$) was $16,619 for biceps tenodesis and $19,388 for SLAP repair.

Conclusion:

In a younger patient population, SLAP repair and biceps tenodesis had comparable quality-adjusted life years and utility in the treatment of type II SLAP tears; however, SLAP repair cost $19,388, while biceps tenodesis cost $16,619, reflecting a 14% cost savings with biceps tenodesis. These findings can be extrapolated to further establish the role for these procedures in treating SLAP tears.
Icaritin inhibits neuroinflammation in a rat cerebral ischemia model by regulating microglial polarization through the GPER–ERK–NF-κB signaling pathway
Authors: Yu Zining , Su Guangjun , Zhang Limei , Liu Gaigai , Zhou Yonggang , Fang Shicai , Zhang Qian , Wang Tianyun , Huang Cheng , Huang Zhihua , Li Liangdong
Published: November 2022

Background

Activated microglia play a key role in initiating the inflammatory cascade following ischemic stroke and exert proinflammatory or anti-inflammatory effects, depending on whether they are polarized toward the M1 or M2 phenotype. The present study investigated the regulatory effect of icaritin (ICT) on microglial polarization in rats after cerebral ischemia/reperfusion injury (CI/RI) and explored the possible anti-inflammatory mechanisms of ICT.

Methods

A rat model of transient middle cerebral artery occlusion (tMCAO) was established. Following treatment with ICT, a G protein-coupled estrogen receptor (GPER) inhibitor or an extracellular signal-regulated kinase (ERK) inhibitor, the Garcia scale and rotarod test were used to assess neurological and locomotor function. 2,3,5-Triphenyltetrazolium chloride (TTC) and Fluoro-Jade C (FJC) staining were used to evaluate the infarct volume and neuronal death. The levels of inflammatory factors in the ischemic penumbra were evaluated using enzyme-linked immunosorbent assays (ELISAs). In addition, western blotting, immunofluorescence staining and quantitative PCR (qPCR) were performed to measure the expression levels of markers of different microglial phenotypes and proteins related to the GPER–ERK–nuclear factor kappa B (NF-κB) signaling pathway.

Results

ICT treatment significantly decreased the cerebral infarct volume, brain water content and fluorescence intensity of FJC; improved the Garcia score; increased the latency to fall and rotation speed in the rotarod test; decreased the levels of interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), Iba1, CD40, CD68 and p-P65-NF-κB; and increased the levels of CD206 and p-ERK. U0126 (an inhibitor of ERK) and G15 (a selective antagonist of GPER) antagonized these effects.

Conclusions

These findings indicate that ICT plays roles in inhibiting the inflammatory response and achieving neuroprotection by regulating GPER–ERK–NF-κB signaling and then inhibiting microglial activation and M1 polarization while promoting M2 polarization, which provides a new therapeutic for against cerebral ischemic stroke.

Graphical Abstract
Current utilization of interosseous access in pediatrics: a population-based analysis using an EHR database, TriNetX
Authors: Hoskins Meloria , Sefick Samantha , Zurca Adrian D. , Walter Vonn , Thomas Neal J. , Krawiec Conrad
Published: November 2022

Background

When central or peripheral intravenous access cannot be achieved in a timely manner, intraosseous (IO) access is recommended as a safe and equally effective alternative for pediatric resuscitation. IO usage and its complications in the pediatric population have been primarily studied in the setting of cardiac arrest. However, population-based studies identifying noncardiac indications and complications associated with different age groups are sparse.

Results

This was a retrospective observational cohort study utilizing the TriNetX® electronic health record data. Thirty-seven hospitals were included in the data set with 1012 patients where an IO procedure code was reported in the emergency department or inpatient setting. The cohort was split into two groups, pediatric subjects < 1 year of age and those ≥ 1 year of age. A total incidence of IO line placement of 18 per 100,000 pediatric encounters was reported. Total mortality was 31.8%, with a higher rate of mortality seen in subjects < 1 year of age (39.2% vs 29.0%; p = 0.0028). A diagnosis of cardiac arrest was more frequent in subjects < 1 year of age (51.5% vs 38.0%; p = 0.002), and a diagnosis of convulsions was more frequent in those ≥ 1 of age (28.0% vs 13.8%; p <0.01). Overall, 29 (2.9%) subjects had at least one complication.

