bluuebunny/crossref_metadata_2025 huggingface dataset:
Patency of arteriovenous fistulas and grafts for dialysis access: An analysis using the Korean National Health Insurance Service database from 2008 to 2019
Authors: Mo Hyejin , Kwon Sukyung , Kim Daehwan , Kim Ye Jee , Kim Hyangkyoung , Yang Seung Boo , Kwon Young Joo
Published: June 2023

Background:

Arteriovenous (AV) access practice and its outcomes vary internationally. To provide a better understanding of the patterns and outcomes of AV access creation, we investigated the patency and risk factors of arteriovenous fistulas (AVFs) and grafts (AVGs) as initial AV access in the Korean adult population using data from the last 10 years.

Methods:

The National Health Insurance Service database was queried retrospectively to identify patients undergoing hemodialysis with AVFs and AVGs as well as their clinical characteristics and outcomes from 2008 to 2019. AV access patency and its associated risk factors were evaluated.

Results:

During the study period, 64,179 AVFs and 21,857 AVGs were placed. The mean patient age was 62.6 ± 13.6 years (21.5% were ⩾75 years old), and 39.3% patients were women. More than half of the patients underwent AV access creation at tertiary care hospitals. At 1 year, the primary, primary assisted, and secondary patency rates were 62.2%, 80.7%, and 94.2% for AVFs, and 46.0%, 68.4%, and 86.8% for AVGs, respectively. AVG, older age, female sex, diabetes, and creation at general hospitals (vs tertiary hospitals) were associated with decreased patency outcomes (all, p < 0.05).

Conclusion:

This study using national data showed that three quarters of patients with AV access had AVF and AVF showed superior performance to AVG and identified several patient and center factors related to AV access patency in Korea.
ECTRIMS/EAN consensus on vaccination in people with multiple sclerosis: Improving immunization strategies in the era of highly active immunotherapeutic drugs
Authors: Otero-Romero Susana , Lebrun-Frénay Christine , Reyes Saúl , Amato Maria Pia , Campins Magda , Farez Mauricio , Filippi Massimo , Hacohen Yael , Hemmer Bernhard , Juuti Rosa , Magyari Melinda , Oreja-Guevara Celia , Siva Aksel , Vukusic Sandra , Tintoré Mar
Published: June 2023

Background:

With the new highly active drugs available for people with multiple sclerosis (pwMS), vaccination becomes an essential part of the risk management strategy

Objective:

To develop a European evidence-based consensus for the vaccination strategy of pwMS who are candidates for disease-modifying therapies (DMTs).

Methods:

This work was conducted by a multidisciplinary working group using formal consensus methodology. Clinical questions (defined as population, interventions, and outcomes) considered all authorized DMTs and vaccines. A systematic literature search was conducted and quality of evidence was defined according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. The recommendations were formulated based on the quality of evidence and the risk–benefit balance.

Results:

Seven questions, encompassing vaccine safety, vaccine effectiveness, global vaccination strategy and vaccination in sub-populations (pediatric, pregnant women, elderly and international travelers) were considered. A narrative description of the evidence considering published studies, guidelines, and position statements is presented. A total of 53 recommendations were agreed by the working group after three rounds of consensus.

Conclusion:

This first European consensus on vaccination in pwMS proposes the best vaccination strategy according to current evidence and expert knowledge, with the goal of homogenizing the immunization practices in pwMS.
Platformed listening in podcasting: An approach from material and scales potentials
Authors: Lopez Debora C , Cortez Natália , Jáuregui Carlos , Freire Marcelo
Published: June 2023

This article proposes to investigate delineations of the audience in podcasting in streaming media ecology. To meet this objective, we highlight the scales between contents, circulation, and consumption of podcasts in platformization contexts. We observe these relationships from an intersectional approach that involves spaces between codes, contents and software to understand the dynamics of interrelationships between contents and its flows which are associated with the emergence of varied audiences, derived from listening practices, characterized by binge listening; fidelity strategies; hybrid recommendation practices, playlists and cross-device consumption in multiplatform architecture.
One Year Outcomes of Zilver PTX Versus Eluvia for Femoropopliteal Disease in Real-World Practice: REALDES Study
Authors: Shibata Tsuyoshi , Iba Yutaka , Shingaki Masami , Yamashita Osamu , Tsubakimoto Yoshinori , Kimura Fumiaki , Hatada Atsutoshi , Kasashima Fuminori , Ueno Kyohei , Nakanishi Keitaro , Morishita Kiyofumi , Nakajima Tomohiro , Nakazawa Junji , Ohkawa Akihito , Hosaka Itaru , Arihara Ayaka , Tsushima Shingo , Kawaharada Nobuyoshi
Published: June 2023

Purpose:

This multicenter, prospective, observational study aimed to compare Zilver PTX and Eluvia stents in real-world settings for treating femoropopliteal lesions as the differences in the 1-year outcomes of these stents have not been elucidated.

