bluuebunny/crossref_metadata_2025 huggingface dataset:
No evidence of pulmonary hypertension revealed in an echographic evaluation of right-sided hemodynamics in hyperthyroid cats
Authors: Lachance Laury , Conversy Bérénice , Wiggen Kelly , Pavard Christophe , Reinero Carol , Masseau Isabelle
Published: November 2022

Objectives

Hyperthyroidism is a common endocrinopathy affecting middle-aged to elderly cats, with multisystemic repercussions. Hyperthyroid humans show decreased lung compliance and increased cardiac output with subsequent left heart failure leading to pulmonary capillary congestion. Prognosis worsens with the development of increased pulmonary vascular pressures (ie, pulmonary hypertension [PH]) in hyperthyroid humans. The effect of excess thyroid hormone concentration on pulmonary arterial hemodynamics is unknown in cats. Assessing pulmonary vascular pressures in veterinary medicine relies heavily on echocardiographic measurements performed at the level of the heart and pulmonary trunk. This study investigated right-sided cardiac and pulmonary arterial hemodynamics in hyperthyroid cats using echocardiography.

Methods

Echocardiographic examinations of hyperthyroid cats identified through a bi-institutional database search were reviewed for the determination of systolic pulmonary arterial pressure (PAP) and 20 other metrics. Values were compared with those of a healthy cat group using non-parametric statistical analyses.

Results

Systolic PAP could not be determined in 23/26 hyperthyroid and 13/14 healthy cats owing to unmeasurable tricuspid regurgitation flow velocity. Hyperthyroid cats were roughly twice as old ( P <0.001) and had 2–4-fold higher respiratory rates ( P <0.001) than healthy cats. Hyperthyroid cats showed an increase in acceleration time-to-ejection time ratio of pulmonary flow (1.4-fold, P = 0.001), pulmonary artery velocity time integral (1.2–1.6-fold, P = 0.001), maximal pulmonary velocity (1.3–1.7-fold, P = 0.002), stroke volume (1.5-fold, P = 0.001) and cardiac output (1.6-fold, P <0.001) vs healthy cats. None of the other echocardiographic metrics reached statistical significance.

Conclusions and relevance

Systolic PAP estimation proved unsuitable as a sole measurement for the assessment of PH in hyperthyroid cats owing to the frequent inability to interrogate tricuspid regurgitant flow velocity. Hyperthyroid cats have altered echocardiographic measures of pulmonary hemodynamics dissimilar to those reported in hyperthyroid humans. Differential effects of thyrotoxic cardiomyopathy on ventricular systolic function may underlie species differences.
Denial and Diagnosis of Methamphetamine Dependence Severity
Authors: Rice Myra , Dean Andy C , Suh Jaymee , London Edythe D
Published: November 2022

Introduction:

Denial, or lack of awareness of problems related to substance misuse, is a common feature of drug use disorders and can affect engagement in treatment and recovery. This study tested for association of denial with severity of symptoms used in the diagnosis of Methamphetamine Dependence.

Methods:

This secondary analysis used data from 69 participants (52.2% male) who met criteria for the diagnosis of Methamphetamine Dependence on the Structured Clinical Interview for DSM-IV (SCID). The association between diagnostic severity, determined from a SCID summary score (8 items), and denial, measured by the University of Rhode Island Change Assessment Scale (URICA) Precontemplation score, was tested by Pearson correlation. In post hoc t-tests, participants who differed on individual SCID items were compared on the Precontemplation score. The additional URICA subscales (Contemplation, Maintenance, Action) were also tested on a secondary basis.

Results:

SCID summary scores were negatively correlated with URICA Precontemplation scores ( P = .003). Post-hoc tests revealed that participants who denied continued methamphetamine use despite persistent or recurrent problems (SCID item 6) had significantly higher Precontemplation scores than those who endorsed these problems ( t = 3.066, P = .003). In contrast, positive correlations were observed between diagnostic severity and greater openness/willingness to change on the URICA (eg, Maintenance, r = .26; P = .01).

