bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient Experiences of Symptoms and Coping Strategies in the Early Postoperative Phase Following Hemithyroidectomy: A Qualitative Interview Study
Authors: Beka Ervin , Gimm Oliver , Johansson Kenth , Söderlund Schaller Anne , Drott Jenny
Published: August 2024

The aim was to explore patients’ early experiences of symptoms after hemithyroidectomy and how these symptoms influenced their daily lives. An inductive explorative qualitative research design was performed. Sixteen patients from two hospitals were interviewed between two-three weeks after the surgery. All the patients experienced compression symptoms before the surgery. The study was analyzed with conventional manifest content analysis. The inductive analysis yielded two main categories and one subcategory. The two main categories were: Early postoperative symptoms that caused disadvantage in daily life and Early postoperative symptoms and coping strategies. The subcategory was: Early postoperative experiences of concerns about the future. Key points: 1. Patients experienced early postoperative symptoms that affected their lives in multiple levels, making them develop coping strategies and awaking concerns about remaining symptoms in the future. 2. The effect of hemithyroidectomy influenced patients’ daily life in the early postoperative phase considerably. 3. The study shows that tailored preoperative patient information is important. The findings may guide professionals to tailored preoperative information to optimize the care for this patient group.
Trajectories of U.S. Parents’ Remote Work during the COVID-19 Pandemic
Authors: Petts Richard J. , Carlson Daniel L.
Published: August 2024

The COVID-19 pandemic had numerous consequences for work and family, but one of the most important was the substantial increase in remote work. Despite interest in changes to remote work and questions about whether the new environment of remote work will persist long-term, we know little about variation in workers’ experiences with remote work since the beginning of the pandemic. In this data visualization, we use longitudinal data on U.S. working parents from 2020–2023 and group-based trajectory models to illustrate varying patterns of remote work for partnered parents. The heterogeneity of parents’ experiences with remote work throughout the pandemic reveals important nuances not previously identified in tracking polls and highlights important gender differences that likely had implications for mothers’ and fathers’ well-being and gender equality.
Residential Mobility, Housing Costs, and Relationships among Neighbors
Authors: Beck Kevin
Published: August 2024

Drawing on the California Health Interview Survey, I test the hypothesis that cost-related movers—renters who recently moved due to unaffordable housing costs—are less likely to trust their neighbors and count on them for support than renters who recently moved for other housing-related reasons and renters who did not recently move. I find that, on average, trust and support are lower among cost-related movers. My findings suggest that cost-related movers might be less trusting because they tend to be more wary of strangers, which could include their neighbors. They further suggest that cost-related movers might be less likely to have neighbors they can count on for support because they are more likely to perceive their neighborhoods as unsafe. The findings contribute to the scholarship on residential mobility by demonstrating that beyond the frequency with which renters move, the types of moves they experience may also shape their local relationships.
Intergenerational Educational (Im)mobility Among Those Born in the United States, 1940 to 1990
Authors: Jeffrey Wesley
Published: August 2024

This visualization highlights patterns of intergenerational educational immobility across five birth cohorts in the United States. Namely, a strong link is observed between parent and offspring educational attainment that has remained largely stable over the years. The author discusses the challenges of achieving equality of educational opportunity in the United States in light of the relative nature of educational credentials.
Are we ready to cure post-stroke cognitive impairment? Many key prerequisites can be achieved quickly and easily
Authors: Godefroy Olivier , Aarabi Ardalan , Béjot Yannick , Biessels Geert Jan , Glize Bertrand , Mok Vincent CT , Schotten Michel Thiebaut de , Sibon Igor , Chabriat Hugues , Roussel Martine
Published: August 2024

Purpose:

Post-stroke (PS) cognitive impairment (CI) is frequent and its devastating functional and vital consequences are well known. Despite recent guidelines, they are still largely neglected. A large number of recent studies have re-examined the epidemiology, diagnosis, imaging determinants and management of PSCI. The aim of this update is to determine whether these new data answer the questions that are essential to reducing PSCI, the unmet needs, and steps still to be taken.

Methods:

Literature review of stroke unit-era studies examining key steps in the management of PSCI: epidemiology and risk factors, diagnosis (cognitive profile and assessments), imaging determinants (quantitative measures, voxelwise localization, the disconnectome and associated Alzheimer’s disease [AD]) and treatment (secondary prevention, symptomatic drugs, rehabilitation and noninvasive brain stimulation) of PSCI.

Findings:

(1) the prevalence of PSCI of approximately 50% is probably underestimated; (2) the sensitivity of screening tests should be improved to detect mild PSCI; (3) comprehensive assessment is now well-defined and should include apathy; (4) easily available factors can identify patients at high risk of PSCI; (5) key imaging determinants are the location and volume of the lesion and the resulting disconnection, associated AD and brain atrophy; WMH, ePVS, microhemorrhages, hemosiderosis, and cortical microinfarcts may contribute to cognitive impairment but are more likely to be markers of brain vulnerability or associated AD that reduce PS recovery; (6) remote and online assessment is a promising approach for selected patients; (7) secondary stroke prevention has not been proven to prevent PSCI; (8) symptomatic drugs are ineffective in treating PSCI and apathy; (9) in addition to cognitive rehabilitation, the benefits of training platforms and computerized training are yet to be documented; (10) the results and the magnitude of improvement of noninvasive brain stimulation, while very promising, need to be substantiated by large, high-quality, sham-controlled RCTs.