Materials and Methods:

Overall, 200 limbs with native femoropopliteal artery disease were treated with Zilver PTX (96 limbs) or Eluvia (104 limbs) at 8 Japanese hospitals between February 2019 and September 2020. The primary outcome measure of this study was primary patency at 12 months, defined as a peak systolic velocity ratio of ≤2.4, without clinically-driven target lesion revascularization (TLR) or stenosis ≤50% based on angiographic findings.

Results:

The baseline clinical and lesion characteristics of Zilver PTX and Eluvia groups were roughly comparable (of all limbs analyzed, approximately 30% presented with critical limb-threatening ischemia, approximately 60% presented with Trans-Atlantic Inter-Society Consensus II C-D, and approximately half had total occlusion), except for the longer lesion lengths in the Zilver PTX group (185.7±92.0 mm vs 160.0±98.5 mm, p=0.030). The Kaplan–Meier estimates of primary patency at 12 months were 84.9% and 88.1% for Zilver PTX and Eluvia, respectively (log-rank p=0.417). Freedom from clinically-driven TLR rates were 88.8% and 90.9% for Zilver PTX and Eluvia, respectively (log-rank p=0.812).

Conclusions:

The results of the Zilver PTX and Eluvia stents were not different regarding primary patency and freedom from clinically-driven TLR at 12 months after treating patients with femoropopliteal peripheral artery disease in real-world settings.

Clinical Impact

This is the first study to reveal that the Zilver PTX and Eluvia have similar results in real-world practice when the proper vessel preparation is performed. However, the type of restenosis in the Eluvia stent may differ from that in the Zilver PTX stent. Therefore, the results of this study may influence the selection of DES for femoropopliteal lesions in routine clinical practice.
A Randomized Sham-Controlled Mixed Methods Pilot Study of the Feasibility of Acupuncture for Chemotherapy-Induced Neuropathy: Lessons Learned From Patient Experiences in Integrative Cancer Care
Authors: Lagerstedt Kristina , Efverman Anna
Published: June 2023

Objective

Since there is a lack of effective pharmacological therapies for chemotherapy-induced neuropathy and many patients ask for integrative cancer therapies such as acupuncture, the objective of this pilot study was to describe patients’ experiences, and to study the feasibility and short-term effects of genuine acupuncture for chemotherapy-induced neuropathic pain and unpleasant sensations compared to sham acupuncture.

Methods:

The pilot study used mixed methods, collecting quantitative and qualitative data. Patients (n = 12) with chemotherapy-induced neuropathy after colorectal cancer were blindly randomized to genuine acupuncture or telescopic sham acupuncture. Individual interviews were conducted, and were analyzed using qualitative content analysis. The patients registered pain and unpleasant sensations (100 mm Visual Analog Scales) before and after n = 120 sessions, n = 60 genuine and n = 60 sham acupuncture sessions.

Results:

Five categories of patient experiences were described. The neuropathy negatively affected life. Physical activity was perceived to be important for health, but neuropathy was a barrier. The neuropathy required symptom-managing strategies. Acupuncture was pleasant and valuable, but some patients presented doubts regarding its effect mechanisms. After the genuine acupuncture sessions, pain (mean −2.0 steps relief during each session) and unpleasant sensations (−2.4) in the face was reduced more than after sham acupuncture (+0.1 steps worse pain, P = .018, +0.1 steps worse unpleasant sensations, P = .036). After genuine acupuncture, unpleasant sensations in the hands were reduced less (−0.23) compared to after sham acupuncture (−5.5, P = .002). Pain or unpleasant sensations in the feet did not change.

Conclusions:

Patients experienced that the neuropathy negatively changed their life and that acupuncture was pleasant and valuable. Patients receiving genuine acupuncture had short-term effects regarding pain and unpleasant sensations in the face compared to patients receiving sham acupuncture, while hands and feet did not improve. The patients were successfully blinded and complied with the acupuncture. We welcome future full-scaled randomized sham-controlled acupuncture studies.
Learning Curve of Thoracoscopic Nonrobotic Harvest of the Left Internal Mammary Artery in Minimally Invasive Coronary Artery Bypass Grafting
Authors: Akca Ferdi , ter Woorst Joost
Published: June 2023

Objective:

Harvest of the left internal mammary artery (LIMA) is a technically demanding element of minimally invasive coronary surgery. We aimed to evaluate the learning curve of thoracoscopic, nonrobotic LIMA harvest during endoscopic coronary artery bypass (Endo-CAB) surgery.

Methods:

Eighty patients undergoing Endo-CAB surgery were included. LIMA harvest was performed using commonly available video-assisted thoracoscopic instruments. Time from incision until heparin administration was defined as total LIMA harvest time (this includes opening of the pericardium and identification of coronary targets). LIMA harvest times ( N = 80) and total procedure times for single-vessel grafting ( n = 51) were analyzed.

Results:

The mean LIMA harvest time was 58 ± 19 min, ranging from 15 to 113 min. The mean procedure time was 150 ± 39 min. Significant reductions in both LIMA harvest and total Endo-CAB procedure times were observed with increasing experience (logarithmic regression Y = 109 − 14.9*log(x), P < 0.001; Y = 227 − 24.4*log(x), P < 0.001, respectively). No damage to the LIMA occurred during thoracoscopic harvesting.

