bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of intracardiac electrogram of the interventricular septum in the left bundle branch pacing
Authors: Cai Xiaojie , Jiang Longfu , Zhuo Shanshan , Wu Hao
Published: June 2022

Background

Left bundle branch pacing (LBBP) has become a hot topic in the field of physiological pacing. However, only a few studies have described the characteristics of the intrinsic intracardiac electrogram (EGM) while placing the left bundle branch (LBB) lead.

Case presentation

Herein, we reported a case with atrial premature contractions to the ventricle during the LBBP procedure. Paced and intrinsic (supraventricular) EGMs were recorded and analyzed.

Conclusions

The myocardium of the interventricular septum could be divided into four regions based on electrophysiology: the right septal area, the left septal area, the endocardium of the left ventricular septum, and the LBB area. This might guide the electrophysiological localization of the LBB lead in the septum.
Adherence to self-care recommendations and associated factors among adult heart failure patients in public hospitals, Addis Ababa, Ethiopia, 2021: cross-sectional study
Authors: Baymot Aemiro , Gela Debela , Bedada Tadesse
Published: June 2022

Background

Adherence to self-care recommendations in heart failure (HF) patients is essential to improve the patients’ quality of life, prevent hospital admission, and reduce mortality and morbidity. Nevertheless, poor adherence to self-care recommendations remains to be an extensive problem for HF patients. Thus, the aim was to assess adherence to self-care recommendations and associated factors among HF patients in public hospitals, Addis Ababa, Ethiopia, 2021.

Methods

An institutional-based cross-sectional study was conducted among adult HF patients from February 15 to April 15, 2021, in five public hospitals, in Addis Ababa, Ethiopia. A total of 294 adult HF patients completed an interviewer-administered questionnaire in the Amharic language. The Revised HF Compliance Questionnaire was used to measure the adherence to self-care recommendations of HF patients. Data was collected using the Revised HF Compliance Questionnaire, the Japanese heart failure knowledge scale, the multidimensional scale of perceived social support, and the chronic diseases self-efficacy scale. Study participants were selected through a systematic random sampling technique. Data were entered into Epi-info version 7.1 and then exported to SPSS Version 25 for analysis. Descriptive and logistic regression analyses were performed and the statistical significance of associations between the variables was determined using ORs with 95% CI and p-values < 0.05.

Results

Adherence to self-care recommendations among adult HF patients in public hospitals, in Addis Ababa, Ethiopia was 32.70%. Being female (AOR 4.66, 95% CI 1.58–13.67), patients who had high family monthly income (AOR 10.32, 95% CI 2.00–5.13), NYHA class III (AOR: 7.01, 95% CI 2.18–22.57) and class IV (AOR: 6.30, 95% CI 1.01–39.22), who had good self-efficacy (AOR 7.63, 95% CI 2.64–21.97), and who had good knowledge about HF (AOR 3.95, 95% CI 1.56–9.95) were more likely to have good adherence to self-care recommendations, p-value < 0.05.

Conclusion

This study revealed that 32.70% of adult HF patients had good adherence to self-care recommendations. Factors associated with adherence to self-care recommendations of adult HF patients are sex, family monthly income, NYHA classification, self-efficacy, and knowledge about HF. Therefore, interventions focused on sex, family monthly income, NYHA classification, self-efficacy, and knowledge about HF are required to improve adherence to self-care recommendations of adult HF patients.
Views of breast cancer survivors on work participation guidance by general practitioners: a qualitative study
Authors: Sarfo Marie-Christine , van Asselt Kristel M. , Frings-Dresen Monique H. , de Jong Femke , van Dijk Nynke , de Boer Angela G. E. M.
Published: June 2022

Background

Breast cancer survivors can be at high risk of having work-related problems. Previous studies suggest that GPs could discuss work participation with cancer patients and provide guidance.

The aim this study is to explore the experiences and expectations of breast cancer survivors with their GPs’ role regarding guidance on work participation and return to work.

Methods

A qualitative study with Dutch female breast cancer survivors was held in the Netherlands. Four focus groups with 25 participants were conducted and audio-taped. Transcripts were analysed using thematic analysis.

Results

Breast cancer survivors reported a wide range of experiences with guidance from their GPs regarding work participation. Patients who contacted their GPs with work-related issues felt listened to during the consultation. Some patients experienced very limited or no guidance, while others were intensively guided by their GPs. The guidance was provided in the form of counseling, psychosocial support, and referral to other health care professionals. When cancer patients experienced problems with reintegration in work, they expected GPs to have a supportive and referring role in work participation guidance.

Conclusion

In returning to work, breast cancer survivors expect their GPs to play a supportive role, especially when they encounter difficulties in reintegrating. However, their actual experience of guidance received from their GPs varied, from none received at all, to intensive support provided.
The effect of structured medication review followed by face-to-face feedback to prescribers on adverse drug events recognition and prevention in older inpatients – a multicenter interrupted time series study
Authors: Klopotowska Joanna E. , Kuks Paul F. M. , Wierenga Peter C. , Stuijt Clementine C. M. , Arisz Lambertus , Dijkgraaf Marcel G. W. , de Keizer Nicolette , Smorenburg Susanne M. , de Rooij Sophia E. ,   on behalf of the WINGS Study Group, Hoekstra Joost L. B. , Jansen Minke E. P. , Meijer Wim G. , van der Kleij Bea M. , Lagaay Anne M. , van der Hoeven Ruud T. M.
Published: June 2022

Background

The effectiveness of interventions to improve medication safety in older inpatients is unclear, given a paucity of properly designed intervention studies applying clinically relevant endpoints such as hospital-acquired preventable Adverse Drug Events (pADEs) and unrecognized Adverse Drug Events (uADEs). Therefore, we conducted a quality improvement study and used hospital-acquired pADEs and uADEs as main outcomes to assess the effect of an intervention aimed to improve medication safety in older inpatients.

