bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of clinic care on perceptions and knowledge of non-communicable diseases and physical activity from a low-resourced community: a mixed-method study
Authors: Makamu-Beteck S. J. , Moss S. J. , Cameron M. , Watson F. G.
Published: April 2022

Background

Health promotion for the management of risk factors for non-communicable diseases (NCDs) is an integral part of standard care in South Africa. Most persons presenting with NCDs utilise public primary health care centres for disease management. This mixed-methods study aimed at expanding current understanding of the the influence of standard clinic care (usual care) on perceptions and knowledge of risk factors for NCDs and physical activity (PA) among persons from a low-resourced community. Qualitatively the perceptions of women from a low-resourced community about risk factors for NCDs and PA were explored throughout 24-weeks of standard clinic care. Parallel quantitative data was collected to describe changes in risk factors for NCDs and trends in self-reported knowledge about risk factors of NCDs and PA.

Method

A convergent-parallel mixed-methods research design was used. The study was carried out in a public primary health care setting, in the North West Province, South Africa. From a convenience sample of 100 participants, 77 African women aged between 34 and 79 years were recruited for the study. Data were collected at three time-points including baseline, 12 weeks, and 24 weeks of a standard clinic care health-promotion programme. The qualitative data was collected during focus group discussions, and the quantitative data included questionnaires on knowledge of physical activity and risk factors for NCDs as well as anthropometric and biological measurements. Qualitative and quantitative data were analysed independently for each phase and then consolidated for interpretation. All data was collected in the same setting.

Results

Participants' initial understanding and perceptions of NCD risk factors were poor. Qualitative findings showed that participants knew little about the specific physical activity they could engage in and the role of PA in NCD management. Participants preferred low-intensity activities. Heart-disease knowledge improved significantly at 12 weeks intervention compared to baseline MD = -3.655, p < 0.001. There were improvements in PA knowledge at 12 weeks from baseline MD = -0.625 p = 0.02. There were significant weight (MD = 1.420, p = 0.002) and waist circumference reductions (MD = 0.621, p = 0.02) from baseline to 24 weeks.

Conclusion

Standard clinic care improved knowledge of physical activity and risk factors for NCDs, but perceptions of risk factors for NCDs and PA were unchanged. This study offers insight into the perceptions held by women from a low-resource setting and how future interventions to manage and prevent NCDs should be structured.

Trial registration

PACTR201609001771813.
Comparison of percutaneous endoscopic and open posterior lumbar interbody fusion for the treatment of single-segmental lumbar degenerative diseases
Authors: He Li-Ming , Chen Kuo-Tai , Chen Chien-Min , Chang Qiang , Sun Lin , Zhang Yan-Nan , Chang Jian-Jun , Feng Hao-Yu
Published: April 2022

Background

Endoscopic lumbar interbody fusion has become an emerging technique. Some researchers have reported the technique of percutaneous endoscopic transforaminal lumbar interbody fusion. We propose percutaneous endoscopic posterior lumbar interbody fusion (PE-PLIF) as an alternative approach. The purpose of this study was to assess the clinical efficacy of PE-PLIF by comparing percutaneous endoscopic and open posterior lumbar interbody fusion (PLIF).

Methods

Thirty patients were enrolled in each group. Demographic data, perioperative data, and radiological parameters were collected prospectively. The clinical outcomes were evaluated by visual analog scale (VAS) and Oswestry Disability Index (ODI) scores.

Results

The background data were comparable between the two groups. The mean operation time was longer in the PE-PLIF group. The PE-PLIF group showed benefits in less blood loss and shorter hospital stay. VAS and ODI scores significantly improved in both groups. However, the VAS score of low-back pain was lower in the PE-PLIF group. The satisfaction rate was 96.7% in both groups. The radiological outcomes were similar in both groups. In the PE-PLIF group, the fusion rate was 93.3%, and the cage subsidence rate was 6.7%; in the open PLIF group, the fusion and cage subsidence rates were 96.7% and 16.7%. There were minor complications in one patient in the PE-PLIF group and two in the open PLIF group.

Conclusions

The current study revealed that PE-PLIF is safe and effective compared with open PLIF. In addition, this minimally invasive technique may enhance postoperative recovery by reducing tissue damage and blood loss.
Attractiveness of medical disciplines amongst Swiss first-year medical students allocated to different medical education tracks: cross-sectional study
Authors: Markun Stefan , Tandjung Ryan , Rosemann Thomas , Scherz Nathalie , Senn Oliver
Published: April 2022

Background

As most countries, Switzerland is experiencing a shortage of physicians especially in general practice and new medical education tracks with respective focusses have been started in response. This study investigated Swiss medical students’ career openness and attractiveness of different medical disciplines as well as the concordance of students’ career intentions with assigned medical education tracks.

Methods

Cross-sectional study surveying first year medical students assigned to four different Swiss medical education tracks with distinctive additional education focuses (ETH Zurich: medical technology and engineering, University of St. Gallen and University of Lucerne: primary healthcare and University of Zurich: no distinctive focus).