Conclusions:

Total thoracoscopic (nonrobotic) LIMA harvest is an efficient technique with a steep learning curve using routine instruments. More patients might benefit from minimally invasive coronary surgery using thoracoscopic LIMA harvest techniques.
Giant renal angiomyolipomas – Can they be managed safely through minimally invasive selective angioembolisation? Case series and literature review
Authors: Combes Alexander , Palma Catalina Alejandra , March Brayden , Eisinger David , Waugh Richard
Published: June 2023

Objective:

The objective was to determine whether giant renal angiomyolipomas (AMLs) can be managed through selective angioembolisation (SA) and compare outcomes to nephron-sparing surgery (NSS) and nephrectomy.

Methods:

A retrospective case series was compiled from a prospectively maintained database, commenced in 2011 of renal AMLs that underwent SA. We extracted patient demographics, size of AMLs, intervention and outcomes. A literature review of case reports and case series was performed on the management of giant renal AMLs managed through SA, NSS or nephrectomy.

Results:

Of 30 AMLs that underwent SA, 6 patients met the inclusion criteria. The mean diameter of AMLs prior to embolisation was 14.3 cm. All embolised AMLs decreased in size post-embolisation by an average of 18% (mean: 39-month follow-up). There were no complications in our cohort’s follow-up period, including no rise in any patients’ creatinine associated with SA. Our literature review of 284 articles found 82 articles pertaining to 102 giant renal AMLs. Our review identified SA, NSS and nephrectomy to all be effective management pathways for giant AMLs with minimal complications. Total nephrectomy did result in five patients requiring dialysis post-procedure.

Conclusions:

SA is an effective intervention for giant AMLs with comparable outcomes to NSS and nephrectomy and should be considered a suitable management option for giant renal AMLs.

Level of evidence:

Not applicable
The Dark Side of Online Support Groups: Conflictual Experiences in Single-Child Parents’ Facebook Groups
Authors: Ya’ari Khen , Yeshua-Katz Daphna , Segal Engelchin Dorit
Published: June 2023

This study draws on intersectionality and reproductive identity as conceptual frameworks to investigate the motivation and experience of Israeli voluntary single-child parents in online support groups (OSGs) for the parents of only children. A qualitative analysis of 20 semi-structured interviews revealed that the social stigma attached to having one child was a significant factor in their decision to join an OSG for all single-child parents. However, once becoming members of the group, voluntary single-child parents experienced conflictual encounters with their involuntary counterparts and felt stigmatized in the OSG as well. This led them to create their own OSG exclusively for voluntary single-child parents. The interviewees coped with their conflictual OSG membership experience by “cruising” between the two OSGs in a search for social support. Membership in both groups enabled them to gain support for the two distinct components of their reproductive identity: reproductive status; and reproductive decision-making. The findings extend the conceptual framework of intersectionality to OSG research, demonstrating how the interplay between multiple stigmatized identities shapes OSG options, choices, and experiences.
Determinants of populist voting in Pakistan: An analysis of PTI first-win constituencies in the 2018 general elections
Authors: Batool Fizza
Published: June 2023

Populist voting behavior is a relatively new research area with most studies concentrated on European and American voters, despite electoral successes of populist parties in illiberal and hybrid democracies of Asia. The research fills this gap by outlining the determinants of populist voting in Pakistan through constituency-based analysis of electoral data of the 2018 general elections when a Pakistani populist party, Pakistan Tahreek-e-Insaaf, won the elections. The research compares the ideational framework with the strategic framework of populism, examining whether voting for a populist party is determined by the political ideology or attitude of the voters or the mobilization strategy of the party built upon the sociopolitical realities of the region. The focus is on constituencies where PTI was successful for the first time. Based on the analysis of eight such constituencies, both rural and urban, the study concludes that neither the PTI voters’ profile matches the sociodemographic profile of the populist voter mentioned in literature nor their voting decisions seem to be guided by anti-elitist attitude common among European or Latin American populist voters. The research outlines two major factors that can explain the victory of PTI: the politics of electables and the mobilization of non-voters, indicating that the strategic lens of populism better explains voting for PTI.
Tranexamic Acid Treatment Reduces Blood Loss After Elective and Semi-Urgent Reverse Total Shoulder Arthroplasty
Authors: Beyth Shaul , Fraind-Maya Gabriel , Safran Ori
Published: June 2023

Introduction

Post operative blood loss after reverse shoulder arthroplasty (RSA) is associated with the need for blood transfusion and prolonged hospital stay, among other complications. Tranexamic acid (TXA) reduces perioperative blood loss and is effective when delivered systemically or locally. We compared the effects of TXA on perioperative blood loss between elective and semi-urgent RSA.

Methods

We retrospectively reviewed patients who underwent either elective or semi-urgent RSA for fracture repair, with and without TXA treatment. Demographics, clinical records, and laboratory results were collected and analyzed to compare peripheral blood hemoglobin concentrations before and after surgery, the need for blood transfusion, and length of hospital stay between the 2 groups.