Method

The study followed an interrupted time series design and consisted of three equally spaced sampling points during baseline and during intervention measurements. Each sampling point included between 80 to 90 patients. A total of 500 inpatients ≥65 years and admitted to internal medicine wards of three Dutch hospitals were included. An expert team retrospectively identified and assessed ADEs via a structured patient chart review. The findings from baseline measurement and meetings with the internal medicine and hospital pharmacy staff were used to design the intervention. The intervention consisted of a structured medication review by hospital pharmacists, followed by face-to-face feedback to prescribers, on average 3 days per week.

Results

The rate of hospital-acquired pADEs per 100 hospitalizations was reduced by 50.6% (difference 16.8, 95% confidence interval (CI): 9.0 to 24.6, P <  0.001), serious hospital-acquired pADEs by 62.7% (difference 12.8, 95% CI: 6.4 to 19.2, P <  0.001), and uADEs by 51.8% (difference 11.2, 95% CI: 4.4 to 18.0, P <  0.001). Additional analyses confirmed the robustness of the intervention effect, but residual bias cannot be excluded.

Conclusions

The intervention significantly decreased the overall and serious hospital-acquired pADE occurrence in older inpatients, and significantly improved overall ADE recognition by prescribers.

Trial registration

International Standard Randomized Controlled Trial Number Register, trial registration number: ISRCTN64974377, registration date (date assigned): 07/02/2011.
Impact of age on the postural stability measured by a virtual reality tracker-based posturography and a pressure platform system
Authors: Liang Huey-Wen , Chi Shao-Yu , Tai Tzu-Ling , Li Yue-Hua , Hwang Yaw-Huei
Published: June 2022

Background

Center of pressure (CoP) parameters are commonly used to evaluate age-related changes in postural control during standing. However, they mainly reflect ankle strategies and provide limited information about hip strategies, which are essential for postural control among the aged population. Body displacement at the lumbar level (LD) can be used as a proxy for hip strategies.

Objectives

We set up a virtual reality tracker-based posturography to measure LD and compared the CoP and LD parameters in two age groups to explore the roles of ankle and hip strategies during bipedal stance.

Methods

Twenty-seven older healthy participants (63.8 ± 7.1 years old) and 27 younger controls (31.7 ± 9.9 years old) performed four standing tasks with their postural steadiness measured simultaneously with both systems under four stance conditions (combination of eyes-open/eyes-closed and wide-based/narrow-based). Five parameters were calculated from the trajectories of the CoP and LD. The difference in the parameters between two groups was analyzed with the Mann–Whitney U test. The discriminative ability of the parameters from the two systems was computed by the receiver operating characteristic curve analysis and area under the curve (AUC). We also used the intraclass correlation coefficient (ICC) to assess the correlation between two measures.

Results

Most of the parameters obtained from both systems were significantly different between the younger and older groups. Mean velocity in the medial–lateral and anterior–posterior directions could effectively discriminate age-related changes, especially with the LD parameters. The receiver’s operation curve analysis gained the largest AUC (0.85 with both systems) with mean velocity in the medial–lateral direction during narrow-based standing with eyes closed. Meanwhile, we observed a low correlation between parameters obtained from the two methods in velocity measures, with the lowest ICC in the mean velocity in the medial–lateral direction in the older group (ICC = 0.34 ~ 0.41).

Conclusion

Both systems could differentiate age-related changes in postural steadiness, but with dissociated information about mean velocity, especially the mean velocity in the medial–lateral direction in the older group. The results support the complimentary role of using tracker-based posturography to understand the effect of age on the mechanisms of postural control.
The effect of a tele-educational intervention on modifying dysfunctional sexual beliefs of pregnant women: a randomized controlled trial
Authors: Khoddam Shirin , Lotfi Razieh , Kabir Kourosh , Merghati- Khoei Effat
Published: June 2022

Background & aim

Some cultural scenarios in pregnancy and childbirth reinforce dysfunctional sexual beliefs that reverse changes in the couple's sexual life. The present study aimed to investigate the effect of education by sending text messages on modifying dysfunctional sexual beliefs in pregnant women.

Methods & materials

This study is a randomized clinical trial, and 82 eligible pregnant women referred to educational-medical centers to receive prenatal care were randomly assigned to intervention or control group. The intervention group received 24 text messages during eight weeks (three text messages per week), and the control group received only routine care. Data was collected through a demographic questionnaire, reproductive profile, Spinner's Dyadic Adjustment Scale (DAS), and dysfunctional sexual beliefs questionnaire. Both groups completed the questionnaires before and one week after the intervention. Independent t-test, paired t-test, and analysis of covariance was used to analyze the data.