Discussion and conclusion:

These major advances pave the way for the reduction of PSCI. They include (1) the development of more sensitive screening tests applicable to all patients and (2) online remote assessment; crossvalidation of (3) clinical and (4) imaging factors to (5) identify patients at risk, as well as (6) factors that prompt a search for associated AD; (7) the inclusion of cognitive outcome as a secondary endpoint in acute and secondary stroke prevention trials; and (8) the validation of the benefit of noninvasive brain stimulation through high-quality, randomized, sham-controlled trials. Many of these objectives can be rapidly and easily attained.
Coronary artery calcification is prevalent in systemic sclerosis and is associated with adverse prognosis
Authors: Rossdale Jennifer , Graby John , Harris Maredudd , Jones Calum , Greenish Davyd , Bartlett Jessica , Gilroy Andrew , Sanghera Jamie , Pauling John D , Skeoch Sarah , Flower Victoria , Mackenzie Ross Rob , Suntharalingam Jay , Rodrigues Jonathan CL
Published: August 2024

Objective:

Coronary artery calcification assessed on thoracic computed tomography represents the calcific component of established coronary artery disease, is a biomarker of total atheromatous plaque burden and predicts mortality. Systemic sclerosis is a pro-inflammatory condition, and inflammation is also a driver of coronary artery disease. We assessed coronary artery calcification prevalence, mortality risk and potential clinical impact on primary prevention in a cohort of patients with systemic sclerosis, differentiated by clinical phenotype including the presence of interstitial lung disease and pulmonary arterial hypertension.

Methods:

Retrospective analysis of 258 computed tomographies in systemic sclerosis patients from three prospectively maintained clinical and research databases at a single tertiary rheumatology/pulmonary hypertension (PH) service between March 2007 and September 2020 (mean age = 65 ± 12, 14% male). Co-morbidities, statin prescription and all-cause mortality were recorded. Patients were subtyped according to underlying systemic sclerosis complications. Computed tomographies were re-reviewed for coronary artery calcification; severity was graded using a 4-point scale per vessel and summed for total coronary artery calcification score. The impact of reporting coronary artery calcification was assessed against pre-existing statin prescriptions.

Results:

Coronary artery calcification was present in 58% (149/258). Coronary artery calcification was more prevalent in systemic sclerosis-pulmonary arterial hypertension than in systemic sclerosis subgroups with interstitial lung disease or without pulmonary arterial hypertension, controlling for age, sex, co-morbidities and smoking status (71%; χ2(13) = 81.4; p < 0.001). The presence and severity of coronary artery calcification were associated with increased risk of mortality independently of age and co-morbidities (hazard ratio = 2.8; 95% confidence interval = 1.2–6.6; p = 0.018). The ‘number needed to report’ coronary artery calcification presence to potentially impact management was 3.

Conclusions:

Coronary artery calcification is common in systemic sclerosis. Coronary artery calcification predicts mortality independently of age and confounding co-morbidities which suggests this finding has clinical relevance and is a potential target for screening and therapeutic intervention.
Intentional travel group and social network: Identification and dynamics during a pandemic
Authors: Zhou Mingzhi , Lei Shuyu , Wu Jiangyue , Ma Hanxi , Levinson David M , Zhou Jiangping
Published: August 2024

Using multiday continuous smartcard data in 2020, we investigate group-based travel in Hong Kong metro system by identifying metro riders intentionally traveling in groups (ITGs). ITGs serve as our proxies for citywide physical social interactions. Considering ITG members are interrelated through group-based trips, we construct a social network (an ITG network) formed by ITGs to explore the network properties and structures of ITG activities. Examining ITGs both before and during the COVID-19 pandemic, we measure the spatial patterns of ITGs and their dynamics across locales and over time. We find that the degree of the ITG network follows a heavy-tailed distribution. The network size and interconnections vary across time. Some ITG members are more influential vertices than others in maintaining the networks’ topological properties. We illustrate how new data and methods can be used to explore in-person interactions and social activity patterns in transit-reliant cities.
Accessibility derivative: Measuring the accessibility contribution of public transit routes
Authors: Liu Luyu , Miller Harvey J
Published: August 2024

Accessibility is one of the most essential objectives of public transit systems as the transit service’s useability and service quality. The accessibility of transit systems as a whole is well understood; however, it is still unclear how each route contributes to the system-wide accessibility. Meanwhile, with a higher risk of disruptions and more uncertainties from climate change and other disruptions, there is an urgent need to systematically study the impacts of service change with the contribution of each route to general accessibility. To address this gap, we introduce the accessibility derivative, a model-agnostic measure of the contribution of each route in a transit system. We define the derivative of a route as the systemwide change in accessibility after removing the route from the system. We demonstrate how to calculate the derivative numerically from widely available public transit schedule and automated passenger count data. The measure reflects the inherent structure of a transit system and reveals the impacts of potential route-level service changes. The results provide firsthand evidence on public transit assessment and planning, including performance assessment, schedule redesign, and planning transfers.
The Impact of the Fourth Industrial Revolution on Female Workers in the Ready-made Garments and Textile Industry, Bangladesh
Authors: Akter Salma , Amin Md Al , Hossain Md Nur Uddin , Yasmin Asma , Sarker Md Nazirul Islam , Ali Isahaque , Azman Azlinda
Published: August 2024