Conclusions:

The findings highlight the importance of a patient’s insight regarding their addiction in clinical diagnosis. Because minimizing the impact of methamphetamine use may preclude or delay treatment, it is advised that self-report be supplemented to improve accuracy of diagnosis.
Ensuring privacy in telemedicine: Ethical and clinical challenges
Authors: Mishkin Adrienne D , Zabinski Jeffrey S , Holt Grayson , Appelbaum Paul S
Published: November 2022

Data privacy in telemedicine has been extensively considered and reviewed in the literature, such as explorations of consent, who can access information, and the security of electronic systems. However, privacy breaches are also a potential concern in the physical setting and surroundings of the patient. Here we review clinical situations in which there is unanticipated loss of privacy, as well as potential physical and psychological safety concerns for the patient and others when privacy is limited. We identify ethical concerns and explore the challenges of supporting full true autonomous decision-making in this situation. We close with preliminary recommendations at the patient, clinician, and systems levels to help ensure privacy is maintained.
A systematic review of computer-mediated communications in Chinese as a foreign language from 2008 to 2022: Research contexts, theoretical foundations and methodology, affordances and limitations
Authors: Wang Mengdi , Devitt Ann
Published: November 2022

The Covid-19 pandemic has demonstrated how ubiquitous and pervasive technology to support communication and collaboration has become in people’s lives. This article seeks to provide an overview of the use of computer-mediated communication (CMC) in learning Chinese as a foreign language (CFL). The authors systematically reviewed 68 empirical research articles and 3 review articles published between 2008 and 2022 (early April). This in-depth review aims to investigate: (1) the characteristics of CMC-facilitated CFL learning in the worldwide context; (2) common theoretical foundations and methodological approaches; (3) CFL learners’ linguistic and intercultural communicative competence development through CMC; (4) affordances and limitations of CMC in the field of CFL research. Findings from this review suggest that the majority of studies were in formal education contexts within Anglosphere countries. The most commonly acknowledged theoretical foundations in CFL were well aligned with the wider second language acquisition (SLA) domain. A mixed-methods approach was the predominant methodological approach undertaken in the selected papers, with a small number of experimental or quasi-experimental studies between 2008 and 2022. The analysis also identified a clear research gap in relation to young CFL learners in the literature. The predominance of studies at ab initio level would suggest that more research is needed on younger CFL learners and on intermediate and advanced CFL learners using CMC. Additionally, the synthesized affordances of applying CMC technologies in CFL practice from this review were: (1) active engagement; (2) authentic communication; (3) learner centeredness; and (4) opportunities for practice and discovery. By addressing technological and individual CMC implementation limitations in a CFL context, suggestions and recommendations about further research and teaching practice are highlighted in the conclusion section.
The development and validation of the pandemic medication-assisted treatment questionnaire for the assessment of pandemic crises impact on medication management and administration for patients with opioid use disorders
Authors: Leventelis Christonikos , Katsouli Alexandra , Stavropoulos Vasileios , Karasavvidou Anna , Papadopoulos Panagiotis , Barmpas Petros T. , Tasoulis Sotiris , Veskoukis Aristidis S. , Tsironi Maria
Published: November 2022

Pandemic and the globally applied restriction measures mainly affect vulnerable population groups, such as patients with opioid use disorders. Towards inhibiting SARS-Cov-2 spread, the medication-assisted treatment (MAT) programs follow strategies targeting the reduction of in-person psychosocial interventions and an increase of take-home doses. However, there is no available instrument to examine the impact of such modifications on diverse health aspects of patients under MAT. The aim of this study was to develop and validate the PANdemic Medication-Assisted Treatment Questionnaire (PANMAT/Q) to address the pandemic effect on the management and administration of MAT. In total, 463 patients under ΜΑΤ participated. Our findings indicate that PANMAT/Q has been successfully validated exerting reliability and validity. It can be completed within approximately 5 min, and its implementation in research settings is advocated. PANMAT/Q could serve as a useful tool to identify the needs of patients under MAT being at high risk of relapse and overdose.
Autonomous care? Muslim transnational giving networks and perceptions of welfare responsibilities in India
Authors: Larouche Catherine
Published: November 2022

In Uttar Pradesh, many middle-class Muslims increasingly view local and transnational religious giving as a pragmatic way to create tangible socioeconomic improvements in the lives of underprivileged Muslims and mitigate their growing marginalization in India. How does their turn toward transnational religious giving influence their perception of the state’s responsibilities regarding social welfare provision? Based on ethnographic fieldwork research with registered non-profit organizations collecting and distributing Islamic alms ( zakat and sadaqa) in the state of Uttar Pradesh, this article examines how local and transnational religious giving affects the ways in which members of these Muslim philanthropic organizations imagine citizenship and welfare responsibilities in India. Distributive practices within these organizations show a dual focus on fostering Muslims’ economic independence and self-sufficiency by mobilizing local and transnational charitable networks on the one hand and improving access to state welfare on the other. The co-existence of these somewhat divergent strategies suggests that while the state is considered partial and uncaring, it also remains viewed as an indispensable welfare provider. More generally, these observations bring forth a discussion on the extent and effects of the transnationalisation and privatisation of welfare in globally connected South-Asia.
Preemptive Action: Measuring Presidential Assertiveness in Foreign Policy Lawmaking
Authors: Wiedekind Jakob
Published: November 2022