Results

The findings revealed no statistically significant difference in the baseline Dyadic Adjustment mean scores of control (132.4 ± 11.01) and intervention (130.10 ± 10.66) groups. Paired t-test analysis showed that the mean score of dysfunctional sexual beliefs was significantly decreased from (29 ± 7.61) at baseline compared to one week after intervention (10.54 ± 6.97) (p < 0.001). Analysis of covariance test to compare the scores of dysfunctional sexual beliefs in the intervention group (10.54 ± 6.97) and control group (26.80 ± 7.80) showed a statistically significant difference (p < 0.01) with an effect size of 0.67.

Conclusion

This study showed that sending text messages to mobile phones of pregnant women has corrected their dysfunctional sexual beliefs. Therefore, this approach can be used in pregnancy care to promote women's sexual health.

Trial registration

Clinical trial registry: IRCT20161230031662N9.
CKAP2L, a crucial target of miR-326, promotes prostate cancer progression
Authors: Li Qi , Yan Mo , Wang Chunhui , Wang Kaibin , Bao Guochang
Published: June 2022

Background

The overexpression of aberrant cell cycle signaling pathway associated protein has been implicated in multiple malignancies and the identification of all-important one among is the crux of the precise targeted therapy. CKAP2L (Cytoskeleton Associated Protein 2 Like) plays a newish role in cancer progression through activation of the process of cell cycle and mitosis. In this study, we aim to delineate the prominent dysregulated expression of CKAP2L and comprehensively reveal its deregulation in prostate cancer. 

Method

CKAP2L expression was examined in the normal and tumor tissues of prostate cancer patients with RT-QPCR and Western blot. IHC showed the different expression in normal prostate tissue, tissue of BPH, low Gleason Score and high Gleason Score prostate cancer patients. Transwell, colony formation, MTT and flow cytometry were performed to detected the changes in cellular function in vitro. The xenograft model was conducted for the changes in vivo. Dual luciferase and RIP proved the binding relation between CKAP2L and miR-326.

Results

In multiple datasets, CKAP2L was found upregulated and positively associated with Gleason grade and poor clinical outcomes of patients. shRNA mediated silence of CKAP2L suppressed cell proliferation, impaired monolayer formation, inhibited cell invasion. CKAP2L was confirmed to be the direct target of miR-326, which had a carcinostatic effect by binding the 3’untranslated regions (3’UTRs) of CKAP2L mRNA. The deletion of CKAP2L resulted in reduced expression of genes involved in the mitotic cell cycle such as multiple cyclin-dependent kinases and cyclins, but also several genes encoding proteins involved in chromosome segregation and spindle assembly.

Conclusion

Taken together, CKAP2L plays a carcinogenic role in prostate cancer by regulates the expression of cycle-associated proteins.
Comprehensive analysis reveals COPB2 and RYK associated with tumor stages of larynx squamous cell carcinoma
Authors: Zhou Guojin , Zhang Shoude , Jin Mao , Hu Sunhong
Published: June 2022

Background

Laryngeal squamous cell carcinoma (LSCC) is one of the highly aggressive malignancy types of head and neck squamous cell carcinomas; genes involved in the development of LSCC still need exploration.

Methods

We downloaded expression profiles of 96 (85 in advanced stage and 11 in early stage) LSCC patients from TCGA-HNSC. Function enrichment and protein-protein interactions of genes in significant modules were conducted. Univariate and multivariate Cox regression analyses were performed to explore potential prognostic biomarkers for LSCC. The expression levels of genes at different stages were compared and visualized via boxplots. Immune infiltration was examined by the CIBERSORTx web-based tool and depicted with ggplot2. Gene set enrichment analysis (GSEA) was utilized to analyze functional enrichment terms and pathways. Immunohistochemical staining (IHC) was used to verify the expression of genes in the LSCC samples.

Results

We identified 25 modules, including 3 modules significantly related to tumor stages of LSCC via weighted gene co-expression network analysis (WGCNA). UIMC1, NPM1, and DCTN4 in the module ‘cyan’, TARS in the module ‘darkorange’, and COPB2 and RYK in the module ‘lightyellow’ showed statistically significant relation to overall survival. The expression of COPB2, DCTN4, RYK, TARS, and UIMC1 indicated association with the change of fraction of immune cells in LSCC patients; two genes, COPB2 and RYK, indicated different expression in various tumor stages of LSCC. Finally, COPB2 and RYK showed high-expression in tumor tissues of advanced LSCC patients.

Conclusions

Our study provided a potential perceptive in analyzing progression of LSCC cells and exploring prognostic genes.
Evidence-based Shared-Decision-Making Assistant (SDM-assistant) for choosing antipsychotics: protocol of a cluster-randomized trial in hospitalized patients with schizophrenia
Authors: Siafis Spyridon , Bursch Nicola , Müller Katharina , Schmid Lisa , Schuster Florian , Waibel Jakob , Huynh Tri , Matthes Florian , Rodolico Alessandro , Brieger Peter , Bühner Markus , Heres Stephan , Leucht Stefan , Hamann Johannes
Published: June 2022

Background

Choosing an antipsychotic medication is an important medical decision in the treatment of schizophrenia. This decision requires risk-benefit assessments of antipsychotics, and thus, shared-decision making between physician and patients is strongly encouraged. Although the efficacy and side-effect profiles of antipsychotics are well-established, there is no clear framework for the communication of the evidence between physicians and patients. For this reason, we developed an evidence-based shared-decision making assistant (SDM-assistant) that presents high-quality evidence from network meta-analysis on the efficacy and side-effect profile of antipsychotics and can be used as a basis for shared-decision making between physicians and patients when selecting antipsychotic medications.