This research investigates how the Fourth Industrial Revolution (4IR) has affected female employees in Bangladesh’s Ready-made Garments (RMG) and textile industries. Using a qualitative methodological approach, data from eight interviews and one unstructured focus group with female employees and industry stakeholders were gathered. Additionally, five key informant interviews were conducted with industry experts. Analysis of these data revealed that female workers in the RMG and textile industries perceive a threat to their employment due to the declining value of their current skills in the market. The study also suggests that transitioning to new jobs or finding alternative employment will be a challenge without adequate training and support from the government and industry authorities to equip these workers with skills relevant to 4IR-based occupations. The study concludes that enhancing these workers’ preparedness through reskilling and upskilling initiatives is crucial. Furthermore, the study recommends that the relevant authorities devise and implement comprehensive policies addressing the challenges and opportunities presented by 4IR, especially for female workers in the RMG and textile sectors in Bangladesh. The findings of this study will be beneficial to Governments beyond Bangladesh, policymakers, industry owners, professionals, female workers and other stakeholders in this sector.
Short-Term Efficacy of Tenofovir Alafenamide in Acute-On-Chronic Liver Failure: A Single Center Experience
Authors: Li Zhiqin , Zhu Ruirui , Dong Jianxia , Gao Yinghui , Yan Jingya
Published: August 2024

Background:

Patients with acute-on-chronic liver failure (ACLF) who take entecavir (ETV) and tenofovir disoproxil fumarate (TDF) experience a reduction in hepatic events and mortality. The effectiveness of tenofovir alafenamide (TAF) was not well investigated. This study was aim to compare the antiviral efficacy and mortality between TAF and ETV in patients with ACLF caused by the hepatitis B virus (HBV).

Methods:

One hundred and six patients with HBV-ACLF who received TAF (25 mg/day) and ETV (0.5 mg/day) for 12 weeks were analyzed. The primary endpoints were overall mortality and liver transplantation (LT) at week 12. Biochemical responses, virologic responses, mortality, drug safety, and side effects were evaluated.

Results:

At 4 and 12 weeks of TAF treatment, patients showed significantly higher HBV-DNA reduction ( P < .001), higher HBV-DNA undetectability rates ( P < .001), and lower HBV DNA levels ( P < .001) in serum. Lower Child-Turcotte-Pugh (CTP) scores ( P = .003) were observed at 4 weeks in the TAF group, although the CTP scores showed no difference between TAF group and ETV group at 12 weeks ( P = 1.143). Lower alanine aminotransferase (ALT) levels of patients in the TAF group at week 4 and 12 were observed ( P = .023 and P < .0001, separately). The mortality of TAF group was lower after 4 weeks of treatment ( P = .038); however, the 2 groups had similar mortality rates at week 8 and 12. Among the causes of death in HBV-ACLF patients, we found the same incidence of liver-related problems in both groups ( P > .05).

Conclusions:

This study showed that ACLF patients with chronic HBV infection treated with TAF had a rapid decline in HBV DNA, a higher rate of ALT reduction and improved CTP scores compared to the ETV group, thereby improving patient survival.
VCL::ROS1: A Novel ROS1 Oncogenic Fusion Detected on Next Generation Sequencing
Authors: Mehta Anurag , Diwan Himanshi , Nathany Shrinidhi , Batra Ullas , Gupta Manoj , Panigrahi Manoj Kumar , Kumar Dushyant , Mattoo Sakshi , Singh Aayushi
Published: August 2024

Advanced Non-Small Cell Lung Carcinoma (NSCLC) patients with ROS1 gene rearrangement have shown significant therapeutic responses to tyrosine kinase inhibitors approved by the US Food and Drug Administration, with approximately 40 fusion partners documented in the existing literature. Our report highlights a novel fusion partner of ROS1 that has demonstrated a conclusive response to the current standard of treatment.
Developing systemic therapies in a specialist perinatal mental health service using an attachment narrative therapy approach
Authors: Farrer Elaine , Seal Karen , O’Shaughnessy Ruth , Dallos Rudi
Published: August 2024

This paper describes the development of systemic therapies in a Specialist Perinatal Mental Health Service (SPMHS) that developed Attachment Narrative Therapy (ANT) specifically for families in the perinatal stage of the family life cycle. ANT offers a good fit in the perinatal period, integrating systemic family therapy, narrative therapy, and attachment theory. From pregnancy to the child being two is a family life cycle stage of great change and reorganisation. This involves opportunities and challenges for attachments and relationships between parents, the baby and wider family/carers. Attending to cross-generational narratives and attachments are important in ensuring the perinatal stage is navigated successfully. Peri-ANT, a semi-structured version of ANT, was developed as a manualised approach. It can be flexibly adapted to the unique circumstances of each family. The paper describes the perinatal context, service needs and priorities, and the development of Peri-ANT including construction of the manual and how it was delivered.
The “Rocky” Factor: Minimizing Globe Injury in Subsequent Orbital Floor Fractures in Repeat Offenders
Authors: Walsh Landis , Choe Joshua , Barnett Sarah , Nakfoor Bruce , Atamian Elisa , Bradley James P.
Published: August 2024

Background:

Recurrent or repeat orbital floor and/or medial wall fractures may have an increased risk of globe injury and vision loss. To see if the initial orbital floor repair technique and/or chosen material for reconstruction impact the result, we studied repeat offenders who engage in: (1) repeat assaults, (2) unprotected sports injuries, or (3) seizure disorders.