Results

In a cohort of 158 patients, 91 (58%) underwent elective RSA. TXA was administered in 91 (58%) patients from the entire group. TXA administration was associated with a significant decrease in post operative hemoglobin concentration reduction in both the elective and fracture groups ( P = .026 and P = .018, respectively), a significant decrease in post operative blood transfusion rates ( P = .004 and P = .003, respectively), and a decrease in the need for prolonged hospitalization ( P = .038 and P = .009, respectively).

Discussion

The local application of TXA during RSA yielded a significant reduction in perioperative blood loss. We showed a significant positive effect of local TXA administration during RSA that is comparable for both elective and semi-urgent patients. Due to the baseline characteristics of fracture patients, their clinical benefits may be more notable.

Conclusions

The positive outcomes for surgical patients with the use of TXA during RSA can possibly cause future consideration in clinical practice.
Isolated Colonic Histoplasmosis in Patients Undergoing Immunomodulator Therapy: A Systematic Review
Authors: Inayat Faisal , Nawaz Gul , Afzal Arslan , Ajmal Maleeha , Haider Marjan , Sarfraz Muhammad , Haq Zaka Ul , Taj Sobaan , Ishtiaq Rizwan
Published: June 2023

Gastrointestinal histoplasmosis remains an inconspicuous clinicopathologic entity. It is predominantly considered a protean manifestation of disseminated disease. We hereby delineate a unique case of biopsy-proven isolated colonic histoplasmosis in a patient undergoing methotrexate therapy. Furthermore, we present the first systematic review of the MEDLINE, Google Scholar, Embase, and Scopus databases regarding isolated colonic histoplasmosis in adult patients receiving immunomodulator therapy (IMT). A total of 13 case reports (level of clinical evidence: IV) were identified. The mean age was 55.6 ± 11.1 years, with 9 (69.2%) cases reported in women. Patients with subclinical disease (5, 38.5%) were often incidentally diagnosed by screening colonoscopy. Symptomatic individuals predominantly presented with diarrhea (4, 30.8%), weight loss (3, 23.1%), and/or abdominal pain (3, 23.1%). IMT was mainly administered for liver transplant (4, 30.8%), renal transplant (4, 30.8%), and ulcerative colitis (2, 15.4%). Common colonoscopy features included colonic ulcerations (7, 53.8%), polyps or pseudopolyps (3, 23.1%), and/or mass-like lesions (3, 23.1%). Diagnosis was made by histology of colonic biopsy in 11 (84.6%) and resected specimens in 2 (15.4%) patients. Treatment consisted of a combination of amphotericin B with oral itraconazole in 6 (46.2%), oral itraconazole alone in 5 (38.5%), and amphotericin B alone in 2 (15.4%) patients. Complete clinical recovery was achieved in all patients. This article illustrates that isolated colonic involvement can be the only clinical presentation of histoplasmosis. It may masquerade as other bowel disorders, presenting diagnostic and therapeutic conundrums. Gastroenterologists should rule out colonic histoplasmosis in IMT recipients who develop unexplained colitis symptoms.
Book review: Sujata Patel, D. Parthasarathy & George Jose (Eds.), Mumbai/Bombay: Majoritarian Neoliberalism, Informality, Resistance, and Wellbeing
Authors: Wagle Paroma
Published: June 2023

Sujata Patel, D. Parthasarathy & George Jose (Eds.), Mumbai/Bombay: Majoritarian Neoliberalism, Informality, Resistance, and Wellbeing. Routledge, 2022, 280 pp., ₹995, ISBN: 9781032276724.
Three-dimensional delineation of Changers-for-Good: From practice to conceptualization
Authors: Praszkier Ryszard
Published: June 2023

This article advances the psychological knowledge on the phenomenon of Changers-for-Good (C4Gs), that is, individuals who extend the range of the possible, addressing pressing and often insurmountable social problems and achieving durable and systemic social change. C4Gs are presented from both conceptual and practical perspectives. It is documented, through the presented examples and literature review, that their approach could be perceived on three axes: Conceptual, performative, and ethical. Each of these dimensions can be broken down into components: Conceptual: Perceiving challenges as doable, divergent thinking, embracing contradictions, and the cognitive part of the Peace-Oriented Mindset (POM); Performative: Entrepreneurial qualities, propensity for building social capital, and action-oriented POM; Ethical: Empathy, compassion, and—possibly—a blend of the two: Empassion. Moreover, assessment methods for each of these components are presented. It is concluded that the C4G model may be a gateway for educating and training future social sector leaders.
Provincial policies affecting resident quality of life in Canadian residential long-term care
Authors: Irwin Pamela , Taylor Deanne , Keefe Janice M.
Published: June 2023

Background

The precautions and restrictions imposed by the recent Covid-19 pandemic drew attention to the criticality of quality of care in long-term care facilities internationally, and in Canada. They also underscored the importance of residents’ quality of life. In deference to the risk mitigation measures in Canadian long-term care settings during Covid-19, some person-centred, quality of life policies were paused, unused, or under-utilised. This study aimed to interrogate these existing but latent policies, to capture their potentiality in terms of positively influencing the quality of life of residents in long-term care in Canada.