Methods

The planned matched-pair cluster-randomised trial will be conducted in acute psychiatric wards (n = 14 wards planned) and will include adult inpatients with schizophrenia or schizophrenia-like disorders (N = 252 participants planned). On the intervention wards, patients and their treating physicians will use the SDM-assistant, whenever a decision on choosing an antipsychotic is warranted. On the control wards, antipsychotics will be chosen according to treatment-as-usual. The primary outcome will be patients’ perceived involvement in the decision-making during the inpatient stay as measured with the SDM-Q-9. We will also assess therapeutic alliance, symptom severity, side-effects, treatment satisfaction, adherence, quality of life, functioning and rehospitalizations as secondary outcomes. Outcomes could be analysed at discharge and at follow-up after three months from discharge. The analysis will be conducted per-protocol using mixed-effects linear regression models for continuous outcomes and logistic regression models using generalised estimating equations for dichotomous outcomes. Barriers and facilitators in the implementation of the intervention will also be examined using a qualitative content analysis.

Discussion

This is the first trial to examine a decision assistant specifically designed to facilitate shared-decision making for choosing antipsychotic medications, i.e., SDM-assistant, in acutely ill inpatients with schizophrenia. If the intervention can be successfully implemented, SDM-assistant could advance evidence-based medicine in schizophrenia by putting medical evidence on antipsychotics into the context of patient preferences and values. This could subsequently lead to a higher involvement of the patients in decision-making and better therapy decisions.

Trial registration

German Clinical Trials Register (ID: DRKS00027316, registration date 26.01.2022).
Effect of age and sex on the associations between potential modifiable risk factors and both type 2 diabetes and impaired fasting glycaemia among West African adults
Authors: Issaka Ayuba , Cameron Adrian J. , Paradies Yin , Bosu William K. , Houehanou Yèssito Corine N. , Kiwallo Jean B. , Wesseh Chea S. , Houinato Dismand S. , Nazoum Diarra J. P. , Stevenson Christopher
Published: June 2022

Background

Type 2 diabetes mellitus (T2DM) is becoming one of the leading causes of morbidity and mortality worldwide, including among Africans. Knowledge of the association between traditional risk factors and both diabetes and pre-diabetes, and whether these differ by age and sex, is important for designing targeted interventions. However, little is known about these associations for African populations.

Methods

The study used data from WHO STEPS surveys, comprising 15,520 participants (6,774 men and 8,746 women) aged 25–64 years, from 5 different West African countries, namely Burkina Faso (4,711), Benin (3,816), Mali (1,772), Liberia (2,594), and Ghana (2,662). T-test and chi-square tests were used to compare differences in the prevalence of traditional risk factors for both sexes. Multinomial logistic regression was conducted to ascertain the relative risks (RR) and 95% confidence intervals (CI) for both T2DM and impaired fasting glucose (IFG) relating to each risk factor, including obesity [defined by BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)], high blood pressure (HBP), fruit and vegetable consumption, physical inactivity, alcohol consumption, and smoking. Models for each of these traditional risk factors and interactions with age and sex were fitted.

Results

Factors associated with T2DM and IFG were age, obesity [defined by BMI, WC, WHtR, and WHR], HBP, smoking, physical inactivity, and fruit and vegetable consumption (p < 0.05). Analysis of interaction effects showed few significant differences in associations between risk factors and T2DM according to age or sex. Significant interaction with age was observed for HBP*age and T2DM [RR; 1.20, 95% CI: (1.01, 1.42)) (p = 0.04)], WHtR*age and T2DM [RR; 1.23, 95% CI: (1.06, 1.44) (p = 0.007)] and WHR*age and IFG [RR: 0.79, 95% CI: (0.67, 0.94) (p = 0.006)]. Some interactions with age and sex were observed for the association of alcohol consumption and both IFG and T2DM, but no clear patterns were observed.

Conclusion

The study found that with very few exceptions, associations between traditional risk factors examined and both IFG and T2DM did not vary by age or sex among the West African population. Policies and public health intervention strategies for the prevention of T2DM and IFG should target adults of any age or sex in West Africa.
Loudness affects motion: asymmetric volume of auditory feedback results in asymmetric gait in healthy young adults
Authors: Reh Julia , Schmitz Gerd , Hwang Tong-Hun , Effenberg Alfred O.
Published: June 2022

Background

The potential of auditory feedback for motor learning in the rehabilitation of various diseases has become apparent in recent years. However, since the volume of auditory feedback has played a minor role so far and its influence has hardly been considered, we investigate the volume effect of auditory feedback on gait pattern and gait direction and its interaction with pitch.