Methods:

From 715 patients who underwent traumatic orbital floor repair over an 18-year period, 58 “repeat offenders” suffered a subsequent orbital fracture and were studied. Type of repair and outcomes including globe injuries were documented.

Results:

Repeat offenders who had a second orbital fracture had initial repairs with: resorbable plates (63.8%), titanium mesh (12.1%), and split cranial bone grafts (14%). More significant globe injuries occurred when initial repair was with titanium plates (86%) and bone grafts (14%) compared to resorbable plates (0%). Of the total group with initial orbital fractures and repair, 15% were categorized as “at risk” to be repeat offenders based on their medical history and activity. Of the “repeat offenders” who had an additional orbital fracture, 95% (50/58) fell into the “at risk” category for “repeat offending.”

Conclusion:

Resorbable plate orbital floor and/or medial wall fracture repair may offer less significant globe injury for repeat offenders at risk for subsequent orbital trauma.
“I Don’t Get to Play With My Mum Anymore”: Experiences of Siblings Aged 8–12 of Children With Cancer: A Qualitative Study
Authors: Davies Jenny , O’Connor Moira , Halkett Georgia K. B. , Kelada Lauren , Gottardo Nicholas G.
Published: August 2024

Background: Siblings of children with cancer have been shown to experience disruption in multiple domains including family, school, and friendships. Existing literature on siblings’ experiences focuses on older children or on a broad range of ages. Aim: To explore the experience of siblings aged 8–12 years when their brother or sister is diagnosed with cancer. Method: A qualitative design incorporating phenomenology as the theoretical framework was used. Participants were recruited from across Australia via notices on social media sites and by the distribution of flyers. We used thematic analysis to analyze the data. Data were collected via semistructured interviews conducted either in person or online. Findings: A total of 13 siblings (7 boys and 6 girls) aged between 8 and 12 years ( M = 9.8, SD = 1.6) were interviewed. Seven main themes were identified. These were “It was really hard”: Reactions to the cancer diagnosis; “I’m really angry”: Emotional and Physical Responses to siblings’ treatment; “I pretend teddy is real”: Play as an outlet; “It was very lonely”: Missing their siblings; “I missed out on a lot of fun”: Disruption of activities: School, sports, playdates, and parties; Change and Transition and “Making a difficult situation worse”: COVID-19 Pandemic. Discussion: Findings extend the current understanding showing that younger siblings’ developmental and cognitive skills impact their experiences of childhood cancer. Younger siblings outlined the many losses they experienced which demonstrated a need for a comprehensive and tailored program to support young siblings aged under 12 of children with cancer.
Caring During COVID-19: A Study of Intersectionality and Inequities in the Care Economy in 16 Countries
Authors: Musolino Connie , Baum Fran , Flavel Joanne , Freeman Toby , McKee Martin , Chi Chunhuei , Giugliani Camila , Falcão Matheus Zuliane , De Ceukelaire Wim , Howden-Chapman Philippa , Huong Nguyen Thanh , Serag Hani , Kim Sun , Dardet Carlos Alvarez , Gesesew Hailay Abrha , London Leslie , Popay Jennie , Paremoer Lauren , Tangcharoensathien Viroj , Sundararaman T. , Nandi Sulakshana , Villar Eugenio
Published: August 2024

Carers were disproportionately harmed in the COVID-19 pandemic. Despite facing an increased risk of contracting the virus, they continued in frontline roles in care services and acted as “shock absorbers” for their families and communities. In this article, we apply an intersectional lens to examine care work and the structural factors disadvantaging carers during COVID-19 through a comparative case study analysis of 16 low-, middle-, and high-income countries. Data on each country was collected through a qualitative framework during 2021–2022. We found that while carers everywhere were predominantly women with low incomes and precarious employment, other factors were at play in shaping their experiences. Moreover, government responses to mitigate the direct impact of the pandemic have created local and global disparities affecting those working in this sector. Our findings reveal how oppressive social structures such as race, class, caste, and migration status converged in contextually specific ways to shape the gendered nature of care within and between different countries. We call for a better understanding of the multiple axes of inequalities experienced by carers to inform crisis mitigations, coupled with long-term strategies to address social inequities in the care economy and to promote gender equality.
Association between serum vitamin D status and severity of liver cirrhosis: implications for therapeutic targeting in Nigerian patients
Authors: Adiri Winnifred Njideka , Basil Bruno , Onyia Chinwe Philomena , Asogwa Promise , Ugwuanyi Oluchi Joy , Obienu Olive , Ijoma Uchenna Nkemdilim , Nwokediuko Slyvester Chuks
Published: August 2024

Background

Liver cirrhosis is a chronic and progressive liver disease with significant global health implications. Recent evidence suggests an association between serum vitamin D levels and the severity of liver cirrhosis, potentially serving as a therapeutic target. This study aimed to investigate the relationship between serum vitamin D status and the severity of liver cirrhosis in a population of Nigerian patients.