Methods

The study analysed policies related to quality of life of long-term care residents in four Canadian provinces (British Columbia, Alberta, Ontario, and Nova Scotia). Three policy orientations were framed utilising a comparative approach: situational (environmental conditions), structural (organisational content), and temporal (developmental trajectories). 84 long term care policies were reviewed, relating to different policy jurisdictions, policy types, and quality of life domains.

Results

Overall, the intersection of jurisdiction, policy types, and quality of life domains confirms that some policies, particularly safety, security and order, may be prioritised in different types of policy documents, and over other quality of life domains. Alternatively, the presence of a resident focused quality of life in many policies affirms the cultural shift towards greater person-centredness. These findings are both explicit and implicit, and mediated through the expression of individual policy excerpts.

Conclusion

The analysis provides substantive evidence of three key policy levers: situations–providing specific examples of resident focused quality of life policy overshadowing in each jurisdiction; structures–identifying which types of policy and quality of life expressions are more vulnerable to dominance by others; and trajectories–confirming the cultural shift towards more person-centredness in Canadian long-term care related policies over time. It also demonstrates and contextualises examples of policy slippage, differential policy weights, and cultural shifts across existing policies. When applied within a resident focused, quality of life lens, these policies can be leveraged to improve extant resource utilisation. Consequently, the study provides a timely, positive, forward-facing roadmap upon which to enhance and build policies that capitalise and enable person-centredness in the provision of long-term care in Canada.
Influencing factors of the treatment level of elderly care workers and their career development prospects
Authors: Cui Kaichang , Yang Fei , Qian Ruihan , Li Chenmei , Fan Mengting
Published: June 2023

Background

The increasingly aging population in current China has encouraged the emergence of the diversified and multi-level elderly care service industry, and the demand for high-quality elderly life with the help of elderly caregivers continues to grow.

Methods

Based on the existing questionnaire data, this article explores the influencing factors of the treatment level of care staff, and explores their future development prospects.

Results

The results show that whether they have participated in relevant vocational skills competitions, whether they have worked overtime, whether they have overtime wages, and their monthly income have significant effects on their satisfaction of treatment levels. Elderly care workers who have participated in skills competitions are more satisfied about their salary. In addition, workers who rarely and occasionally work overtime are more satisfied compared with those who have never worked overtime; Caregivers with a monthly income of 5,000–6,999 yuan are more satisfied with their salary and treatment than those with below 3,000 yuan.

Conclusion

Therefore, in order to better match the supply and demand of care workers, we should provide formal training and skill competitions for them, appropriately increase their salary level and reasonably arrange their working hours, so as to attract more professional talents into elderly care industry.
Association between allostatic load and adverse outcomes among older patients with heart failure with preserved ejection fraction
Authors: Hao Benchuan , Chen Jianqiao , Cai Yulun , Li Huiying , Zhu Zifan , Xu Weihao , Liu Hongbin
Published: June 2023

Background

The allostatic load (AL) refers to the cumulative weakening of multiple physiological systems caused by repeated adaptation of the body to stressors There are still no studies have focused on the association between AL and the prognosis of patients with heart failure with preserved ejection fraction (HFpEF). The present study aimed to investigate the association between AL and adverse outcomes, including mortality and HF admission, among elderly male patients with HFpEF.

Methods

We conducted a prospective cohort study of 1111 elderly male patients with HFpEF, diagnosed between 2015 and 2019 and followed up through 2021. We constructed an AL measure using a combination of 12 biomarkers. The diagnosis of HFpEF was made according to the 2021 European Society of Cardiology guidelines. A Cox proportional hazards model was used to determine the associations between AL and adverse outcomes.

Results

In multivariate analysis, AL was significantly associated with increased risk of all-cause mortality (medium AL: adjusted hazard ratio [HR] = 2.53; 95% confidence interval [CI] 1.37–4.68; high AL: HR = 4.21; 95% CI 2.27–7.83; per-score increase: HR = 1.31; 95% CI 1.18–1.46), cardiovascular mortality (medium AL: HR = 2.67; 95% CI 1.07–6.68; high AL: HR = 3.13; 95% CI 1.23–7.97; per-score increase: HR = 1.20; 95% CI 1.03–1.40), non-cardiovascular mortality (medium AL: HR = 2.45; 95% CI 1.06–5.63; high AL: HR = 5.81; 95% CI 2.55–10.28; per-score increase: HR = 1.46; 95% CI 1.26–1.69), and HF admission (medium AL: HR = 2.68; 95% CI 1.43–5.01; high AL: HR = 3.24; 95% CI 1.69–6.23; per-score increase: HR = 1.24; 95% CI 1.11–1.39). Consistent results were found in multiple subgroup analyses.