Methods

Thirty-two healthy young participants were randomly divided into two groups: Group 1 (n = 16) received a high pitch (150-250 Hz) auditory feedback; group 2 (n = 16) received a lower pitch (95-112 Hz) auditory feedback. The feedback consisted of a real-time sonification of the right and left foot ground contact. After an initial condition (no auditory feedback and full vision), both groups realized a 30-minute habituation period followed by a 30-minute asymmetry period. At any condition, the participants were asked to walk blindfolded and with auditory feedback towards a target at 15 m distance and were stopped 5 m before the target. Three different volume conditions were applied in random order during the habituation period: loud, normal, and quiet. In the subsequent asymmetry period, the three volume conditions baseline, right quiet and left quiet were applied in random order.

Results

In the habituation phase, the step width from the loud to the quiet condition showed a significant interaction of volume*pitch with a decrease at high pitch (group 1) and an increase at lower pitch (group 2) (group 1: loud 1.02 ± 0.310, quiet 0.98 ± 0.301; group 2: loud 0.95 ± 0.229, quiet 1.11 ± 0.298). In the asymmetry period, a significantly increased ground contact time on the side with reduced volume could be found (right quiet: left foot 0.988 ± 0.033, right foot 1.003 ± 0.040, left quiet: left foot 1.004 ± 0.036, right foot 1.002 ± 0.033).

Conclusions

Our results suggest that modifying the volume of auditory feedback can be an effective way to improve gait symmetry. This could facilitate gait therapy and rehabilitation of hemiparetic and arthroplasty patients, in particular if gait improvement based on verbal corrections and conscious motor control is limited.
Biomechanical comparison of different interspinous process devices in the treatment of lumbar spinal stenosis: a finite element analysis
Authors: Liu Zhengpeng , Zhang Shuyi , Li Jia , Tang Hai
Published: June 2022

Background

Lumbar spinal stenosis (LSS) is a common disease among elderly individuals, and surgery is an effective treatment. The development of minimally invasive surgical techniques, such as the lumbar interspinous process device (IPD), has provided patients with more surgical options.

Objective

To investigate the biomechanical properties of different IPDs, including BacFuse, X-Stop and Coflex, in the treatment of LSS.

Methods

Based on the computed tomography images of a patient with LSS, four finite element (FE) models of L3-S5 were created in this study. The FE models included a surgical model of the intact lumbar spine and surgical models of the lumbar IPDs BacFuse, X-Stop, and Coflex. After validating the models, they were simulated for four physiological motions: flexion, extension, lateral bending and axial rotation, and range of motion (ROM). Stress distribution of discs and facet joints in each segment, stress distribution of the spinous process in the operated section, and stress distribution of the internal fixation were compared and analysed.

Results

Compared to the model of the intact lumbar spine, the other three models showed a decrease in ROM and disc and facet joint stresses in the surgical segment during movement and an increase in ROM and disc and facet joint stresses in the adjacent segments. These effects were greater for the proximal adjacent segment with BacFuse and more pronounced for the distal adjacent segment with Coflex, while X-Stop had the greatest stress effect on the spinous process in the surgical segment.

Conclusion

BacFuse, Coflex and X-Stop could all be implemented to effectively reduce extension and disc and facet joint stresses, but they also increase the ROM and disc and facet joint stresses in adjacent segments, which may cause degeneration.
Single midline incision approach for decompression of greater, lesser and third occipital nerves in migraine surgery
Authors: Olla Danielle R. , Kemper Kortni M. , Brown Amanda L. , Mailey Brian A.
Published: June 2022

Background

The traditional approach for occipital migraine surgery encompasses three separate surgical incisions in the posterior neck to decompress the greater occipital nerves (GON), lesser occipital nerves (LON), and third occipital nerves (TON). Other incisions have been investigated, including singular transverse incisions. We sought to evaluate a single, vertical midline incision approach for decompression of all six occipital nerves.

Methods

Using 10 cadaveric hemi-sides (5 fresh cadaver head and necks). Anatomic landmarks and the location of the bilateral GON, LON, and TON were marked according to previous anatomic studies. A single, midline 9-cm incision was made, and lateral skin flaps were raised to decompress or avulse all six nerves.

Results

Through the midline incision, the GON and TON were identified at 3.5 and 6.2 cm, respectively, inferior to a line bisecting the external auditory canal (EAC) and 1.5 cm lateral to the midline. The LON was identified as 6-cm inferior and 6.5-cm medial to a line bisecting the EAC in the plane just above the investing layer of the deep cervical fascia until the posterior border of the sternocleidomastoid was encountered. The LON had the greatest amount of variation but was identified lateral to the posterior border of the SCM.

Conclusions

A single midline incision approach allows for successful identification and decompression of all six occipital nerves in migraine surgery.
Women’s attitudes toward certification logos, labels, and advertisements for organic disposable sanitary pads: results from a multi-city cross-sectional survey
Authors: Kim Hayeon , Jung Jinyoung , Song Yun-Kyoung , Chang Taegwon , Park Sungmin , Park Jiwon , Kim Kyungim
Published: June 2022

Background

This cross-sectional study evaluated women’s attitudes toward the certification logos, labels, and advertisements for organic disposable sanitary pads (OSPs) and investigated what could be the main reason for them. Additionally, the present study examined whether a relationship could be found between these attitudes and OSPs purchasing behavior.

Methods

This study was conducted using a self-reported online survey of Korean adult women who have purchased OSPs. The study questionnaire had four sections, covering (1) characteristics of OSP purchasing behavior, (2) attitudes toward OSP certification logos, labels, and advertisements, (3) demand on government and companies for proper management, and (4) respondent’s sociodemographic information. The Cronbach’s alpha value of the questionnaire was 0.857.