Methods

This analytical, cross-sectional study involved 201 participants, including 103 with liver cirrhosis and 98 age- and sex-matched controls. Serum vitamin D was measured using ELISA, with deficiency defined as < 20 ng/ml. Cirrhosis severity was assessed using Child-Pugh and MELD scores. Spearman’s correlation was used to assess the relationship between vitamin D and severity of liver cirrhosis while ordinal regression analysis assessed its performance as an indicator of the disease severity.

Result

Among cirrhotic patients, 36.9% were deficient, 31.1% insufficient, and 32.0% had sufficient vitamin D levels. Serum vitamin D showed strong negative correlations with Child-Pugh and MELD scores (r = -0.696, p < 0.001; r = -0.734, p < 0.001, respectively). Ordinal regression showed that higher vitamin D levels were associated with lower severity scores (Child-Pugh: OR = 0.856, 95% CI: 0.815–0.900, p < 0.001; MELD: OR = 0.875, 95% CI: 0.837–0.915, p < 0.001).

Conclusion

Lower serum vitamin D levels correlated with increased liver cirrhosis severity, suggesting its potential as both a prognostic marker and therapeutic target. Further studies should investigate the efficacy of vitamin D supplementation in improving cirrhosis outcomes.
Dual-energy computed tomography with new virtual monoenergetic image reconstruction enhances prostate lesion image quality and improves the diagnostic efficacy for prostate cancer
Authors: Fan Nina , Chen Xiaofeng , Li Yulin , Zhu Zhiqiang , Chen Xiangguang , Yang Zhiqi , Yang Jiada
Published: August 2024

Background

Prostate cancer is one of the most common malignant tumors in middle-aged and elderly men and carries significant prognostic implications, and recent studies suggest that dual-energy computed tomography (DECT) utilizing new virtual monoenergetic images can enhance cancer detection rates. This study aimed to assess the impact of virtual monoenergetic images reconstructed from DECT arterial phase scans on the image quality of prostate lesions and their diagnostic performance for prostate cancer.

Methods

We conducted a retrospective analysis of 83 patients with prostate cancer or prostatic hyperplasia who underwent DECT scans at Meizhou People’s Hospital between July 2019 and December 2023. The variables analyzed included age, tumor diameter and serum prostate-specific antigen (PSA) levels, among others. We also compared CT values, signal-to-noise ratio (SNR), subjective image quality ratings, and contrast-to-noise ratio (CNR) between virtual monoenergetic images (40–100 keV) and conventional linear blending images. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic efficacy of virtual monoenergetic images (40 keV and 50 keV) compared to conventional images.

Results

Virtual monoenergetic images at 40 keV showed significantly higher CT values (168.19 ± 57.14) compared to conventional linear blending images (66.66 ± 15.5) for prostate cancer (P < 0.001). The 50 keV images also demonstrated elevated CT values (121.73 ± 39.21) compared to conventional images (P < 0.001). CNR values for the 40 keV (3.81 ± 2.13) and 50 keV (2.95 ± 1.50) groups were significantly higher than the conventional blending group (P < 0.001). Subjective evaluations indicated markedly better image quality scores for 40 keV (median score of 5) and 50 keV (median score of 5) images compared to conventional images (P < 0.05). ROC curve analysis revealed superior diagnostic accuracy for 40 keV (AUC: 0.910) and 50 keV (AUC: 0.910) images based on CT values compared to conventional images (AUC: 0.849).

Conclusions

Virtual monoenergetic images reconstructed at 40 keV and 50 keV from DECT arterial phase scans substantially enhance the image quality of prostate lesions and improve diagnostic efficacy for prostate cancer.
Longitudinal assessment of sleep and fatigue according to baby feeding method in postpartum women: a prospective observational study
Authors: Mariman An , Hanoulle Ignace , Pevernagie Dirk , Maertens Sarah-Jane , Dehaene Isabelle , Tobback Els , Delesie Liesbeth , Loccufier Anne , Van Holsbeeck Ann , Moons Lara , Vogelaers Dirk
Published: August 2024

Background

Poor subjective sleep quality, depressive symptoms and fatigue occur frequently in postpartum. However, the dynamics of their respective associations from prepartum throughout the maternity period in function of baby feeding method have not been fully elucidated.

Methods

Prospective, longitudinal study using validated questionnaires probing for sleep quality, insomnia, fatigue and depressive symptoms at 35–37 weeks of gestation and at 2, 8 and 12 weeks postpartum in the obstetric departments of two Flemish hospitals. Somers’d ordinal correlation was used for correlations between the results of questionnaires (ratio variables) and the feeding method variable (an ordinal variable); T tests (normal data) or Mann Whitney (non normal data) tests for equality of means; ordinal regression (‘Proportional odds model’) to investigate the predictive value of parameters at one moment on the feeding method choice at a later moment; logistic regression to investigate the predictive value of parameters on later change of feeding method.