Conclusions

A higher AL was associated with poor prognosis in elderly men with HFpEF. AL relies on information that is easily obtained in physical examinations and laboratory parameters and can be assessed in various care and clinical settings to help risk stratification of HFpEF patients.
Frequency of HIV serodifferent couples within TB-affected households in a setting with a high burden of HIV-associated TB
Authors: Anguzu Godwin , Gupta Amanda J , Ochom Emmanuel , Tseng Ashley S. , Zhang Meixin , Barnabas Ruanne V. , Flaxman Abraham D. , Katamba Achilles , Davis J. Lucian , Ross Jennifer M.
Published: June 2023

Introduction

Strong epidemiological links between human immunodeficiency virus (HIV) and tuberculosis (TB) may make household TB contact investigation an efficient strategy for HIV screening and finding individuals in serodifferent partnerships at risk of HIV and linking them to HIV prevention services. We aimed to compare the proportions of HIV serodifferent couples in TB-affected households and in the general population of Kampala, Uganda.

Methods

We included data from a cross-sectional trial of HIV counselling and testing (HCT) in the context of home-based TB evaluation in Kampala, Uganda in 2016–2017. After obtaining consent, community health workers visited the homes of participants with TB to screen contacts for TB and offer HCT to household members ≥ 15 years. We defined index participants and their spouses or parents as couples. Couples were classified as serodifferent if confirmed by self-reported HIV status or by HIV testing results. We used a two-sample test of proportions to compare the frequency of HIV serodifference among couples in the study to its prevalence among couples in Kampala in the 2011 Uganda AIDS Indicator Survey (UAIS).

Results

We included 323 index TB participants and 507 household contacts aged ≥ 18 years. Most index participants (55%) were male, while most (68%) adult contacts were female. There was ≥ 1 couple in 115/323 (35.6%) households, with most couples (98/115, 85.2%) including the index participant and spouse. The proportion of households with HIV-serodifferent couples was 18/323 (5.6%), giving a number-needed-to-screen of 18 households. The proportion of HIV serodifference among couples identified in the trial was significantly higher than among couples in the UAIS (15.7% vs. 8%, p = 0.039). The 18 serodifferent couples included 14 (77.8%) where the index participant was living with HIV and the spouse was HIV-negative, and 4 (22.2%) where the index partner was HIV-negative, while the spouse was living with HIV.

Conclusions

The frequency of HIV serodifference among couples identified in TB-affected households was higher than in the general population. TB household contact investigation may be an efficient strategy for identifying people with substantial exposure to HIV and linking them to HIV prevention services.
Women’s experience of perinatal support in a high migrant Australian population during the COVID-19 pandemic: a mixed methods study
Authors: Melov Sarah J. , Galas Nelma , Swain Julie , Alahakoon Thushari I. , Lee Vincent , Cheung N Wah , McGee Therese , Pasupathy Dharmintra , McNab Justin
Published: June 2023

Background

As a COVID-19 risk mitigation measure, Australia closed its international borders for two years with significant socioeconomic disruption including impacting approximately 30% of the Australian population who are migrants. Migrant populations during the peripartum often rely on overseas relatives visiting for social support. High quality social support is known to lead to improved health outcomes with disruption to support a recognised health risk.

Aim

To explore women’s experience of peripartum social support during the COVID-19 pandemic in a high migrant population. To quantify type and frequency of support to identify characteristics of vulnerable perinatal populations for future pandemic preparedness.

Methods

A mixed methods study with semi-structured interviews and a quantitative survey was conducted from October 2020 to April 2021. A thematic approach was used for analysis.

Results

There were 24 participants interviewed both antenatally and postnatally (22 antenatal; 18 postnatal). Fourteen women were migrants and 10 Australian born. Main themes included; ‘Significant disruption and loss of peripartum support during the COVID-19 pandemic and ongoing impact for migrant women’; ‘Husbands/partners filling the support gap’ and ‘Holding on by a virtual thread’. Half of the participants felt unsupported antenatally. For Australian born women, this dissipated postnatally, but migrants continued to feel unsupported. Migrant women discussed partners stepped into traditional roles and duties of absent mothers and mothers-in-law who were only available virtually.

Conclusion

This study identified disrupted social support for migrant women during the pandemic, providing further evidence that the pandemic has disproportionately impacted migrant populations. However, the benefits identified in this study included high use of virtual support, which could be leveraged for improving clinical care in the present and in future pandemics. The COVID-19 pandemic impacted most women’s peripartum social support with migrant families having ongoing disruption. Gains in the pandemic included greater gender equity for domestic work as husbands/partners increased their contribution to domestic work and childcare.
Pan-cancer analysis of TASL: a novel immune infiltration-related biomarker for tumor prognosis and immunotherapy response prediction
Authors: Li Huanyu , Sun Xiaoyu , Zhao Yanyun , Zhang Changzhu , Jiang Kai , Ren Jie , Xing Lijuan , He Miao
Published: June 2023

Background

New immunotherapeutic strategies based on predictors are urgently needed. Toll-like receptor adaptor interacting with SLC15A4 on the lysosome (TASL) was recently confirmed to fulfill an important role in the innate immune response. However, whether TASL is involved in tumor development and immunotherapy response prediction has not been reported.

Methods

TCGA and GTEx were used to yield transcriptional, genetic, and epigenetic levels of TASL in 33 cancer types. CIBERSORT was used to explore the correlation between TASL expression and multiple immune-related signatures and tumor-infiltrating immune cell content in different cancer types. The ability of TASL to predict tumor immunotherapy response was analyzed in seven datasets. Finally, we tested TASL expression in human glioma cell lines and tissue samples and analyzed its correlation with clinicopathological parameters.