Results

A total of 500 respondents completed the questionnaire. Overall, high reliability was found for the certification logos (3.73 ± 0.61), labels on the product packaging (3.71 ± 0.63), and advertisements of OSPs (3.41 ± 0.62). Respondents indicated that these had fairly positive effects on their decision-making regarding product reliability, product image, and their own purchasing behavior. The aspects most frequently affected from the informants were safety to human health. All attitudes toward OSP certification logos, labels, and advertisements that were evaluated in this study became more positive in the direction from non-buyers to occasional buyers and to habitual buyers (all P < 0.05). The most significant demand from the respondents for OSP companies and the government was to clearly indicate hazardous ingredients on the OSP packaging (42.0%) and to strengthen the sanctions for false advertising (37.8%), respectively.

Conclusions

The results of this study clearly indicate the importance of using certification logos, labels, and advertisements in the OSP market. These results can be utilized by OSP companies to improve the effectiveness of their marketing strategies or by policy makers and certifying bodies to manage the informants properly in the OSP market.
Women’s sexual autonomy as a determinant of cervical cancer screening uptake in Addis Ababa, Ethiopia: a case–control study
Authors: Midaksa Miresa , Destaw Alemnew , Addissie Adamu , Kantelhardt Eva Johanna , Gizaw Muluken
Published: June 2022

Cervical cancer (CC) is the fourth most common cancer in women worldwide and the leading cause of cancer deaths in developing countries. CC can be prevented through available preventive interventions. However, most patients in developing countries, such as Ethiopia, present late with advanced stage disease due to low participation in CC screening and require treatment involving multiple modalities. Women’s social, economic and cultural backgrounds have been associated with the level of participation in CC screening programmes. Therefore, this study aimed to assess women’s sexual autonomy as a determinant of lifetime CC screening among women in Addis Ababa, Ethiopia. An institutional-based case–control study was conducted in which controls were women who had received screening services during the last 5 years, and cases were randomly selected from women coming for other services but never screened or aware of the screening service. Accordingly, 294 women were enrolled. Data were collected by using a pre-tested standard questionnaire through interviewing. Bivariate and multivariable logistic regression analyses were performed to assess the women’s sexual autonomy as a determinant of lifetime CC screening. The study revealed higher sexual autonomy led to higher odds for having been screened (adjusted odds ratio (AOR) = 3.128, 95% CI (1.730, 5.658)). Moreover, direct referral to the screening service (AOR = 3.173, 95% CI (1.57, 6.45)) and parity had positively affected the lifetime uptake of CC screening (AOR = 2.844, 95% CI (1.344, 6.014)). We found that women’s own sexual autonomy was associated with the improvement of CC screening uptake. Empowering women could alleviate barriers to CC screening in the community.
Developing and implementing a self-monitoring toolkit for a coordinated multinational randomized acupuncture trial
Authors: Baedorf Kassis Sylvia , Lu Weidong , White Sarah A. , Shin Im Hee , Park Sung Hwan , Jeong Young Ju , Yao Chang , Ligibel Jennifer , Bierer Barbara E.
Published: June 2022

Background

In 2019, investigators from China, South Korea and the United States of America initiated a coordinated multinational trial. The trial included three parallel randomized studies with a planned pooled analysis of individual patient data, to test the effectiveness of acupuncture on hot flash-related symptoms in hormone receptor-positive breast cancer patients prescribed adjuvant endocrine therapy. Given the study's approach, there was no central coordinating center or data monitoring committee for the study, so a site performance self-monitoring toolkit was developed and implemented to support study teams in collecting and maintaining high-quality regulatory information, and consistent review of study data and documentation.

Methods

The site performance self-monitoring toolkit was created based on best practices related to post-approval quality assurance/quality improvement (QA/QI) procedures that support data quality. The toolkit included: (1) a binder of essential study management documents and related monitoring logs for sites to complete and maintain (herein called regulator binder), (2) a study start-up checklist, (3) a self-assessment study conduct and oversight checklist to be completed regularly, and (4) a study close-out checklist. In addition, a process of regular virtual meetings to discuss documentation progress coupled with periodic external remote review of completed logs and checklists provided accountability checks.

Results

Over the course of the study, the sites in China and South Korea completed the entirety of the site performance self-monitoring toolkit, and successfully submitted their completed materials for review. The process of implementing a self-monitoring toolkit in a multinational integrative medicine study is described qualitatively. Periodic external review of the completed toolkit materials revealed categories of findings. Written follow-up reports were provided to sites and discussion of the documents occurred via separate virtual meetings.

Conclusions

Site study team self-monitoring provides a feasible, consistent, and effective way to review the collection and maintenance of data and regulatory documentation for quality assessment in minimal risk clinical research studies and can augment formal study monitoring activities in higher risk studies. Iterative feedback and support appeared to drive a disciplined approach to maintaining regulatory document compliance and helped sustain investigator and study team engagement in the process.