Results

We surveyed 354 medical students (response rate across all included medical education tracks 71.1%), 64.8% female, mean age 20 years. Regarding career openness, we found that 52.8% of medical students had neither a strong commitment nor a strong reservation for any of the proposed career options and 17.0% had a strong commitment. Among medical disciplines, medical subspecialties were attractive to the largest part of students (inpatient subspecialties attractive for 71%, outpatient for 58%), attractiveness of general practice was moderate (30%), academic (22%) and industrial sector (17%) careers were least attractive. Proportions of medical students attracted to general practice were similar at medical education tracks with focus on primary healthcare compared to other medical education tracks (32.2% vs. 25.8%, p = 0.391). Conversely, proportions of medical students attracted to academic or industry careers were significantly higher at the ETH Zurich compared to other medical education tracks (37.2%, vs. 13.1%, p < 0.001 and 31.9%, vs. 8.8%, p < 0.001 respectively).

Conclusion

While most first-year medical students were open to careers in many medical disciplines, attractiveness of disciplines varied strongly. Students attracted to academic or industrial careers accumulated at the medical education track with concordant teaching focus but students attracted to general practice did not accumulate at medical education tracks focused on primary healthcare. For medical education tracks with primary care teaching focus this is both a challenge and an opportunity to specifically counteract the shortage of general practitioners in Switzerland.
Factors associated with information literacy of nursing undergraduates in China
Authors: Li Xing , Zhang Jia-Yi , Zheng Yan-Xue , Wang Ya-Xi , Hao Wen-Nv
Published: April 2022

Objective

Information literacy is an important foundation for evidence-based nursing practice. Quantitative studies using validated questionnaires on information literacy of nursing undergraduates in China are rare. The students’ baseline information literacy must be evaluated before exploring ways to improve their level of information literacy. This study aimed to investigate the factors potentially involved in the information literacy of nursing undergraduates.

Methods

In this cross-sectional study, male and female nursing undergraduates (n = 710) from Inner Mongolia, China were included in the final sample. The Information Literacy Competency Scale of the Applied Undergraduate Student (ILCSAUS) was used for evaluation. Multivariate stepwise linear regression analysis was performed to assess the association between various factors associated with information literacy.

Results

The students’ information literacy score was 105.00 (94.00–119.00). The highest score in the four dimensions was information awareness dimension, and the average score was 4.00 (3.80–4.40). Multivariable stepwise linear regression analysis showed that received training in medical statistics, received training in literature retrieval and utilization, and birth place were independently associated with information literacy scores (p  < 0.05).

Conclusions

Results indicate that learning about medical statistics, literature retrieval and utilization, and paying attention to students born in countries and towns can help improve information literacy in the nursing undergraduates.
Personal and professional quality of life among French health care workers during the first COVID-19 wave: a cross-sectional study
Authors: Grelier Armand , Guerin Olivia , Levavasseur Fathia , Caillot Frédérique , Benichou Jacques , Caron François
Published: April 2022

Background

We aimed to assess the personal and professional quality of life changes among health care workers of different professions during the COVID-19 pandemic in a large French university hospital. Other published data originated from countries with different health care systems and outbreak dynamics.

Methods

All health care workers from our hospital were invited to fill-in an anonymous e-questionnaire of 71 questions regarding perceived personal, professional and overall quality of life before and during the first COVID-19 wave, general profile, occupation and job characteristics, change of assignment, COVID-care features if relevant, general perception during the first wave, and personal experience of being encouraged or stigmatised.

Results

There were 794 participants, with a majority of nursing professionals (n = 416, 56%), including 57 nurse managers, 243 nurses, and 116 nurse assistants. Other participants were physicians (n = 188) and other health care staff (n = 140). Before the crisis, professional quality of life was low (6.5 on a 10-point scale) overall. The personal quality of life was higher (8.1) particularly for physicians and nurse managers. The COVID crisis saw a marked decrease in the personal quality of life (− 1.7), more pronounced in younger health care workers. Professional quality of life was less affected (− 0.4) and stayed almost constant for physicians. Staff in COVID units had a more positive perception of the crisis but experienced more fatigue, which resulted in similar quality of life levels in COVID and non-COVID units. Encouragements originated more often from relatives or colleagues than hospital managers and were exceptionally common: 63.4% of all participants, from 50.5% for other staff to 71.3% for physicians (p = 0.0005). Stigmatisation was reported by 19.3% of participants, with a higher proportion (p = 0.0001) among nurses (26.3%) and assistant nurses (23.3%) than among physicians (8.5%). From multivariate analysis, higher age, working as a physician and receiving encouragements were independently associated with lower loss of overall quality of life.

Conclusions

The resilience of health care workers was high overall during the first COVID wave although the quality of life decreased more among nursing staff. Social support in the form of encouragements is a key part of management, particularly in times of crisis.
Stress of conscience of COVID-19 among perianaesthesia nurses having worked in a COVID-ICU during the coronavirus pandemic: an international perspective
Authors: Nilsson Ulrica , Odom-Forren Jan , Ring Mette , van Kooten Hanneke , Brady Joni M.
Published: April 2022

Background

Several studies have reported that working in a COVID-ICU impacted nurses’ mental well-being. Yet little is known about how perianaesthesia nurses who have been working in a COVID-ICU perceived their stress of conscience. The aim of this study was to: (1) describe and compare stress related to troubled conscience among perianaesthesia nurses in three countries who have been working in a COVID-ICU during the pandemic, (2) compare their levels of troubled conscience between working in a COVID-ICU and their usual workplace, and (3) compare nurses that usually work in an ICU department with nurses who usually work outside of the ICU.