Conclusions

More IOs were placed in subjects ≥ 1 year of age, and a higher rate of mortality was seen in subjects < 1 year of age. Lower frequencies of noncardiac diagnoses at the time of IO placement were found in both groups, highlighting IO may be underutilized in noncardiac settings such as convulsions, shock, and respiratory failure. Given the low rate of complications seen in both groups of our study, IO use should be considered early on for urgent vascular access, especially for children less than 1 year of age.
Cardiovascular risk management: the success of target level achievement in high- and very high-risk patients in Hungary
Authors: Jancsó Zoltán , Csenteri Orsolya , Szőllősi Gergő József , Vajer Péter , Andréka Péter
Published: November 2022

Background

The management of risk factors in patients with high cardiovascular risk and its effectiveness is of paramount importance. Over the last decade, several studies have examined the achievement of cardiovascular risk factors’ target levels in Europe. In the present Hungarian study, we assessed the cardiovascular risk level of participants aged 40–65 years and the success of achieving risk factors’ target levels in high- and very high-risk patients. We compared these results with the results of two similar European studies.

Methods

We conducted a cross-sectional study involving 37,778 patients aged 40–65 years from Hungary between 2019 and 2020. Cardiovascular risk levels and target values were set according to the 2016 European Guideline. Target achievement was evaluated for body mass index, waist circumference, blood pressure, total, LDL, and HDL cholesterol, triglyceride, and HbA1c (in diabetics).

Results

For 37,298 patients, all the data were available to determine their cardiovascular risk category. Of these, 23.1% had high and 31.4% had very high cardiovascular risk (men: 27.1 and 39.6%, women: 20.5 and 26.1%, respectively). Achievement of the LDL-C target of 1.8 mmol/l was only 8.0% among very high-risk patients, which was significantly lower than the European average (29%). Achievement of target blood pressure among high-risk patients was better than the European average (63.4% vs. 44.7%, respectively); however, achievement was slightly lower among very high-risk patients compared with the European average (49.4% vs. 58%, respectively). The proportion of patients with type 2 diabetes who achieved a HbA1c below 7% was 57.3% in the high-risk population and 53% in the very high-risk population, which was in line with the European average success rates (58.5 and 54%, respectively). Waist circumference (< 88 cm for women and < 102 cm for men) was achieved by 29.4% of patients in the very high-risk group in our survey, which was lower than the European average of 41%.

Conclusions

The success rate of cardiovascular risk management in Hungary is lower than the European average in several parameters. Furthermore, our data highlight the poor effectiveness of obesity management in Hungary. General practice partnerships may be important sites for positive change.
Fear of childbirth: validation of the Kiswahili version of Wijma delivery expectancy/experience questionnaire versions A and B in Tanzania
Authors: Massae Agnes F. , Larsson Margareta , Leshabari Sebalda , Mbekenga Columba , Pembe Andrea B. , Svanberg Agneta S.
Published: November 2022

Background

Fear of childbirth is common both before and after childbirth, often leading to complications in mother and new-born. The Wijma Delivery Expectancy/Experience Questionnaires (W-DEQ) are commonly used to measure fear of childbirth among women before (version A) and after childbirth (version B). The tools are not yet validated in the Tanzanian context. This study aimed to validate the reliability, validity, and factorial structure of their Kiswahili translations.

Methods

A longitudinal study was conducted in six public health facilities in the Pwani region, Tanzania. In all, 694 pregnant and 625 postnatal women were concurrently selected and responded to W-DEQ-A and W-DEQ-B. Validation involved: translating the English questionnaires into Kiswahili; expert rating of the relevancy of the Kiswahili versions’ items; computing content validity ratio; piloting the tools; data collection; statistical analysis with reliability evaluated using Cronbach’s alpha and the intraclass correlation coefficient. Tool validity was assessed using factor analysis, convergent and discriminant validity. Exploratory factor analysis and confirmatory factor analysis were conducted on data collected using W-DEQ-A and W-DEQ-B, respectively.

Results

Exploratory factor analysis revealed seven factors contributing to 50% of the total variation. Four items did not load to any factor and were deleted. The factors identified were: fear; lack of self-efficacy; lack of positive anticipation; isolation; concerns for the baby; negative emotions; lack of positive behaviour. The factors correlated differently with each other and with the total scores. Both Kiswahili versions with 33 items had good internal consistency, with Cronbach’s alphas of .83 and .85, respectively. The concerns for the baby factor showed both convergent and discriminant validity. The other six factors showed some problems with convergent validity. The final model from the confirmatory factor analysis yielded 29 items with good psychometric properties (χ2/df = 2.26, p =  < .001, RMSEA = .045, CFI = .90 and TLI = .81).