Trial registration

ClinicalTrials.gov IdentifierNCT03783546(21/12/2018).
Personal statement versus psychological test as admission to the nursing degree: an evaluation
Authors: Traynor Marian , Neill Colin Mc , Roulston Audrey
Published: June 2022

Background

A review of admissions to nursing in Northern Ireland was prompted by the growing number of applications and a desire to ensure that the applicants had the right values for a career in nursing. Concerns regarding authorship, plagiarism and reliability of personal statements used to select applicants to interview was the focus of this research. This study evaluates the psychometric properties of a Personal Statement (PS) as a method for admission to a nursing programme and a values-based psychological screening tool, Nurse Match (NM).

Methods

A self-selecting, purposive sample (n = 228; 9.7%) was drawn from applicants to Schools of Nursing in the United Kingdom (n = 2350). Participants all of whom had completed a Personal Statement were asked to complete a psychological tool and the scoring outcomes and psychometric properties of both tests were investigated. Statistical analysis was conducted using Minitab 17.

Results

Applicants from 18 schools and five colleges responded. The majority (72.4%) were aged 18–19. Findings provide practical, theoretical, statistical, and qualitative reasons for concluding that the Personal Statement has substantial limitations as a measure of suitability. It does not compare well with international test standards for psychometric tests. In contrast, NM is a valid and reliable measure with good discriminatory power, standardised administration and consistent marking.

Conclusion

NM is a viable alternative to the PS for shortlisting applicants for nursing interviews.
Driving new technologies in hospitals: association of organizational and personal factors with the readiness of neonatal intensive care unit staff toward webcam implementation
Authors: Hoffmann Jan , Reimer Alinda , Mause Laura , Müller Andreas , Neo-CamCare  , Dresbach Till , Scholten Nadine
Published: June 2022

Background

The use of webcam technology in neonatal intensive care units (NICUs) enables parents to see their child when the parents cannot be present at the NICU. The webcam’s use has been gaining increasing attention. Lead physicians and lead nursing staff play a key role in the decision of whether to implement webcams. This study investigates factors that are associated with the readiness for the implementation of a webcam system among lead NICU staff.

Methods

A postal survey was conducted among all lead physicians and lead nursing staff in all German NICUs between December 2020 and April 2021 (total N = 416, one lead physician and one lead nursing staff per NICU, N = 208). On the basis of normalization process theory, personal (technology acceptance) and organizational (innovation climate) attributes were chosen to determine their association with the readiness for the implementation of a webcam system. The association of these factors was determined using multiple linear regression models for both lead physicians and lead nurses.

Results

Overall, a response rate of 66.59% (n = 277) was achieved. Technology acceptance proved to be a significant factor associated with the readiness for the implementation of a webcam system among lead physicians. Furthermore, staff already working with webcams in their NICUs indicated a significantly higher level of technology acceptance than staff without webcam experience and without any desire to use a webcam in the future. No significant association was found between innovation climate and the readiness for the implementation of a webcam system.

Conclusions

Technology acceptance was identified as a factor associated with the readiness for the implementation of a webcam system. The insights from this study can be used to manage potential barriers regarding the readiness for implementation of webcams in NICUs.

Trial registration

The Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00017755. Date of Registration in DRKS: 25-09-2019.
Biological aging mediates the associations between urinary metals and osteoarthritis among U.S. adults
Authors: Chen Li , Zhao Ying , Liu Fangqu , Chen Huimin , Tan Tianqi , Yao Ping , Tang Yuhan
Published: June 2022

Background

Osteoarthritis (OA) is a worldwide public health concern, mainly afflicting older adults. Although the etiology of OA remains unclear, environmental factors are increasingly considered as non-negligible risk factors. This study aims to evaluate the associations of urinary metals with OA risk and the mediated effect of biological aging.

Methods

Nine urinary metal concentrations were detected among 12,584 U.S. adults based on the National Health and Nutrition Examination Survey (NHANES), including barium (Ba), cadmium (Cd), cobalt (Co), cesium (Cs), molybdenum (Mo), lead (Pb), antimony (Sb), thallium (Tl), and uranium (Tu). Multivariable logistic regression and weighted quantile sum (WQS) regression were used to explore the associations of single metal and mixed metals with OA risk, respectively. Furthermore, biological aging was measured from different perspectives, including cell senescence (telomere length) and whole-body aging (phenotypic age and biological age). Mediation analyses were conducted to investigate the mediated effects of aging on the associations of metals with OA risk.

Results

In the single-exposure model, Cd, Co, and Cs were identified to be positively associated with OA risk, with odds ratios (OR) ranging from 1.48 to 1.64 (all P < 0.05). Mixed-exposure analyses showed consistent associations (OR 1.23, 95%CI 1.10 to 1.37) and highlighted that Cd, Co, and Cs were responsible for the outcomes. Additionally, Cd, Co, Cs, Pb, and Tl were positively associated with biological aging markers, while all biological aging markers had significant associations with OA risk. Further mediation analyses showed that the associations of single metal (mainly Cd and Cs) and mixed metals with OA risk parallelly mediated by the above biological aging markers, with the proportion of mediation ranging from 16.89 to 69.39% (all P < 0.05). Moreover, such associations were also serially mediated through telomere length-biological age path and telomere length-phenotypic age path (the proportion of mediation: 4.17–11.67%), indicating that metals accelerated cell senescence to lead to whole-body aging and finally aggravated OA progress.