Methods

A descriptive, international cross‐sectional online survey including the Stress of Conscience Questionnaire (SCQ) was distributed between organizational member countries of the International Collaboration of PeriAnaesthesia Nurses.

Results

A total of 246 nurses from three countries participated. Significant differences were found in stress of conscience when working in the Covid-ICU between Sweden 31.8 (8.6), Denmark 23.1 (8.6), and Netherlands 16.4 (6.5) p < 0.001. Significant differences were also found between nurses working in a COVID-ICU in contrast with their usual workplace: 23.1(5.6) versus 17.7(5.3), p < 0.001. The most stressful aspect of conscience reported was that work in the COVID-ICU was so demanding, nurses did not have sufficient energy to be involved with their family as much as they desired. No statistical differences were found between nurses that usually work in an ICU department with nurses who usually work outside of the ICU.

Conclusion

The COVID-19 pandemic has negatively impacted stress of conscience among nurses working in the COVID-ICU. Swedish nurses were found to be more significantly impacted. This could be related to low numbers of existing ICU beds and ICU nurses prior to the pandemic necessitating a longer time required for working in a COVID-ICU. Stress of conscience also increased when working in the Covid-ICU compared to working in the usual workplace, and the most stressing aspect reported was that COVID-ICU work was so demanding that nurses did not have the energy to devote themselves to their family as they would have liked.
Surgical site infection after laparoscopic resection of colorectal cancer is associated with compromised long-term oncological outcome
Authors: Sugamata Nana , Okuyama Takashi , Takeshita Emiko , Oi Haruka , Hakozaki Yuhei , Miyazaki Shunya , Takada Musashi , Mitsui Takashi , Noro Takuji , Yoshitomi Hideyuki , Oya Masatoshi
Published: April 2022

Background

We evaluated the influence of infectious complications, particularly surgical site infection (SSI), on long-term oncological results after elective laparoscopic resection of colorectal cancer.

Methods

A total of 199 patients who underwent laparoscopic elective resection with negative resection margins for stage I–III colorectal cancer were retrospectively examined. The postoperative course was recorded based on hospital records, and cancer relapse was diagnosed based on radiological or pathological findings under a standardized follow-up program. The severity of complications was graded using Clavien-Dindo (CD) classification.

Results

SSI was found in 25 patients (12.6%), with 12 (6.0%) showing anastomotic leak. The postoperative relapse-free survival (RFS) rate was significantly lower in patients with SSI (49.2%) than in patients without SSI (87.2%, P<0.001). Differences in RFS were found after both colectomy and rectal resection (P<0.001 and P<0.001, respectively). RFS did not differ between patients who had major SSI CD (grade III) and those who had minor SSI CD (grades I or II). Multivariate Cox regression analysis identified the occurrence of SSI and pathological stage as independent co-factors for RFS (P<0.001 and P=0.003).

Conclusion

These results suggest that postoperative SSI compromises long-term oncological results after laparoscopic colorectal resection. Further improvements in surgical technique and refinements in perioperative care may improve long-term oncological results.
GLA:D® Back Australia: a mixed methods feasibility study for implementation
Authors: Fernandez Matthew , Young Anika , Kongsted Alice , Hartvigsen Jan , Barton Christian , Wallis Jason , Kent Peter , Kawchuk Greg , Jenkins Hazel , Hancock Mark , French Simon D.
Published: April 2022

Background

Practice-based guidelines recommend patient education and exercise as first-line care for low back pain (LBP); however, these recommendations are not routinely delivered in practice. GLA:D® Back, developed in Denmark to assist clinicians to implement guideline recommendations, offers a structured education and supervised exercise program for people with LBP in addition to a clinical registry to evaluate patient outcomes. In this study we evaluated the feasibility of implementing the GLA:D® Back program in Australia. We considered clinician and patient recruitment and retention, program fidelity, exploring clinicians’ and patients’ experiences with the program, and participant outcome data collection.

Methods

Clinicians (chiropractors and physiotherapists) were recruited and participated in a 2-day GLA:D® Back training course. Patients were eligible to participate if they had persistent or recurrent LBP. Feasibility domains included the ability to: (1) recruit clinicians to undergo training; (2) recruit and retain patients in the program; (3) observe program fidelity; and (4) perceive barriers and facilitators for GLA:D® Back implementation. We also collected data related to: (5) clinician confidence, attitudes, and behaviour; and (6) patient self-reported outcomes related to pain, disability, and performance tests.

Results

Twenty clinicians (8 chiropractors, 12 physiotherapists) participated in the training, with 55% (11/20) offering GLA:D® Back to their patients. Fifty-seven patients were enrolled in the program, with 67% (38/57) attending the final follow-up assessment. Loss to follow up was mainly due to the effects of the COVID-19 pandemic. We observed program fidelity, with clinicians generally delivering the program as intended. Interviews revealed two clinician themes related to: (i) intervention acceptability; and (ii) barriers and facilitators to implementation. Patient interviews revealed themes related to: (i) intervention acceptability; and (ii) program efficacy. At 3 months follow-up, clinicians demonstrated high treatment confidence and biomedical orientation. Patient outcomes trended towards improvement.