To what extent and under which conditions do presidents challenge foreign policy legislation through Statements of Administration Policy (SAPs)? While the presidents’ use of executive orders and signing statements has been studied extensively, this paper argues that SAPs are a subtler and less politically costly tool that is more important than scholars realized. Delivered at a crucial intervention point along the legislative process, these communications provide a key gateway for assertive presidential challenges. Relying on a novel assertiveness-score, this paper finds that SAPs target legislative content more aggressively over time and that the composition of government predicts executive assertiveness particularly well. Next to that, I show that presidents are more assertive when their term comes to an end. These insights contribute to our understanding of spiking interbranch tensions in American Politics.
Information interference and loss in a dual task situation: Task 1, choice reaction time; Task 2, unspeeded recall
Authors: Hartley Alan A
Published: November 2022

The extraction and maintenance of second task information was explored in four dual task experiments. A variant of the psychological refractory period procedure was used with the first task, a speeded choice reaction to a tone and the second task, the unspeeded recall of letter triplets. Prior research had shown that recall accuracy dropped as the stimulus-onset asynchrony (SOA) decreased and task overlap increased. This could be due to interference with extracting perceptual information or to loss of the information while awaiting central resources. All four experiments showed evidence of interference, with the accuracy of recall for the first letter recalled relatively unaffected by SOA but with accuracy for later letters dropping as SOA decreased. Two of the experiments showed evidence for loss of second task information, with accuracy lower on trials with longer first task reaction times. The two other experiments showed loss of information when either the response complexity of Task 1 or the perceptual encoding difficulty was increased, increasing the processing time. The observed interference was attributed to slowed extraction of perceptual information. The observed loss was consistent with the encoded information being held in a fragile temporary store, susceptible to loss until consolidated into short-term memory. The evidence showed that the interference and the loss were independent processes.
Synthesis of 3-(2-oxopropyl)-2-arylisoindolinone derivatives via a three-component reaction of diaryliodonium salts with 2-formylbenzonitriles and phenylacetylenes
Authors: Li Yang , Li Yuan , Fei Haiyang , Kong Ruiping , Yu Zhenzhong , He Liu
Published: November 2022

A copper-catalyzed multicomponent cascade cyclization using readily available substrates, including 2-formylbenzonitriles, phenylacetylenes, and diaryliodonium salts, is achieved. A broad reaction scope is presented with good functional group compatibility, giving rise to a range of 3-(2-oxopropyl)-2-arylisoindolinones in moderate to good yields.
EU membership or oligarchic rule: The choice facing Georgia
Authors: Samadashvili Salome
Published: November 2022

This article reviews the recent developments with respect to Georgia’s application to become a member of the EU, filed in March 2022. It addresses the circumstances under which the application was filed, the conditions tabled by the EU for granting Georgia candidate status, the challenges that lie ahead and what the EU can do to help Georgia overcome them. The article argues that without strong external pressure the conditions set by the EU are not likely to be met by Georgia’s ruling regime.
Technology-Supported University Teaching Models in China During the Pandemic: National Survey and Future Prospects
Authors: Wang (汪潇潇) Xiaoxiao , Guo (郭双双) Shuangshuang
Published: November 2022

Highlights

The Ministry of Education Research Center for Online Education conducted a national survey of university administrators of learning and teaching. The survey results showed that (a) the universities in eastern China had developed and introduced more massive open online courses (MOOCs) than those in the central and western regions; (b) of the various measures for blended learning, the universities tended to focus on supporting hardware development before providing training and incentive measures to teachers; and (c) the universities had widely used hybrid learning approaches. In relation to hybrid learning, Tsinghua University explored infrastructure upgrades, teacher training, and the optimal use of the rain classroom and its clone class, and launched the global hybrid classroom and global open courses. In the future, it will be necessary to further promote education equity in line with national policies and provide and perfect incentives to improve the quality of blended learning and expand hybrid learning while improving interaction through technology.
How is Satisfaction with Online-to-Offline App Formed? Importance of Confirmation Through Offline Experience
Authors: Choi Hyoung Yong , Kim Sang Soo
Published: November 2022