Conclusions

These findings suggested that exposure to metals increased OA risk, which was possibly and partly mediated by biological aging.
Characterization of B cell receptor H-CDR3 repertoire of spleen in PRV-infected mice
Authors: Deng Lishuang , Yang Fan , Xu Zhiwen , Li Fengqin , Zhao Jun , Deng Huidan , Jian Zhijie , Lai Siyuan , Sun Xiangang , Zhu Ling
Published: June 2022

Pseudorabies virus (PRV), also known as suid Alphaherpesvirus 1 (SuHV-1), which is one of the most devastating infectious pathogen of swine industry worldwide. Vaccination is the safest and most effective PRV prevention and control strategy. B cell receptor (BCR) is membrane-bound immunoglobulin located on the surface of B cells capable of specifically binding foreign antigens, which is one of the most important molecules regulating the proliferation and function of B cells. Here, to assess the molecular diversity of BCR H-CDR3 repertoire after different PRV strains infection, we detected the IGHV, IGHD, IGHJ genes usage and CDR3 sequence changes of mice spleen with PRV vaccine strain (Bartha-K61), variant strain (XJ) and mock infection by high-throughput sequencing. We found that PRV-infected groups shared partial BCR sequences, which are most likely to be PRV-specific BCR candidates. However, there were still differences in the IGHV genes usage as well as the combined usage of IGHV and IGHJ genes between the Bartha-K61 strain and XJ strain infection groups. In addition, the CDR3 sequences exhibited large differences in the types and lengths in PRV infection groups. Our study contributes to a better understanding of the host adaptive immune response to PRV infection and provides a theoretical basis for further research on novel and efficient PRV vaccines in the future.
CD40 monoclonal antibody and OK432 synergistically promote the activation of dendritic cells in immunotherapy
Authors: Zhang Juan , Wang Lei , Li Shuyi , Gao Xuefeng , Liu Zhong
Published: June 2022

Background

Colorectal cancer (CRC) with pulmonary metastasis usually indicates a poor prognosis, whereas patients may benefit from adoptive cell therapy. Tumor-specific cytotoxic T lymphocytes (CTLs) have been reported as a promising treatment for CRC. However, the antitumor effect of CTLs remains limited partially due to insufficient production of effector cells via the activation by antigen-presenting dendritic cells (DCs).

Method

This study showed that a combination of CD40 mAb and Picibanil (OK-432) could significantly enhance the activation of CTLs by DCs, both in vitro and in vivo. Flow cytometry, colon cancer mouse model, and pathological staining were employed to demonstrate the specific functions.

Results

This approach promoted the maturation of DCs, augmented the production of stimulatory cytokines, and suppressed the secretion of inhibitory cytokines. Additionally, it facilitated the killing efficiency of CTLs via stimulating their proliferation while restraining the number of Tregs, concomitantly with the positive regulation of corresponding cytokines. Furthermore, the combined unit could hurdle the expansion of tumor cells on metastatic lungs in the colon cancer mouse model.

Conclusion

Collectively, the combination of CD40-mAb and OK-432 facilitated the maturation of DCs and enhanced the cytotoxicity of T cells, promising therapeutic approach against CRC.

Graphical Abstract
Inhibition of AKT induces p53/SIRT6/PARP1-dependent parthanatos to suppress tumor growth
Authors: Zhang Yizheng , Zhang Chuchu , Li Jiehan , Jiang Meimei , Guo Shuning , Yang Ge , Zhang Lingling , Wang Feng , Yi Shiqi , Wang Jiangang , Fu Yang , Zhang Yingjie
Published: June 2022

Background

Targeting AKT suppresses tumor growth through inducing apoptosis, however, during which whether other forms of cell death occurring is poorly understood.

Methods

The effects of increasing PARP1 dependent cell death (parthanatos) induced by inhibiting AKT on cell proliferation were determined by CCK-8 assay, colony formation assay, Hoechst 33,258 staining and analysis of apoptotic cells by flow cytometry. For the detailed mechanisms during this process, Western blot analysis, qRT-PCR analysis, immunofluorescence and co-immunoprecipitation were performed. Moreover, the inhibition of tumor growth by inducing p53/SIRT6/PARP1-dependent parthanatos was further verified in the xenograft mouse model.

Results

For the first time, we identified that inhibiting AKT triggered parthanatos, a new form of regulated cell death, leading to colon cancer growth suppression. For the mechanism investigation, we found that after pharmacological or genetic AKT inhibition, p53 interacted with SIRT6 and PARP1 directly to activate it, and promoted the formation of PAR polymer. Subsequently, PAR polymer transported to outer membrane of mitochondria and resulted in AIF releasing and translocating to nucleus thus promoting cell death. While, blocking PARP1 activity significantly rescued colon cancer from death. Furthermore, p53 deletion or mutation eliminated PAR polymer formation, AIF translocation, and PARP1 dependent cell death, which was promoted by overexpression of SIRT6. Meanwhile, reactive oxygen species production was elevated after inhibition of AKT, which might also play a role in the occurrence of parthanatos. In addition, inhibiting AKT initiated protective autophagy simultaneously, which advanced tumor survival and growth.

Conclusion

Our findings demonstrated that AKT inhibition induced p53-SIRT6-PARP1 complex formation and the activation of parthanatos, which can be recognized as a novel potential therapeutic strategy for cancer.