Conclusion

GLA:D® Back implementation in Australia appears feasible based on clinician recruitment, program acceptability and potential benefits for patient outcomes from the small sample of participating clinicians and patients. However, COVID-19 impacted patient recruitment, retention, and data collection. To scale-up GLA:D® Back in private and public settings, further work is warranted to address associated barriers, and to leverage facilitators.
Are there differences in arthroscopic and histological features between traumatic and degenerative rotator cuff tears in elderly patients? A prospective dual-center analysis
Authors: Shibata Terufumi , Izaki Teruaki , Nishio Jun , Miyake Satoshi , Arashiro Yasuhara , Minamikawa Tomohiko , Minokawa So , Shibata Yozo , Yamamoto Takuaki
Published: April 2022

Background

Discriminating traumatic rotator cuff tears (RCTs) from degenerative RCTs is sometimes difficult in elderly patients because the prevalence of asymptomatic RCTs increases with age. Little intraoperative information is available on the characteristics of traumatic and degenerative RCTs in elderly patients. The purpose of this study was to compare the arthroscopic findings and histological changes of the coracoacromial ligament (CAL) between traumatic and degenerative RCTs in elderly patients.

Methods

Forty-two shoulders of 42 patients aged ≥ 65 years underwent arthroscopic rotator cuff repair. Nineteen patients had traumatic full-thickness RCTs (Group T), and 23 had degenerative full-thickness RCTs (Group D). The quality of the rotator cuff tissue and the condition of the long head of the biceps were examined. The grade of CAL was evaluated both arthroscopically and histologically. The stiffness of the musculotendinous unit was calculated by measuring the force and displacement using a tensiometer. The arthroscopic and histological findings of the two groups were compared.

Results

Although the mean tendon displacement was comparable, the stiffness was different between Group T and Group D (0.56 ± 0.31 and 1.09 ± 0.67 N/mm, respectively;p < 0.001). Both arthroscopic and histological analysis of the CAL showed that the degenerative changes in the CAL were milder in Group T than in Group D (p < 0.001 andp < 0.001, respectively). There was a moderate positive correlation between the arthroscopic findings of CAL degeneration and the histopathological changes in this ligament (r = 0.47,p = 0.002).

Conclusions

Traumatic RCTs were characterized by preserved elasticity of the musculotendinous unit and milder CAL degeneration compared with degenerative RCTs even in elderly patients.
HIF activation enhances FcγRIIb expression on mononuclear phagocytes impeding tumor targeting antibody immunotherapy
Authors: Hussain Khiyam , Liu Rena , Smith Rosanna C. G. , Müller Kri T. J. , Ghorbani Mohammadmersad , Macari Sofia , Cleary Kirstie L. S. , Oldham Robert J. , Foxall Russell B. , James Sonya , Booth Steven G. , Murray Tom , Dahal Lekh N. , Hargreaves Chantal E. , Kemp Robert S. , Longley Jemma , Douglas James , Markham Hannah , Chee Serena J. , Stopforth Richard J. , Roghanian Ali , Carter Matthew J. , Ottensmeier Christian H. , Frendéus Bjorn , Cutress Ramsey I. , French Ruth R. , Glennie Martin J. , Strefford Jonathan C. , Thirdborough Stephen M. , Beers Stephen A. , Cragg Mark S.
Published: April 2022

Background

Hypoxia is a hallmark of the tumor microenvironment (TME) and in addition to altering metabolism in cancer cells, it transforms tumor-associated stromal cells. Within the tumor stromal cell compartment, tumor-associated macrophages (TAMs) provide potent pro-tumoral support. However, TAMs can also be harnessed to destroy tumor cells by monoclonal antibody (mAb) immunotherapy, through antibody dependent cellular phagocytosis (ADCP). This is mediated via antibody-binding activating Fc gamma receptors (FcγR) and impaired by the single inhibitory FcγR, FcγRIIb.

Methods

We applied a multi-OMIC approach coupled with in vitro functional assays and murine tumor models to assess the effects of hypoxia inducible factor (HIF) activation on mAb mediated depletion of human and murine cancer cells. For mechanistic assessments, siRNA-mediated gene silencing, Western blotting and chromatin immune precipitation were utilized to assess the impact of identified regulators on FCGR2B gene transcription.

Results

We report that TAMs are FcγRIIbbright relative to healthy tissue counterparts and under hypoxic conditions, mononuclear phagocytes markedly upregulate FcγRIIb. This enhanced FcγRIIb expression is transcriptionally driven through HIFs and Activator protein 1 (AP-1). Importantly, this phenotype reduces the ability of macrophages to eliminate anti-CD20 monoclonal antibody (mAb) opsonized human chronic lymphocytic leukemia cells in vitro and EL4 lymphoma cells in vivo in human FcγRIIb+/+ transgenic mice. Furthermore, post-HIF activation, mAb mediated blockade of FcγRIIb can partially restore phagocytic function in human monocytes.