Results

188 women indicating a choice for either bottle or breastfeeding in prepartum (27–35 weeks’ gestation) were included. Higher fatigue assessed through the Fatigue Severity Scale within late pregnancy was moderately associated with primary bottle feeding choice. Fatigue decreased at early and late postpartum in bottle feeding (-0.38 ± 1.04; p = .110 and − 0.31 ± 1.01; p = .642 respectively), but remained unchanged from late pregnancy through early and late postpartum in breastfeeding (0.04 ± 1.21; p = .110 and − 0.27 ± 0.96; p = .642 respectively), resulting in similar fatigue in both feeding methods in early through late postpartum. There were no differences in sleep quality or insomnia symptoms at all time points. Presence of postpartum depressive symptoms were associated with early switching to bottle feeding (Somers’ d correlation 0.11 (p = .021).

Conclusions

Fatigue and depressive symptoms are inversely associated with breastfeeding initiation or maintenance and influence feeding method dynamics.
Artificial intelligence reveals the predictions of hematological indexes in children with acute leukemia
Authors: Cheng Zhangkai J. , Li Haiyang , Liu Mingtao , Fu Xing , Liu Li , Liang Zhiman , Gan Hui , Sun Baoqing
Published: August 2024

Childhood leukemia is a prevalent form of pediatric cancer, with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) being the primary manifestations. Timely treatment has significantly enhanced survival rates for children with acute leukemia. This study aimed to develop an early and comprehensive predictor for hematologic malignancies in children by analyzing nutritional biomarkers, key leukemia indicators, and granulocytes in their blood. Using a machine learning algorithm and ten indices, the blood samples of 826 children with ALL and 255 children with AML were compared to a control group of 200 healthy children. The study revealed notable differences, including higher indicators in boys compared to girls and significant variations in most biochemical indicators between leukemia patients and healthy children. Employing a random forest model resulted in an area under the curve (AUC) of 0.950 for predicting leukemia subtypes and an AUC of 0.909 for forecasting AML. This research introduces an efficient diagnostic tool for early screening of childhood blood cancers and underscores the potential of artificial intelligence in modern healthcare.
A clearer vision: unveiling the importance of cycloplegic refraction and the pseudomyopia prevalence in Chinese preschoolers
Authors: Liu Peipei , Zhu Bidan , Fu Jing , Sun Yunyun , Liu Xiangxiang , Li Lei , Wang Shana , Qin Xi
Published: August 2024

Background

This study aimed to investigate the difference between cycloplegic and noncycloplegic refraction and evaluate the pseudomyopia prevalence in Chinese preschool children during the outbreak of COVID-19.

Methods

A cross-sectional study was conducted in the Tongzhou District of Beijing, China. Refractive error was measured under both noncycloplegic and cycloplegic conditions with autorefraction. The difference between noncycloplegic and cycloplegic spherical equivalent refraction (SER) and pseudomyopia prevalence were analyzed. Pseudomyopia was defined as SER ≤-0.50D in precycloplegic assessments and >-0.50D in post-cycloplegic assessments.

Results

Out of the 1487 participants who were enrolled in the study, 1471 individuals (98.92%) between the ages of 3–6 years completed all required procedures. A statistically significant difference in refraction was observed between noncycloplegic and cycloplegic measurements, the median of difference in spherical equivalent refraction (SER) of 0.88D (dioptre)(0.50,1.38). There was a high intraclass correlation (ICC) between these two methods for cylinders (ICC = 0.864; 95% CI, 0.850–0.877). The median DSE for myopia, emmetropia and hyperopia were 0.25D (0.00, 0.38),0.25D (0.06, 0.50) and 1.00D (0.62, 1.38), an hypermetropes showed considerably greater differences than myopes and emmetropes (Kruskal-Wallis test, H = 231.023, P = 0.000). Additionally, girls displayed a greater DSE than boys. Furthermore, when comparing against-the-rule (ATR) and oblique astigmatism, it was found that with-the-rule (WTR) astigmatism had the largest DSE. The study found varying prevalence rates of myopia, emmetropia, and hyperopia with and without cycloplegia, which were 1.90% vs. 10.06%, 11.49% vs. 50.31%, and 86.61% vs. 39.63%, respectively. Additionally, the overall prevalence of pseudomyopia was determined to be 8.29%. Participants with pseudomyopia had a significantly higher mean difference in SER (DSE) compared to non-pseudomyopic participants.

Conclusions

Cycloplegic refraction is more sensitive than a noncycloplegic one for measuring refractive error in preschool children. Pseudomyopia is prevalent in preschool children during the COVID-19 outbreak period. Our study indicates the possibility that cycloplegic refraction should be performed in preschool children routinely.
Early postoperative fever as a predictor of pancreatic fistula after pancreaticoduodenectomy: a single-center retrospective observational study
Authors: Ju Jae-Woo , Jang Hwan Suk , Lee Mirang , Lee Ho-Jin , Kwon Wooil , Jang Jin-Young
Published: August 2024

Background

The connection between early postoperative fever and clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy remains unclear. This study aimed to investigate this association and assess the predictive value of early postoperative fever for CR-POPF.