Conclusions

The Kiswahili W-DEQ-A-Revised and W-DEQ-B-Revised are reliable tools and measure fear of childbirth with a multifactorial structure, encompassing seven factors with 29 items. They are recommended for measuring fear of childbirth among pregnant and postnatal Tanzanian women. Further studies are needed to address the inconsistent convergent validity in the revised versions and assess the psychometric properties of W-DEQ-A among pregnant women across gestational ages.
Validation of the Persian version of the Perinatal Anxiety Screening Scale (PASS) among antenatal and postnatal women
Authors: Amiri Parastoo , Bahaadinbeigy Kambiz , Asadi Fatemeh , Rahmati Shoboo , Mazhari Shahrzad
Published: November 2022

Background

Anxiety disorder is more common in women than men. To some extent, it can be attributed to childbirth and factors related to pregnancy in women. Therefore, it is necessary for mothers to use valid and reliable scale to assess perinatal anxiety, such as the perinatal anxiety screening scale (PASS). The purpose of this study was to investigate the validity and reliability of the PASS in Persian language.

Methods

The PASS was translated into Persian (PASS-IR). Generally, 224 women antenatal and 125 postnatal answered the questions of PASS, EPDS-10, BAI and DASS-21 questionnaires. The data was collected in the health centers of Kerman by random sampling method. Finally, content validity, factor analysis, internal consistency and test-retest reliability were evaluated.

Results

The mean age of the participants was 32.89 years (range between 18 and 45 and SD = 6.23). More than half of the participating were at risk of severe anxiety (53.5%). Content Validity Index (CVI) and Content Validity Ratio (CVR) were 0.80 and 0.87. PASS-IR subscales include social anxiety and specific fears, general anxiety and adjustment, acute anxiety and trauma, and perfectionism and control. PASS-IR was significantly correlated with EPDS-10 (rho = 0.42), BAI (rho = 0.53), DASS-21 with three concepts of depression, anxiety and stress (rho = 0.51, rho = 0.49 and rho = 0.49), and adverse life events (rho = 0.30).

Conclusion

The results of this study show that PASS-IR has good validity and reliability. Therefore, it can be used to screen for anxiety disorder among Iranian women in the perinatal stage.
Induction TPF followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locally advanced hypopharyngeal cancer: a preliminary analysis of a randomized phase 2 trial
Authors: Luo Xi , Huang Xiaodong , Luo Jingwei , Xiao Jianping , Wang Kai , Qu Yuan , Chen Xuesong , Zhang Ye , Wu Runye , Wang Jingbo , Zhang Jianghu , Xu Guozhen , Gao Li , Liu Shaoyan , Wang Xiaolei , He Xiaohui , Luo Dehong , Yi Junlin
Published: November 2022

Purpose

Concurrent chemoradiotherapy (CCRT) is a standard treatment choice for locally advanced hypopharyngeal carcinoma. The aim of this study was to investigate whether induction chemotherapy (IC) followed by CCRT is superior to CCRT alone to treat locally advanced hypopharyngeal carcinoma.

Methods and materials

Patients (n = 142) were randomized to receive two cycles of paclitaxel/cisplatin/5-fluorouracil (TPF) IC followed by CCRT or CCRT alone. The primary end point was overall survival (OS). The secondary end points included the larynx-preservation rate, progression-free survival (PFS), distant metastasis-free survival (DMFS), and toxicities.

Results

Ultimately, 113 of the 142 patients were analyzed. With a median follow-up of 45.6 months (interquartile range 26.8–57.8 months), the 3-year OS was 53.1% in the IC + CCRT group compared with 54.8% in the CCRT group (hazard ratio, 1.004; 95% confidence interval, 0.573–1.761; P = 0.988). There were no statistically significant differences in PFS, DMFS, and the larynx-preservation rate between the two groups. The incidence of grade 3–4 hematological toxicity was much higher in the IC+ CCRT group than in the CCRT group (54.7% vs. 10%, P < 0.001).

Conclusions

Adding induction TPF to CCRT did not improve survival and the larynx-preservation rate in locally advanced hypopharyngeal cancer, but caused a higher incidence of acute hematological toxicities.