Conclusion

Our findings provide a detailed molecular and cellular basis for hypoxia driven resistance to antitumor mAb immunotherapy, unveiling a hitherto unexplored aspect of the TME. These findings provide a mechanistic rationale for the modulation of FcγRIIb expression or its blockade as a promising strategy to enhance approved and novel mAb immunotherapies.
Iterative 2D sparse signal reconstruction with masked residual updates for automotive radar interference mitigation
Authors: Chen Shengyi , Stockel Philipp , Taghia Jalal , Kühnau Uwe , Martin Rainer
Published: April 2022

Compressive sensing has attracted considerable attention in automotive radar interference mitigation. However, these algorithms usually cannot be applied directly to commercial automotive radar as most of them are computationally intense. In this paper, we therefore introduce a computationally efficient two-dimensional masked residual updates (2D MRU) compressive sensing framework. By utilizing the sparsity of the beat signal in the frequency domain, the range-Doppler (RD) spectrum can be reconstructed with the help of undistorted samples in the beat signal. Unlike the other schemes, where a 2D signal measurement is vectorized into a 1D signal, the proposed 2D MRU can directly take a 2D signal measurement and reconstruct the corresponding RD spectrum. Furthermore, the 2D MRU framework can be easily integrated into well-known optimization schemes such as basis pursuit, iterative hard thresholding, iterative soft thresholding, orthogonal matching pursuit, and approximate message-passing algorithm. In addition to the standard iterative thresholding algorithms, we propose a novel prior-model-based iterative thresholding method to further reduce the computation time and reconstruction error. Theoretical analysis shows that the proposed framework can successfully reconstruct the RD spectrum with high probability. Moreover, numerical experiments demonstrate the superiority of the proposed framework in terms of computational complexity.
On the behaviour of solutions to a kind of third order neutral stochastic differential equation with delay
Authors: Mahmoud Ayman M. , Ademola Adeleke T.
Published: April 2022

This article demonstrates the behaviour of solutions to a kind of nonlinear third order neutral stochastic differential equations. Setting $x^{\prime }(t)=y(t)$

x
′

(
t
)
=
y
(
t
)
, $y^{\prime }(t) =z(t)$

y
′

(
t
)
=
z
(
t
)
the third order differential equation is ablated to a system of first order differential equations together with its equivalent quadratic function to derive a suitable downright Lyapunov functional. This functional is utilised to obtain criteria which guarantee stochastic stability of the trivial solution and stochastic boundedness of the nontrivial solutions of the discussed equations. Furthermore, special cases are provided to verify the effectiveness and reliability of our hypotheses. The results of this paper complement the existing decisions on system of nonlinear neutral stochastic differential equations with delay and extend many results on third order neutral and stochastic differential equations with and without delay in the literature.
Improving the quality of long-term care services in workforce dimension: expert views from Australia and South Korea
Authors: Lee Hyo Young , Short Stephanie , Lee Mi-Joung , Jeon Yun-Hee , Park Eunok , Chin Young-Ran
Published: April 2022

Background

The long-term care workforce is an essential factor in the provision of qualified long-term care services. Identifying workforce issues can help developing countries in East Asia and the Pacific prepare for the increase in the older population. Their experiences can be used as lessons for other countries. This study aimed to identify the workforce issues that should be addressed in order to provide high-quality long-term care services for older adults.

Methods

In-depth interviews and content analysis were conducted with a purposive sample of long-term care experts. There were eight participants from Australia and 14 from South Korea. The participants were questioned on important workforce issues to improve the quality of long-term care services. These were open-ended questions that comprised ideas derived from the literature. Major themes were systematically and comprehensively classified and coded to examine recurring comments and themes.

Results

The issues in the two countries were very similar: labor shortages, inadequate working conditions, insufficient career and staff training, and the need of counselors or consultants for finding proper services. There were also differences in terms of competency of the service operators and their corresponding multicultural competency.

Conclusions

Providing high-quality long-term care service requires multipronged approaches to workforce capacity and work environment. An adequate and competent workforce should be established to match the service needs of the older population. To improve quality, better working conditions and improved motivation to work in care for older people should be considered. Concurrently, each country would need a workforce strategy tailored to different conditions and environments. This should include policies to induce an influx into the workforce.
Prevalence and correlates of infertility related psychological stress in women with infertility: a cross-sectional hospital based survey
Authors: Teklemicheal Ashebir Getachew , Kassa Eyasu Mesfin , Weldetensaye Eskinder Kebede
Published: April 2022

Background

Psychological stress is commonly found among infertile women. Untreated stress can affect negatively the success of infertility treatment. Most of the available knowledge is generated from developed countries and is largely based on women undergoing In vitro fertilization (IVF) treatment. However, very little is known on infertile women from Ethiopia including other countries in East Africa. The aim of this study was to determine the prevalence of psychological stress and possible demographic-clinical correlates in Ethiopian women suffering from infertility.

Method

This cross sectional descriptive correlation study was conducted from May to August, 2021 involving 96 women undergoing a non-IVF treatment for infertility at Gandhi Memorial and Tikur Anbessa hospitals. The sampling was continuous and based on inclusion criteria that include infertility duration of a minimum one year, female sex and Ethiopian nationality. Data on Infertility related stress was collected using the Copenhagen Multi‐Centre Psychosocial Infertility-Fertility Problem Stress questionner administered by an interviewer. The socio demographic and clinical factors were collected using Amharic version of structured interviewer administered questionnaire and chart review. The analysis of relationship between infertility related stress and background variables was done with an independent sample t-test or one-way ANOVA statistics supplemented with effect size assessment.