Online-to-offline mobile applications (O2O apps), which attract potential customers online and entice them to purchase in physical stores, are growing in popularity. However, little is known about the mechanisms by which satisfaction with O2O apps is formed through offline experiences. Drawing on the expectation confirmation model (ECM), this study proposes that the confirmation of expectations through offline experiences is the key to explaining satisfaction with O2O apps. Response data from 271 consumers of Kakao Hair, an O2O application that is widely used for hair shop customers in South Korea, were collected and analyzed. The analysis found that the confirmation of expectations through offline experiences directly influences O2O app satisfaction, and indirectly influences O2O app satisfaction through trust in and the perceived usefulness of O2O applications. This study contributes to both ECM literature and mobile application literature by demonstrating how confirmation of expectations through offline experiences affect O2O app satisfaction and intention to continue using O2O apps.
Agricultural Risk Management and Production Efficiency among Peasant Farmers in Taraba State, North Eastern Nigeria
Authors: Egbeadumah Maryanne Odufa , Aboshi Elisha Apakeh , Bulus Godiya , Zarewa Mohammad N.
Published: November 2022

This study was on agricultural risk management and production efficiency among peasant farmers in Wukari Local Government of Taraba State with specific objectives to; determine the socio-economic characteristics of the peasant farmers in the area; identify the risk faced by farmers in the area; analyse the risk management strategies and determine their management efficiency in combating the production risk. The Data for the study were collected using structured questionnaire. Descriptive and inferential statistics were used to analyse the data collected. The study showed that 88.8% faced risk from time to time while 5.6% of the respondents often face risk and another 5.6% never experienced risk at all. Diversification (56%) has been the major approach of risk management by respondents in the study area while integration (32%) and forward contracting (11.2%) methods were less employed. The coefficients of age (0.1044) was significant 1%, sex (0.7008) was significant at 5%, Educational level (0.3478) was significant at 1%, access to extension (2.6627) was significant at 1% and agribusiness risk (3.215) was significant at 1%. They were all positive indicating that they have positive relationship with the productivity of farmers. The allocative cost efficiency of risk management among the farmers stands at maximum: 20.57, minimum: 16.28 and mean: 18.55 indicating that the efficient level of production is very low thus demanding adequate management to increase production efficiency. It was recommended that the Government and stakeholders should help the farmers in time of risk to boost their morale for adequate production.
Listening: Considerations in Teaching an Invisible Skill
Authors: Hatch Emily
Published: November 2022

Music surrounds us and students have plenty of experience in passive listening. However, they need to be deliberately taught how to deeply and critically listen to music. The National Core Arts Standards do not specifically measure listening as a skill but to evaluate musical works, critical listening skills are essential. This article outlines considerations for teaching this invisible skill and provides ideas for student responses to their listening to make the invisible process of listening visible and accessible to teachers to assess and evaluate.
Downregulation of miR-451 in cholangiocarcinoma help the diagnsosi and promotes tumor progression
Authors: Guo Dengfang , Wang Qingling , Huang Jiancheng , Hu Zhanglin , Chen Chun , Zhang Chun , Lin Feng
Published: November 2022

Background

Cholangiocarcinoma is a kind of invasive malignant tumor followed by hepatocellular carcinoma. miR-451 was suggested to function as regulator in various human tumors, but its role in mediating tumor progression and predicting the prognosis of cholangiocarcinoma remains unknown. The clinical significance and biological function of miR-451 in cholangiocarcinoma were assessed in this study.

Results

The tissue and serum expression of miR-451 was decreased in cholangiocarcinoma compared with corresponding normal samples. The downregulation of miR-451 was associated with the progressive TNM stage and positive lymph node metastasis of patients. miR-451 was identified to be an indicator of the diagnosis and prognosis of cholangiocarcinoma distinguishing cholangiocarcinoma patients from healthy volunteers and predicting the poor outcome of patients. miR-451 also served as a tumor suppressor negatively regulating the cellular processes of cholangiocarcinoma.