Trial registration

ClinicalTrials.gov, number NCT03558035. Date of first registration, 15/06/2018.
Comparison of alternate part-time patching and pencil push-up training for patients with intermittent exotropia
Authors: Song Desheng , Yin Ling , Chen Danni , Qian Jing , Chen Zhijun
Published: November 2022

Background

To compare the effect of alternate part-time patching and pencil push-up training on control ability in patients with intermittent exotropia.

Methods

Patients (3–7 years old) with previously untreated intermittent exotropia were randomly assigned to receive alternate part-time patching, pencil push-up training, or observation. Control ability was assessed using the Office Control Score. Stereoacuity at 40 cm was evaluated with Titmus. Results were compared after a 12-week follow-up.

Results

Ninety-two patients (28 in patching, 30 in pencil push-ups, and 34 in observation group) completed 12-week follow-up assessments. Based on 6-point scale, the mean deviation control was significantly better in patching and pencil push-up group after 12 weeks at distance (P = 0.002 and 0.026, respectively). Furthermore, there were greater control changes in patching and pencil push-up groups in comparison with observation group from baseline to 12 weeks (P<0.001; P = 0.003, respectively). After 12 weeks of treatment, stereoacuity and stereoacuity changes were not significantly different between either the intervention group or control group (P = 0.140 and 0.393, respectively).

Conclusions

Based on the common office control scale, alternate part-time patching and pencil push-up training were effective treatment strategies for intermittent exotropia.
Mid-term outcomes of right subaxillary approach versus median sternotomy incision for ventricular septal defect with patent ductus arteriosus
Authors: Qiu Zhi-Huang , Wu Qing-Song , Xiao Jun , Chai Tian-Ci , Tang Mi-Rong , Xie Xian-Biao , Liao Dong-Shao , Chen Liang-Wan
Published: November 2022

Background

This study aimed to evaluate and compare two surgical approaches to repair ventricular septal defect (VSD) with patent ductus arteriosus (PDA) and to explore the patients’ health-related quality of life (HRQoL).

Methods

We conducted a retrospective study of all patients who had surgical repair of VSD and PDA between 2013 and 2015 using the right subaxillary approach (group A) or the median sternotomy incision (group B). The outcomes of both techniques were compared. Paediatric QoL Inventory 4.0 scale was applied to assess patients’ HRQoL in the 6th postoperative year. Multiple linear regression analysis was performed to explore factors associated with higher HRQoL scores.

Results

A total of 128 patients were included (group A, n = 70 and group B, n = 58). Patients in group A were older and heavier than patients in group B. In group B, the diameters of VSD and PDA were larger and the pulmonary artery pressures were higher than those in group A (p < 0.001). No mortality occurred on a mean follow-up of 8.3 ± 1.2 years. Patients in group A had higher HRQoL scores than those in group B in terms of emotional and social functioning dimensions. The right subaxillary approach (OR: 3.56; 95% CI 1.65–5.46), higher parents’ education level (OR: 1.62; 95% CI 0.65–2.31), and better family economic status (OR: 1.48; 95% CI 0.79–2.45) were associated with higher HRQoL scores.

Conclusions

Younger and smaller patients receiving median sternotomy incisions due to large defects and pulmonary hypertension had lower HRQoL scores. The right subaxillary approach, higher parents’ education level, and better family economic status were associated with higher HRQoL scores.
Nutritional and health status of adult Syrian refugees in the early years of asylum in Germany: a cross-sectional pilot study
Authors: Al Masri Feras , Müller Mattea , Straka Dorothee , Hahn Andreas , Schuchardt Jan Philipp
Published: November 2022

Background

Migration is usually accompanied by changes in the social, cultural, and religious environment, socioeconomic status, and housing conditions, all of which affect nutritional health. In a cross-sectional study, we assessed the dietary intake as well as nutritional and health situation in a population of Syrian refugees who have resided in Germany for at least six months up to four years since 2015. The primary aim of this pilot study was to evaluate the nutritional and health status in comparison to reference values.

Methods

Between December 2018 and March 2020, 114 adult Syrian refugees were included in the study. The subjects filled out questionnaires on sociodemographic variables, exercise, and nutrition behavior (three-day nutrition record). After a fasting blood draw, the subjects were examined for anthropometric parameters (height, weight, body mass index, waist circumference, waist-hip ratio, and body composition via a bioelectrical impedance analyzer). Various blood markers including iron status, hematological parameters, Vitamin D status, lipid metabolism, glucose metabolism, and total homocysteine (tHcy) were measured.