Results

The prevalence of infertility related stress was overall 92.71% (95% CI, 87–98%). The personal, marital, and social subdomain mean scores (SD) were 2.74 (.80), 1.54 (.81) and 1.90 (.80), respectively. Infertility related stress was higher for those women who were: aged above 35, living in a cohabitation marital type, has no living children, and with 4–6 years duration of infertility (all P < 0.05). Whereas, there was insufficient evidence to suggest that infertility related stress varies by education, income, knowledge of cause of infertility or history of past treatment (all P > 0.05).

Conclusions

The prevalence of psychological stress among Ethiopia women having infertility was very high. The results provide preliminary evidence that infertility related stress is associated with age, marital status, motherhood status and duration of infertility. Responsible bodies need to avail psychological screening and services prioritizing women at higher risk of developing stress.
The role of ncRNAs in neuroblastoma: mechanisms, biomarkers and therapeutic targets
Authors: Huang Shaohui , Gong Naying , Li Jiangbin , Hong Mingye , Li Li , Zhang Ling , Zhang Hua
Published: April 2022

Neuroblastoma (NB) is a malignant tumor in young children that originates from the neural crest of the sympathetic nervous system. Generally, NB occurs in the adrenal glands, but it can also affect the nerve tissues of the neck, chest, abdomen, and pelvis. Understanding the pathophysiology of NB and developing novel therapeutic approaches are critical. Noncoding RNAs (ncRNAs) are associated with crucial aspects of pathology, metastasis and drug resistance in NB. Here, we summarized the pretranscriptional, transcriptional and posttranscriptional regulatory mechanisms of ncRNAs involved in NB, especially focusing on regulatory pathways. Furthermore, ncRNAs with the potential to serve as biomarkers for risk stratification, drug resistance and therapeutic targets are also discussed, highlighting the clinical application of ncRNAs in NB.
Standardizing the classification of gastric cancer patients with limited and adequate number of retrieved lymph nodes: an externally validated approach using real-world data
Authors: Wang Wei , Yang Yu-Jie , Zhang Ri-Hong , Deng Jing-Yu , Sun Zhe , Seeruttun Sharvesh Raj , Wang Zhen-Ning , Xu Hui-Mian , Liang Han , Zhou Zhi-Wei
Published: April 2022

Background

Currently, there is no formal consensus regarding a standard classification for gastric cancer (GC) patients with < 16 retrieved lymph nodes (rLNs). Here, this study aimed to validate a practical lymph node (LN) staging strategy to homogenize the nodal classification of GC cohorts comprising of both < 16 (Limited set) and ≥ 16 (Adequate set) rLNs.

Methods

All patients in this study underwent R0 gastrectomy. The overall survival (OS) difference between the Limited and Adequate set from a large Chinese multicenter dataset was analyzed. Using the 8th American Joint Committee on Cancer (AJCC) pathological nodal classification (pN) for GC as base, a modified nodal classification (N’) resembling similar analogy as the 8th AJCC pN classification was developed. The performance of the proposed and 8th AJCC GC subgroups was compared and validated using the Surveillance, Epidemiology, and End Results (SEER) dataset comprising of 10,208 multi-ethnic GC cases.

Results

Significant difference in OS between the Limited and Adequate set (corresponding N0–N3a) using the 8th AJCC system was observed but the OS of N0limited vs. N1adequate, N1limited vs. N2adequate, N2limited vs. N3aadequate, and N3alimited vs. N3badequate subgroups was almost similar in the Chinese dataset. Therefore, we formulated an N’ classification whereby only the nodal subgroups of the Limited set, except for pT1N0M0 cases as they underwent less extensive surgeries (D1 or D1 + gastrectomy), were re-classified to one higher nodal subgroup, while those of the Adequate set remained unchanged (N’0 = N0adequate + pT1N0M0limited, N’1 = N1adequate + N0limited (excluding pT1N0M0limited), N’2 = N2adequate + N1limited, N’3a = N3aadequate + N2limited, and N’3b = N3badequate + N3alimited). This N’ classification demonstrated less heterogeneity in OS between the Limited and Adequate subgroups. Further analyses demonstrated superior statistical performance of the pTN’M system over the 8th AJCC edition and was successfully validated using the SEER dataset.

Conclusion

The proposed nodal staging strategy was successfully validated in large multi-ethnic GC datasets and represents a practical approach for homogenizing the classification of GC cohorts comprising of patients with < 16 and ≥ 16 rLNs.
Do I want more if you help me? The impact of grandparental involvement on men’s and women’s fertility intentions
Authors: Rutigliano Roberta , Lozano Mariona
Published: April 2022

Grandparental support is positively associated with women’s labor force participation and fertility transitions. Specifically, grandparental support shapes adult child’s entry into parenthood by influencing adult child’s expectations about future care. In this framework, the current study investigates whether observed grandparental support impacts adult sons’ and adult daughters’ fertility intentions in a lowest-low fertility country such as Spain. We use data from the new wave of the Spanish Fertility Survey (2018), and we find that receiving grandparental support has a positive and significant impact on women’s but not on men’s fertility intentions. Furthermore, this impact remains positive after controlling for women’s socio-economic characteristics. Finally, education results the main mediator for the relationship between grandparental support and women’s fertility intentions, with highly educated women displaying a significantly increase of their fertility intentions compared to their low-educated counterparts. Our findings highlight gender differences in the perceived role of grandparental support for future fertility, and the importance of informal care for balancing family and work in the Spanish context.
Female employment and first childbirth in Italy: what news?
Authors: Alderotti Giammarco
Published: April 2022