Methods

This retrospective observational study included adult patients who underwent pancreaticoduodenectomy at a tertiary teaching hospital between 2007 and 2019. Patients were categorized into those with early postoperative fever (≥ 38 °C in the first 48 h after surgery) and those without early postoperative fever groups. Weighted logistic regression analysis using stabilized inverse probability of treatment weighting (sIPTW) and multivariable logistic analysis were performed. The c-statistics of the receiver operating characteristic curves were calculated to evaluate the impact on the predictive power of adding early postoperative fever to previously identified predictors of CR-POPF.

Results

Of the 1997 patients analyzed, 909 (45.1%) developed early postoperative fever. The overall incidence of CR-POPF among all the patients was 14.3%, with an incidence of 19.5% in the early postoperative fever group and 9.9% in the group without early postoperative fever. Early postoperative fever was significantly associated with a higher risk of CR-POPF after sIPTW (adjusted odds ratio [OR], 1.73; 95% confidence interval [CI], 1.34–2.22; P < 0.001) and multivariable logistic regression analysis (adjusted OR, 1.88; 95% CI, 1.42–2.49; P < 0.001). The c-statistics for the models with and without early postoperative fever were 0.76 (95% CI, 0.73–0.79) and 0.75 (95% CI, 0.72–0.78), respectively, showing a significant difference between the two (difference, 0.02; 95% CI, 0.00–0.03; DeLong’s test, P = 0.005).

Conclusions

Early postoperative fever is a significant but not highly discriminative predictor of CR-POPF after pancreaticoduodenectomy. However, its widespread occurrence limits its applicability as a predictive marker.
Healthcare staff experiences on the impact of COVID-19 on emergency departments: a qualitative study
Authors: Butun Ahmet
Published: August 2024

Background

The COVID-19 pandemic has had a major impact on the access and delivery of healthcare services, posing unprecedented challenges to healthcare staff worldwide. Frontline healthcare staff faced unique stressors and challenges that impact their well-being and patient care. This qualitative study aimed to explore the experiences and perspectives of frontline ED healthcare staff on emergency care services during the COVID-19 pandemic, providing valuable insights into the challenges, adaptations, and lessons learned in delivering emergency care.

Methods

This study utilized a qualitative approach. In-depth semi-structured interviews were conducted with 30 ED healthcare staff from three different hospitals located in Turkey between 15/03/2022 and 30/04/2022. Convenience sampling was used to recruit participants. The duration of the interviews ranged from 28 to 37 min. Data saturation was reached as no new information was gathered. The data were analyzed using the thematic analysis method. NVivo software was used to manage the data analysis process. Member check was carried out to ensure that the generated themes conformed to the participants’ views.

Results

15 sub-themes under three themes emerged: (1) the impact of COVID-19 on emergency care services, including sub-themes of “introducing a COVID-19 unit in the ED”, “changes in the routine functioning of EDs”, “changes in the number of ED visits”, “quality of care”, “resources”, and “increased workload”; (2) the psychological effects of COVID-19 on ED healthcare staff, including sub-themes of “staying away from family”, “fear”, “society’s perspective on healthcare professionals”, “morale-staff burnout”, “psychological and emotional effects”, and “unable to receive sufficient support”; and (3) the difficulties faced by ED healthcare staff, including sub-themes of “difficult working conditions”, “community-based effects difficulties”, and “COVID-19 is an unknown situation”.

Conclusion

Staff burnout threatens the quality of patient care and staff retention, and therefore this should be addressed by ED directors and leaders. This study could inform appropriate stakeholders regarding lessons learned from COVID-19 to better manage future pandemics. Learning from such lived experiences and developing appropriate interventions to minimize the difficulties faced during COVID-19 would allow better management of future pandemics. This study calls for a reform to address the challenges faced by healthcare staff, improve the overall response to public health crises, and enhance the resilience of healthcare systems for future crises.
Meconium microbiota in naturally delivered canine puppies
Authors: Bertero Alessia , Banchi Penelope , Del Carro Angela , Corrò Michela , Colitti Barbara , Van Soom Ann , Bertolotti Luigi , Rota Ada
Published: August 2024

Background

Microbial colonization during early life has a pivotal impact on the host health, shaping immune and metabolic functions, but little is known about timing and features of this process in dogs. The objectives of this study were to characterize the first step of intestinal microbiota development in naturally delivered canine puppies and to investigate its relationship with the maternal bacterial flora, using traditional culture and molecular analyses. Sixty puppies of two breeds, Appenzeller Cattle Dog (n = 3 dams) and Lagotto Romagnolo (n = 6), housed in the same breeding kennel, were included in the study. Swabs were collected in duplicate (for culture and for molecular analysis) from the dams’ vagina and rectum at the end of parturition, from puppies’ rectum, before maternal care, and from the environment (floor of the nursery and parturition box).

Results

93.3% meconium samples showed bacterial growth, limited to a few colonies in 57.0% of cases. High growth was detected for Enterococcus faecalis, which was the most frequently isolated bacterium. The genus Enterococcus was one of the most represented in the dams’ rectum and vagina (88.9% and 55.6%, respectively). The genera Staphylococcus, Enterococcus, Escherichia and Proteus were also often isolated in meconium but were usually present in maternal samples as well, together with ubiquitous bacteria (Acinetobacter, Psychrobacter). In the environmental samples, just a few bacterial species were found, all with low microbial load. Additionally, bacteria of the phyla Proteobacteria, Firmicutes, and Actinobacteria were identified in meconium through molecular analysis, confirming the culture results and the early colonization of the newborn gut. Maternal, meconium and environmental samples had similar alpha diversity, while beta-diversity showed differences among families (i.e. a dam and her litter), and association indexes revealed a significant correlation between family members and between sample origin, suggesting a strong contribution of the maternal flora to the initial seeding of the canine neonatal gut and a strong individual dam imprint.