Results

TASL is widely heterogeneous at the transcriptional, genetic, and epigenetic levels. High TASL expression is an independent poor prognostic factor for immune “cold” tumor Low-Grade Glioma (LGG) but an opposite factor for “hot” tumors Lung Adenocarcinoma (LUAD) and Skin Cutaneous Melanoma (SKCM). TASL may affect tumor immune infiltration by mediating tumor-infiltrating lymphocytes and tumor-associated macrophages. It may differentially affect the prognosis of the three cancers by regulating the immunosuppressive microenvironment in LGG and the immunostimulatory microenvironment in LUAD and SKCM. High TASL expression is a potential biomarker for the positive response to immunotherapy in cancers such as SKCM and was also experimentally confirmed to be positively associated with adverse clinicopathological features of gliomas.

Conclusion

TASL expression is an independent prognostic factor for LGG, LUAD, and SKCM. High TASL expression is a potential biomarker for the positive response to immunotherapy in certain cancer types such as SKCM. Further basic studies focusing on TASL expression and tumor immunotherapy are urgently needed.
The self-assessment scale of cognitive complaints in Schizophrenia: validation of the Arabic version among a sample of lebanese patients
Authors: Haddad Chadia , Sacre Hala , Abboche Elie , Salameh Pascale , Calvet Benjamin
Published: June 2023

Background

Several subjective scales have been used to measure cognitive complaints in patients with schizophrenia, such as the Self-Assessment Scale of Cognitive Complaints in Schizophrenia (SASCCS), which was designed to be clear, simple, and easy to use. This study aimed to examine the ability of SASCCS as a validated tool to collect and assess subjective cognitive complaints of patients with schizophrenia.

Methods

A cross-sectional study among 120 patients with schizophrenia was performed between July 2019 and Mars 2020 at the Psychiatric Hospital of the Cross, Lebanon. The SASCCS was used to assess how patients with schizophrenia perceived their cognitive impairment.

Results

The internal consistency of the SASCCS scale was 0.911, and the intra-class correlation coefficient was 0.81 (p < 0.001), suggesting a good stability over time. The factor analysis of the SASCCS scale showed a 5-factor solution using the Varimax rotated matrix. The SASCCS total score positively correlated with their own factors. A negative correlation was found between the objective cognitive scale and subjective cognitive complaints, which were positively correlated with clinical symptoms and depression. No significant association was found between insight and subjective cognitive complaints.

Conclusion

The SASCCS scale showed appropriate psychometric properties, with high internal consistency, good construct validity, and adequate concurrent validity, which makes it valuable for the evaluation of subjective cognitive complaints in patients with schizophrenia.
An intersectional approach to exploring lived realities and harnessing the creativity of ethnic minority youth for health gains: protocol for a multiphase mixed method study
Authors: Ramalho Rodrigo , Sharma Vartika , Liang Renee , Simon-Kumar Rachel , Ameratunga Shanthi , Lee Arier , Kang Kristy , Peiris-John Roshini
Published: June 2023

Background

Understanding the diversity and multiplicity of identities experienced by youth in Aotearoa (Te reo Māori name of the country) New Zealand (NZ) is vital to promoting their wellbeing. Ethnic minority youth (EMY) in NZ (defined as those identifying with Asian, Middle Eastern, Latin American and African ethnic origins) have been historically under-studied and under-counted, despite reporting high levels of discrimination, a major determinant of mental health and wellbeing and potentially a proxy for other inequities. In this paper, we describe the protocol for a multi-year study that examines, using an intersectional approach, how multiple marginalised identities impact mental and emotional wellbeing of EMY.

Methods

This is a multiphase, multi-method study designed to capture the diversity of lived realities of EMY who self-identify with one or more additional marginalised intersecting identity (the population referred here as EMYi). Phase 1 (Descriptive study) will involve secondary analyses of national surveys to examine the prevalence and relationships between discrimination and wellbeing of EMYi. Phase 2 (Study on public discourse) will analyse data from media narratives, complemented by interviews with stakeholders to explore discourses around EMYi. Phase 3 (Study on lived experience) will examine lived experiences of EMYi to discuss challenges and sources of resilience, and how these are influenced by public discourse. Phase 4 (Co-design phase) will use a creative approach that is youth-centered and participatory, and will involve EMYi, creative mentors and health service, policy and community stakeholders as research partners and advisors. It will employ participatory generative creative methods to explore strengths-based solutions to discriminatory experiences.

Discussion

This study will explore the implications of public discourse, racism and multiple forms of marginalisation on the wellbeing of EMYi. It is expected to provide evidence on the impacts of marginalisation on their mental and emotional wellbeing and inform responsive health practice and policy. Using established research tools and innovative creative means, it will enable EMYi to propose their own strength-based solutions. Further, population-based empirical research on intersectionality and health is still nascent, and even more scarce in relation to youth. This study will present the possibility of expanding its applicability in public health research focused on under-served communities.
Preoperative predictors for return to physical activity following anterior cruciate ligament reconstruction (ACLR): a systematic review
Authors: Carter Hayley M. , Lewis Gwyn N. , Smith Benjamin E.
Published: June 2023

Background

Rates of return to physical activity after anterior cruciate ligament reconstruction surgery are sub-optimal. Optimising presurgical treatment may improve return rates. The purpose of this systematic review was to identify modifiable preoperative predictors for return to physical activity after anterior cruciate ligament reconstruction.