In the last decades, female participation in the labour market has been found to be increasingly associated with higher fertility levels in high-income countries—albeit to a lesser extent in countries characterised by poor welfare support to working mothers. Among the latter camp, Italy is an intriguing case study, which is marked by lower female labour force participation and fertility rates when compared to most other European countries. Recent macro-level evidence suggests that a reverse in the female employment/fertility relationship is gradually taking place in Italy, driven largely by the Northern regions. However, the evolution of the relationship between female employment and fertility has (to the best of my knowledge) never been addressed at the micro-level. Through the use of individual-level retrospective data, this study analyses the link between female employment and fertility, paying special attention to differences between Northern and Southern Italy, and its evolution over time. The results suggest that female employment began to be positively associated to fertility at the individual level, both in Northern and Southern Italy (although to slightly different extents), from 2010 onwards.
Influence of cellular models and individual factor in the biological response to head CT scan exams
Authors: Devic Clément , Bodgi Larry , Sonzogni Laurène , Pilleul Frank , Ribot Hervé , De Charry Charlotte , Le Moigne François , Paul Didier , Carbillet Fanny , Munier Mélodie , Foray Nicolas
Published: April 2022

Background

While computed tomography (CT) exams are the major cause of medical exposure to ionising radiation, the radiation-induced risks must be documented. We investigated the impact of the cellular models and individual factor on the deoxyribonucleic acid double-strand breaks (DSB) recognition and repair in human skin fibroblasts and brain astrocytes exposed to current head CT scan conditions.

Method

Nine human primary fibroblasts and four human astrocyte cell lines with different levels of radiosensitivity/susceptibility were exposed to a standard head CT scan exam using adapted phantoms. Cells were exposed to a single-helical (37.4 mGy) and double-helical (37.4 mGy + 5 min + 37.4 mGy) examination. DSB signalling and repair was assessed through anti-γH2AX and anti-pATM immunofluorescence.

Results

Head CT scan induced a significant number of γH2AX and pATM foci. The kinetics of both biomarkers were found strongly dependent on the individual factor. Particularly, in cells from radiosensitive/susceptible patients, DSB may be significantly less recognised and/or repaired, whatever the CT scan exposure conditions. Similar conclusions were reached with astrocytes.

Conclusions

Our results highlight the importance of both individual and tissue factors in the recognition and repair of DSB after current head CT scan exams. Further investigations are needed to better define the radiosensitivity/susceptibility of individual humans.
THC labeling on cannabis products: an experimental study of approaches for labeling THC servings on cannabis edibles
Authors: Goodman Samantha , Hammond David
Published: April 2022

Background

Over-consumption is a common adverse outcome from cannabis edibles. States such as Colorado require each serving of cannabis edible to carry a THC symbol. This study aimed to test whether packaging edibles in separate servings and/or indicating the THC level per serving improves consumer understanding of serving size.

Methods

An 3 × 2 experimental task was conducted as part of the 2019 International Cannabis Policy Study online survey. Respondents from Canada and the US (n = 45,504) were randomly assigned to view an image of a chocolate cannabis edible. Packages displayed THC labels according to 1 of 6 experimental conditions: packaging (3 levels: whole multi-serving bar; individual chocolate squares; separately packaged squares) and THC stamp (2 levels: stamp on each square vs. no stamp). Logistic regression tested the effect of packaging and THC stamp on odds of correctly identifying a standard serving, among edible consumers and non-consumers separately. Edible consumers were also asked about their awareness of a standard THC serving.

Results

Only 14.6% of edible consumers reported knowing the standard serving of THC for cannabis edibles. In the experimental task, among non-consumers who saw stamped bars, the multi-serving bar (AOR = 1.16 (1.08, 1.24) p < 0.001) and individually packaged squares (AOR = 1.08 (1.01, 1.16), p = 0.031) elicited more correct responses than individual squares. There was no difference in packaging formats when stamps were absent (p > 0.05 for all). Among edible consumers, there was no effect of the packaging (p = 0.992) or stamp manipulation (p = 0.988). Among both edible consumers and non-consumers, respondents in US states with legal recreational cannabis performed better than Canadians (p < 0.001).

Conclusions

Regulations that require THC information to be stamped or indicated on each serving of cannabis edible may facilitate understanding of how much to consume, especially among novice consumers.
Fibroblast growth factor-23 rs7955866 polymorphism and risk of chronic kidney disease
Authors: Ammar Yaser Aly , Maharem Dalia Aly , Mohamed Amira Hussein , Khalil Gihane Ibrahim , Shams-Eldin Riham Said , Dwedar Fatma Ibrahim
Published: April 2022

Background

A missense gain-of-function fibroblast growth factor-23 (FGF23) gene single nucleotide polymorphism (SNP) (rs7955866) has been associated with FGF23 hypersecretion, phosphaturia, and bone disease. Excess circulating FGF23 was linked with atherosclerosis, hypertension, initiation, and progression of chronic kidney disease (CKD).