Conclusions

miR-451 played a vital role in the early detection and risk prediction of cholangiocarcinoma. miR-451 also suppressed the progression of cholangiocarcinoma, which provides a potential therapeutical target for cholangiocarcinoma treatment.
Serum marker and CT characteristics of coronary calcified nodule assessed by intravascular ultrasound
Authors: Li Jing , Li Jing , Jian Zhijie , Wu Jianhua , Yang Jian , Guo Ning , Huang Xin
Published: November 2022

Background

Calcified nodule (CN) is a type of potentially vulnerable plaque. Its formation mechanism remains unknown. This study was to assess serum marker and computed tomography angiography (CTA) characteristics of CN validated by intravascular ultrasound (IVUS).

Methods

Patients who underwent coronary CTA followed by invasive coronary angiography and IVUS were retrospectively analyzed. Serum levels of alkaline phosphatase (ALP), gamma-glutamyltransferase, and calcium were collected.

Results

IVUS detected 128 de novo calcified lesions in 79 patients with coronary artery disease (CAD). CNs were identified in 11.4% (9/79) of patients and 9.4% (12/128) of lesions. Compared with patients with non-nodular calcified plaques, CN patients had higher serum level of ALP (82.00 vs 65.00 U/L, P = 0.022) and total plaque volume (673.00 vs 467.50 mm3, P = 0.021). Multivariable analyses revealed that serum ALP level and total plaque volume were independently associated with the prevalence of CN in CAD patients with calcified plaques. At lesion level, the CN group had a higher frequency of moderate to heavy calcification on angiography (75.00% vs 40.52%, P = 0.017). In terms of CTA characteristics, plaques with CN had a more severe diameter stenosis (79.00% vs 63.00%, P = 0.007), higher plaque burden (85.40% vs 77.05%, P = 0.005), total plaque density (398.00 vs 283.50 HU, P = 0.008), but lower lipid percentage (14.65% vs 19.75%, P = 0.010) and fiber percentage (17.90% vs 25.65%, P = 0.011). Mean plaque burden is an independent predictor of the prevalence of CN in calcified plaques (odds ratio = 1.102, 95% confidence interval: 1.025–1.185, P = 0.009). The AUC is 0.753 (95% confidence interval: 0.615–0.890, P = 0.004). When using 84.85% as the best cutoff value, the diagnostic sensitivity and specificity of mean plaque burden for predicting the presence of CN within calcified plaques were 66.7% and 80.2%, respectively.

Conclusions

CN had different CTA imaging features from non-nodular coronary calcification. The presence of a CN was associated with a higher serum ALP level and plaque burden.
Feasibility of a protocol for deprescribing antihypertensive medication in older patients in Dutch general practices
Authors: Hassan Dimokrat , Versmissen Jorie , Hek Karin , van Dijk Liset , van den Bemt Patricia M. L. A.
Published: November 2022

Background

Older patients using antihypertensive medication may experience Adverse Drug Events (ADEs), and thus benefit from deprescribing. The lack of a practical protocol may hamper deprescribing. Therefore, we aimed to develop a deprescribing protocol, based on a review of literature, combined with a feasibility test in a small number of patients.

Methods

A deprescribing protocol for general practitioners was drafted and tested in older patients using multiple antihypertensive medication in a single arm intervention. Patients were included if they were 75 years or older, were using two or more antihypertensives, had at least one ADE linked to antihypertensive medication and deprescribing was considered to be safe by their general practitioner. The primary outcome was the percentage of patients for whom one or more antihypertensive drugs were stopped or reduced in dose after 12 months of follow up while maintaining safe blood pressures. Secondary outcomes were the proportion of patients reporting no ADEs after 12 months and the number of deprescribed antihypertensives. Patient’s opinions on deprescribing and enablers and barriers for study participation were also collected.

Results

Nine general practitioners included 14 patients to deprescribe antihypertensive medication using the deprescribing protocol. After 12 months antihypertensive drug use was lowered in 11 patients (79%). These patients had a mean systolic blood pressure increase of 16 mmHg and a mean diastolic blood pressure increase of 8 mmHg. Nine patients (64%) reported experiencing no ADEs anymore after twelve months. The mean number of deprescribed antihypertensives was 1.1 in all patients and 1.4 (range: 0.5 to 3.5) in patients who successfully lowered their medication.

At baseline, being able to use less medication was the most frequently mentioned enabler to participate in this study. The most frequently mentioned positive experience at the end of the study was using less medication, which was in line with the most mentioned enabler to participate in this study.