Results

About half of the participants (71 male, 43 female) had lived in Germany for less than three years. Over 60% of men and 30% of women were overweight (BMI 25–30 kg/m2) or obese (BMI > 30 kg/m2), while 79% of men and 74% of women observed an elevated body fat mass. The evaluation of the three-day nutrition records revealed an unfavorable supply situation for numerous critical nutrients. More than half of the women (53.5%) had depleted iron stores (serum ferritin < 15 µg/l). The 25-OH-Vitamin D blood levels showed a high prevalence of Vitamin D insufficiency (25–49.9 nmol/l: 38% of men and 21% of women) and deficiency (< 25 nmol/l: 44% of men and 70% of women). 83% of men and 67% of women showed tHcy levels in plasma > 10 nmol/l. Fasting insulin levels and the HOMA-IR index indicate a risk for insulin resistance. Hyperlipidemia was prevalent, especially in males with 24% showing hypertriglyceridemia (> 150 mg/dl) and LDL-hypercholesterolemia (> 130 mg/dl).

Conclusions

The nutritional and health status of the cohort of Syrian refugees in Germany examined in this study is unsatisfactory, and many of the investigated refugees are at risk for developing cardiovascular disease and type 2 diabetes mellitus. Further studies are required to investigate the nutritional and health situation of refugees. This is obligatory to find ways to avoid malnutrition with all its associated health, sociodemographic, and economic consequences.
Community-based non-pharmacological interventions for pregnant women with gestational diabetes mellitus: a systematic review
Authors: Igwesi-Chidobe Chinonso Nwamaka , Okechi Peace Chioma , Emmanuel Grace Nneoma , Ozumba Benjamin C.
Published: November 2022

Background

Non-pharmacological interventions are the first line of Gestational diabetes mellitus (GDM) management. Community-based interventions are cheaper, more accessible, with higher patient satisfaction.

Objectives

To systematically review community-based non-pharmacological interventions and evaluate their effectiveness for GDM.

Search strategy

Twelve bibliographic databases and reference list of related studies from inception until January 2022.

Selection criteria

All primary studies of community-based non-pharmacological interventions for GDM reported in English which investigated any behavioural or clinical outcome(s).

Data collection and analysis

Data were extracted using modified Cochrane’s data extraction template. Studies were evaluated using Cochrane Collaboration’s risk of bias tool. Narrative synthesis was used to summarise findings. This study is registered with PROSPERO (CRD42021257634).

Main results

Twenty-seven studies involving 6,242 pregnant women with GDM investigated self-management programmes, medical nutrition/diet therapy, exercise/physical activity, combined diet and exercise, calcium plus vitamin D supplementation, and continuous glucose monitoring. Self-management programmes were more effective than routine care in improving self-efficacy, two-hour postprandial blood glucose, and lifestyle behaviours but were as effective as routine care in improving infant birth weight. Self-management programmes were superior to or as effective as usual care in improving fasting blood glucose, blood glucose control, glycated haemoglobin, macrosomia, and preterm delivery. Medical nutrition/diet therapy was more effective than usual care in improving postprandial blood glucose levels. Postprandial blood glucose levels were better improved by regular supervised exercise plus daily brisk walks or a daily walking intervention than routine obstetric care or no treatment. The effects of exercise/physical activity programmes were mostly inconsistent for other outcomes. Diet and exercise were superior to diet alone in reducing maternal weight gain although there were similar outcomes for other pregnancy and foetal outcomes. Limited or conflicting evidence was found for other outcomes and interventions including calcium and vitamin D supplementation and continuous glucose monitoring intervention.

Conclusions

Community-based non-pharmacological interventions are more effective than placebo; and are more or as effective as usual care. Self-management programmes and medical nutrition/diet therapy had the most promising GDM outcomes.

Funding

There was no funding for this study. The study design, data collection, data analysis and interpretation, and writing of this manuscript were not influenced externally by any funder.
Nurses’ experiences of the role of organizational and environmental factors in the development of love of the profession: a qualitative study
Authors: Bolandian-Bafghi Shahnaz , Adib-Hajbaghery Mohsen , Zandi Mitra
Published: November 2022

Background

Love of the profession has significant relationship with nurses’ job motivation and care quality. However, there is limited information about organizational and environmental factors affecting love of the profession among nurses.