Methods

The study included 72 CKD stage 2/3 Egyptian patients (27–71 years old, 37 females) and 26 healthy controls matching in age and sex. Repeated measures of blood pressure were used to quantify hypertension on a semiquantitative scale (grades 0 to 5). Fasting serum urea, creatinine, uric acid, total proteins, albumin, calcium, phosphorus, vitamin D3, intact parathyroid hormone (iPTH), and intact FGF23 (iFGF23) were measured. DNA extracted from peripheral blood leucocytes was used for genotyping of FGF23 rs7955866 SNP using the TaqMan SNP genotyping allelic discrimination method.

Results

Major causes of CKD were hypertension, diabetic kidney disease, and CKD of unknown etiology. There was no significant difference in minor allele (A) frequency between the studied groups (0.333 in GI and 0.308 in GII). Median (IQR) serum iFGF23 was significantly higher in GI [729.2 (531.9–972.3)] than in GII [126.1 (88.5–152.4)] pg/mL, P < 0.001. Within GI, the minor allele (A) frequency load, coded for codominant inheritance, had a significant positive correlation with both hypertension grade (r = 0.385, P = 0.001) and serum iFGF23 (r = 0.259, P = 0.028). Hypertension grade had a significant positive correlation with serum phosphorus and iFGF23.

Conclusions

For the first time in an Egyptian cohort, we report a relatively high frequency of the rs7955866 SNP. It may remain dormant or become upregulated in response to some environmental triggers, notably dietary phosphorus excess, leading to increased circulating iFGF23 with ensuing hypertension and/or renal impairment. Subjects with this SNP, particularly in the homozygous form, are at increased risk for CKD of presumably “unknown” etiology, with a tendency for early onset hypertension and increased circulating iFGF23 out of proportion with the degree of renal impairment. Large-scale population studies are needed to confirm these findings and explore the role of blockers of the renin–angiotensin–aldosterone system and sodium chloride cotransporters in mitigating hypertension associated with FGF23 excess.
Gender (r)evolution and contemporary psychiatry
Authors: Furlong Yulia , Janca Aleksandar
Published: April 2022

Perlson et al's editorial ‘Envisioning a future for transgender and gender-diverse people beyond the DSM’ heralds the arrival of the ICD-11's gender incongruence categories among conditions related to sexual health, brightening the spotlight on the re- (or rather de-)classification of gender-related disorders, which is a step in the right direction.
Elevated pulse pressure and its associations with demographic and clinical parameters in a clinically representative sample of outpatients with psychotic disorders
Authors: Holmberg Christopher , Torgerson Jarl , Gremyr Andreas
Published: April 2022

Elevated pulse pressure is associated with metabolic and neurocognitive diseases. Preliminary small-scale studies among patients with psychotic disorders have indicated that these patients had an increased pulse pressure compared with controls. However, it is unclear whether and how these associations are manifested among larger heterogenous samples of patients with psychotic disorders. We examined elevated pulse pressure and its associations with demographic and clinical characteristics in a clinically representative sample of outpatients with psychotic disorders (n = 1289). In a subsample (n = 343), we also examined associations with six domains of functioning. Controlling for age and cardiovascular disease, body mass index (BMI) and employment status independently predicted the odds ratio of having elevated pulse pressure. Elevated pulse pressure was also primarily associated with the physical domains of functioning. Outpatients with psychotic disorders that have high BMI and are unemployed thus seem to be at increased risk for elevated pulse pressure and should therefore be particularly considered for blood pressure screenings.
Interrupting Prolonged Sitting with Intermittent Walking Increases Postprandial Gut Hormone Responses
Authors: CHEN YUNG-CHIH , WALHIN JEAN-PHILIPPE , HENGIST AARON , GONZALEZ JAVIER T. , BETTS JAMES A. , THOMPSON DYLAN
Published: April 2022

Introduction

Continuous exercise can increase postprandial gut hormone such as glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) responses, but it is unknown whether interrupting prolonged sitting with intermittent walking elicits this effect.

Method

Ten participants with central overweight/obesity (7 men and 3 postmenopausal women, 51 ± 5 yr; mean ± SD) completed a randomized crossover study in which they consumed breakfast and lunch in the laboratory while either sitting continuously for the entire 5.5-h period (SIT) or the prolonged sitting interrupted every 20 min by walking briskly (6.4 km·h−1) for 2 min (BREAKS). Blood samples were collected at regular intervals to examine postprandial plasma GLP-1, PYY, and glucose-dependent insulinotropic polypeptide concentrations. Adipose tissue samples were collected at baseline and at the end of the trials to examine changes in net dipeptidyl peptidase 4 secretion from primary explants.

Results

Mean (95% confidence interval) postprandial GLP-1 and PYY incremental area under curve values were elevated by 26% and 31% in the BREAKS trial versus SIT (8.4 [0.7, 16.1] vs 6.7 [−0.8, 14.2], P = 0.001, and 26.9 [8.1, 45.6] vs 20.4 [5.1, 35.8] nmol·330 min·L−1, P = 0.024, respectively) but without any such effect on glucose-dependent insulinotropic polypeptide (P = 0.076) or net adipose tissue dipeptidyl peptidase 4 secretion (P > 0.05).

Conclusions

Interrupting prolonged sitting with regular short bouts of brisk walking increases postprandial GLP-1 and PYY concentrations in healthy middle-age men and women with central adiposity.