Conclusion

This study showed that the meconium of vaginally delivered puppies has its own microbiota immediately after birth, and that it is shaped by the dam, which gives a specific imprint to her litter.
Detecting heart stress using NT-proBNP in patients with type 2 diabetes mellitus and hypertension or high-normal blood pressure: a cross-sectional multicentric study
Authors: Landolfo Matteo , Spannella Francesco , Giulietti Federico , Ortensi Beatrice , Stella Lucia , Carlucci Maria A. , Galeazzi Roberta , Turchi Federica , Luconi Maria P. , Zampa Roberto , Cecchi Sofia , Tortato Elena , Petrelli Massimiliano , Sarzani Riccardo
Published: August 2024

Background

We evaluated the prevalence of “heart stress” (HS) based on NT-proBNP cut-points proposed by the 2023 Consensus of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in asymptomatic patients with T2DM and hypertension or high-normal blood pressure (BP) eligible for SGLT2 inhibitors (SGLT2i) and/or GLP-1 receptor agonists (GLP1-RA), drugs with proven benefits on reducing the incidence of HF, hospitalizations, cardiovascular events and mortality.

Methods

A cross-sectional multicentric study was conducted on 192 consecutive outpatients, aged ≥ 55 years, with hypertension or high-normal BP, referred to three diabetology units. NT-proBNP was collected before starting new anti-diabetic therapy. Patients with known HF were excluded, and participants were classified based on the age-adjusted NT-proBNP cut-points.

Results

Mean age: 70.3 ± 7.8 years (67.5% males). Patients with obesity (BMI ≥ 30 Kg/m2): 63.8%. Median NT-proBNP: 96.0 (38.8–213.0) pg/mL. Prevalence of chronic kidney disease (CKD, eGFR < 60 mL/min/1.73m2): 32.1%. Mean arterial BP: 138.5/77.0 ± 15.8/9.9 mmHg. The NT-proBNP values, according to the proposed age-adjusted cut-points, classified 28.6% of patients as “HS likely” (organize elective echocardiography and specialist evaluation), 43.2% as “HS not likely” (a grey area, repeat NT-proBNP at six months) and 28.2% as “very unlikely HS” (repeat NT-proBNP at one year). The presence of CKD and the number of anti-hypertensive drugs, but not glycemic parameters, were independently associated with HS.

Conclusions

According to NT-proBNP, over a quarter of T2DM patients with hypertension/high-normal BP, among those eligible for SGLT2i and/or GLP1-RA, were already at risk of cardiac damage, even subclinical. Most would receive an indication to echocardiogram and be referred to a specialist, allowing the early implementation of effective strategies to prevent or delay the progression to advanced stages of cardiac disease and overt HF.
Sucrose as an electron source for cofactor regeneration in recombinant Escherichia coli expressing invertase and a Baeyer Villiger monooxygenase
Authors: Sovic Lucija , Malihan-Yap Lenny , Tóth Gábor Szilveszter , Siitonen Vilja , Alphand Véronique , Allahverdiyeva Yagut , Kourist Robert
Published: August 2024

Background

The large-scale biocatalytic application of oxidoreductases requires systems for a cost-effective and efficient regeneration of redox cofactors. These represent the major bottleneck for industrial bioproduction and an important cost factor. In this work, co-expression of the genes of invertase and a Baeyer–Villiger monooxygenase from Burkholderia xenovorans to E. coli W ΔcscR and E. coli BL21 (DE3) enabled efficient biotransformation of cyclohexanone to the polymer precursor, ε-caprolactone using sucrose as electron source for regeneration of redox cofactors, at rates comparable to glucose. E. coli W ΔcscR has a native csc regulon enabling sucrose utilization and is deregulated via deletion of the repressor gene (cscR), thus enabling sucrose uptake even at concentrations below 6 mM (2 g L−1). On the other hand, E. coli BL21 (DE3), which is widely used as an expression host does not contain a csc regulon.

Results

Herein, we show a proof of concept where the co-expression of invertase for both E. coli hosts was sufficient for efficient sucrose utilization to sustain cofactor regeneration in the Baeyer–Villiger oxidation of cyclohexanone. Using E. coli W ΔcscR, a specific activity of 37 U gDCW−1 was obtained, demonstrating the suitability of the strain for recombinant gene co-expression and subsequent whole-cell biotransformation. In addition, the same co-expression cassette was transferred and investigated with E. coli BL21 (DE3), which showed a specific activity of 17 U gDCW− 1. Finally, biotransformation using photosynthetically-derived sucrose from Synechocystis S02 with E. coli W ΔcscR expressing BVMO showed complete conversion of cyclohexanone after 3 h, especially with the strain expressing the invertase gene in the periplasm.

Conclusions

Results show that sucrose can be an alternative electron source to drive whole-cell biotransformations in recombinant E. coli strains opening novel strategies for sustainable chemical production.