Aim

This study aimed at exploring nurses’ experiences of the role of organizational and environmental factors in the development of love of the profession.

Methods

This qualitative study was conducted in 2020–2021 using the conventional content analysis approach. Participants were Fifteen Iranian nurses with deep love of the profession, nursing instructors, and nursing managers purposefully selected from different healthcare and academic settings in seven large cities of Iran. Data were gathered via semi-structured interviews and were analyzed via the conventional content analysis method proposed by Graneheim and Lundman.

Results

Organizational and environmental factors affecting the development of love of the profession were grouped into three main categories: The social context of the profession (with two subcategories), family support (with two subcategories), and organizational health (with four subcategories). Subcategories were respectively historical context of the profession, the evolving context, emotional family support, instrumental family support, quality of interpersonal relationships in the organization, level of organizational justice, level of authority delegation to nurses, and level of organizational support.

Conclusion

Different organizational and environmental factors can affect nurses’ love of the profession development. Improving public image of nursing, providing nurses with stronger support, improving organizational climate, and strengthening interpersonal relationships in healthcare settings are recommended to develop nurses’ Love of the profession.
Detection of viruses from feces of wild endangered Macaca maura: a potential threat to moor macaque survival and for zoonotic infection
Authors: Cardeti Giusy , Cersini Antonella , Manna Giuseppe , De Santis Paola , Scicluna Maria Teresa , Albani Alessandro , Simula Massimiliano , Sittinieri Stefania , De Santis Laura , De Liberato Claudio , Ngakan Putu Oka , Wahid Isra , Carosi Monica
Published: November 2022

Background

To date, there is a scarcity of information and literature on Macaca maura health status relative to viral diseases. The objectives of the present study were to investigate on the potential spread of enteric and non-enteric viruses shed in the environment through a wild macaque feces and to understand the possible interrelation in the spread of zoonotic viruses in a poorly studied geographical area, the Sulawesi Island. This study will also contribute providing useful information on potential threats to the health of this endangered species.

Methods

The sampling was conducted between 2014 and 2016 in the Bantimurung Bulusaraung National Park, in the south of the Sulawesi Island and non-invasive sampling methods were used to collect fresh stools of the M. maura, one of the seven macaque species endemic to the island of Sulawesi, Indonesia. The population under study consisted in two wild, neighboring social macaque groups with partially overlapping home ranges; twenty-four samples were collected and examined using negative staining electron microscopy and a panel of PCR protocols for the detection of ten RNA and two DNA viruses.

Results

Viral particles resembling parvovirus (5 samples), picornavirus (13 samples) and calicivirus (13 samples) were detected by electron microscopy whereas the PCR panel was negative for the 12 viruses investigated, except for one sample positive for a mosquito flavivirus. The results did not correlate with animal sex; furthermore, because all of the animals were clinically healthy, it was not possible to correlate feces consistency with viral presence.

Conclusions

As information on viral infections in wild moor macaques remains limited, further studies are yet required to identify the fecal–oral and blood transmitted potentially zoonotic viruses, which may infect the moor macaque and other macaque species endemic to the South Sulawesi Island.
Epidemiologic and import risk analysis of Peste des petits ruminants between 2010 and 2018 in India
Authors: Zhang Shuwen , Liang Ruirui , Yang Qiaoling , Yang Yunfeng , Qiu Songyin , Zhang Hui , Qu Xiaosheng , Chen Qin , Niu Bing
Published: November 2022

Background

Peste des petits ruminants (PPR) is a serious disease that affects goats, sheep and other small ruminants. As one of the earliest and most serious countries, PPR has seriously threatened India's animal husbandry economy.

Results

In this study, the spatiotemporal characteristics of the PPR in India outbreaks were analyzed. Between 2010 and 2018, the epidemic in India broke out all over the country in a cluster distribution. Epidemic clusters in northern and southern India are at higher risk, and the outbreak time of PPR has significant seasonality. The results of the analysis of the development and transmission of PPR under the natural infection conditions showed that the PPR outbreak in India reached a peak within 15 days. Finally, the quantitative risk analysis results based on scenario tree show showed that the average probability of infecting PPRV in live sheep exported from India was 1.45 × 10–4.

Conclusions

This study analyzed the prevalence of PPR in India. The analysis of transmission dynamics on the development of the epidemic provides a reference for the prevention and control of the epidemic. At the same time, it provides risk analysis and suggestions on trade measures for the trading countries of India.