Methods

Seven electronic databases (CINAHL, MEDLINE and SPORTDiscus via EBSCOhost, AMED, PsycINFO and EMBASE via OVID and Web of Science) were searched from inception to 31 March 2023. The population of focus was adults aged 18–65 who had undergone primary anterior cruciate ligament reconstruction. Studies needed to identify at least one potential modifiable preoperative predictor variable and the relationship between the predictor(s) and return to physical activity. All time-points of assessment and study designs were included. Data extraction was completed by one reviewer and verified by a second reviewer. Two reviewers completed the risk of bias assessment using the Quality in Prognostic Studies tool and Grading of Recommendations Assessment, Development and Evaluation system.

Results

The search identified 2281 studies, eight met the inclusion criteria. Five studies scored ‘high’, and three studies scored ‘moderate’ risk-of-bias. All preoperative predictors were of very low-quality evidence. Five different outcome measures were used to assess return to physical activity including Tegner, Marx, Physical Activity Scale, return to play at the elite level and return to preinjury level (undefined). This was measured between 1- and 10-years post-surgery. Nine preoperative physical, six psychosocial and five demographic/clinical factors were assessed and four were found to be predictive. These included quadriceps strength, psychological profile, patient estimated ability to return and graft type (patella tendon, BPTB).

Conclusion

Very-low level evidence suggests that increasing quadriceps strength, managing patient expectations of their treatment outcomes, improving motivation to resume preinjury activity levels and considering the use of a BPTB graft will support return to physical activity after ACLR.

Trial registration

This study was prospectively registered in PROSPERO: CRD 42020222567.
Bone cement distribution may significantly affect the efficacy of percutaneous vertebroplasty in treating symptomatic Schmorl’s nodes
Authors: Cai Kaiwen , Jiang Guoqiang , Lu Bin , Zhang Kai , Luo Kefeng
Published: June 2023

Purpose

Percutaneous vertebroplasty(PVP) has been widely used in treating symptomatic Schmorl’s nodes(SNs). However, there were still some patients with poor pain relief. At present, there is a lack of research to analyze the reasons for poor efficacy.

Methods

Review the SNs patients treated with PVP in our hospital from November 2019 to June 2022, collect their baseline data. Reverse reconstruction software was used to calculate the filling rate of bone edema ring(Rf). NRS score was used to evaluate pain and ODI to evaluate function. The patients were divided into remission group(RG) and non remission group(n-RG) according to symptom. In addition, according to the Rf, they were divided into excellent, good and poor groups. Differences between groups were investigated.

Results

A total of 26 vertebrae were included in 24 patients. When grouped according to symptoms, patients in n-RG were older, and surgical segments were tend to locate in lower lumbar spine. The proportion of Poor distribution was significantly higher. When grouped according to the cement distribution, the preoperative NRS and ODI of the three groups were comparable, but the NRS and ODI of Poor group were significantly worse than the Excellent and Good groups postoperatively and at the last follow-up.

Conclusions

The cement distribution may significantly affect the efficacy of PVP in treating symptomatic SNs. We suggest that the bone edema ring should be filled as fully as possible to ensure the efficacy. In addition, advanced age and low lumbar lesions are also adverse factors for clinical outcomes.
Time elapsed since peruvian children’s last dental care and head of household educational attainment: findings from a national database
Authors: Garcés-Elías María Claudia , Del Castillo-López César Eduardo , Beltrán Jorge A. , León-Manco Roberto A.
Published: June 2023

Background

It has been documented that the parents’ highest level of education has an impact on their children’s access to oral health services and the frequency of their use.This study aimed to determine the association between time elapsed since peruvian children’s last dental care and head of household educational attainment.

Methods

Cross-sectional study using a database of children aged 0 to 11 years, with a final sample of 8012 participants. The dependent variable in this study was the time elapsed since last dental care and the independent variable was the head of household educational attainment. Other covariates considered were natural region, area of residence, place of residence, altitude, wealth index, health insurance coverage, sex and age. Descriptive, bivariate and multivariate statistical analyses were applied.

Results

Time elapsed since last dental care in the year 2021 was 5.68 years (SD = 5.25). A hierarchical multiple linear regression analysis was performed, analyzing the variables dimensions by separate and joint models. When head of household educational attainment was analyzed, there was no statistical significance (p = 0.262); however, other models did (p < 0.05). Model 4, which addresses all dimensions, was significant (p < 0.001) with an R2% of 0.011 and constant equal to 5.788; it showed significance with place of dental care, health insurance, altitude and age.

Conclusions

No association was found between head of household educational attainment and time elapsed since last dental care; however, the latter was associated with place of care, health insurance coverage, altitude and age in Peruvian children.