Conclusion

A protocol for deprescribing antihypertensives in older patients was considered feasible, as it resulted in a substantial degree of safe deprescribing in this pilot study. Larger studies are needed to demonstrate the effect and safety of deprescribing antihypertensives in older patients.
Comparison of the duration of viral RNA shedding and anti-SARS-CoV-2 spike IgG and IgM antibody titers in COVID-19 patients who were vaccinated with inactivated vaccines or not: a retrospective study
Authors: Xu Chuancai , He Zhisong , Lei Wei , Chen Li , Shen Dan , Wang Xiaofei , Xu Deyu , Xu Ying , Huang Jian’an
Published: November 2022

Background

At present, the role of inactivated vaccines in viral RNA shedding among Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) breakthrough infections is still unknown.

Methods

We collected data of 147 coronavirus disease 2019 (COVID-19) patients with mild-to-moderate illness who were hospitalized in the Third People’s Hospital of Yangzhou from 7 to 20 August 2021 and analyzed the differences in symptoms and laboratory tests among fully vaccinated (FV), partially vaccinated (PV) and unvaccinated (UV) patients.

Results

The median duration of viral RNA shedding was shorter in the FV (12 [IQR, 9.5–14] days) and PV (13 [IQR, 9–16.75] days) groups than in the UV group (15 [IQR, 11.75–17.25] days) (adjusted P < 0.001 and adjusted P = 0.23, respectively). The median titers of SARS-CoV-2-specific IgG and IgM were significantly higher in the FV (12.29 S/co [IQR, 2.08–63.59] and 0.3 S/co [IQR, 0.05–2.29], respectively) and PV (0.68 S/co [IQR, 0.14–28.69] and 0.12 S/co [0.03–5.23], respectively) groups than in the UV group (0.06 S/co [IQR, 0.03–0.47] and 0.04 S/co [IQR, 0.02–0.07]) (adjusted P < 0.001 and adjusted P = 0.008, respectively).

Conclusions

Inactivated vaccines may shorten viral RNA shedding in breakthrough infected patients who have mild-to-moderate illness and may improve the ability of the host to generate specific antibodies to infection.
Dietary diversity in primary schoolchildren of south-central Côte d’Ivoire and risk factors for non-communicable diseases
Authors: Traoré Sylvain G. , Kouassi Kouadio B. , Coulibaly Jean T. , Beckmann Johanna , Gba Bomey C. , Lang Christin , Long Kurt Z. , Dao Daouda , Gerber Markus , Probst-Hensch Nicole , Pühse Uwe , Utzinger Jürg , Bonfoh Bassirou
Published: November 2022

Background

A balanced nutrition is important for children’s physical and cognitive development; yet, remains a challenge in many parts of low- and middle-income countries (LMICs). Early detection of nutritional deficiency and metabolic syndrome in school-aged children is necessary to prevent non-communicable diseases (NCDs) in later life. This study aimed at obtaining baseline data on health, nutritional status, and metabolic markers of NCDs among primary schoolchildren in Côte d’Ivoire.

Methods

A cross-sectional survey was conducted among 620 children from 8 public primary schools located in the south-central part of Côte d’Ivoire. Underweight and overweight were defined as a body mass index (BMI; kg/m2) < 5th and 85th up to 95th percentile for sex and age, respectively. Dietary diversity of children was calculated based on a 24-hour recall conducted with the primary caretaker according to the guideline of Food and Agriculture Organization. Anaemia, malaria, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood glucose levels (HbA1c) were assessed, using capillary blood samples. Logistic models were performed to identify risk factors associated with overweight, HDL-C, LDL-C, and HbA1c.

Results

Among the 620 children (330 girls, 290 boys; Mage 8.0 (± 1.7) years), 530 children attended school in a semi-urban and 90 in a rural area. Around 60% of children had a medium dietary diversity score (DDS). Children in peri-urban areas consumed more cereals (80.2% vs. 63.3%, p < 0.05). Most children were normal weight (n = 496), whereas 3.9% of children classified as prediabetic, 5% were underweight, and 15% overweight. LDL-C and HDL-C levels of children were associated with age, high DDS, and moderate anaemia. A significant association was found between prediabetes and malaria infection, as well as medium and high DDS. Overweight was associated with malaria infection and moderate anaemia.

Conclusion

Overweight, prediabetes, low HDL-C, malaria, and anaemia are the main concerns of children’s health in Taabo. Our findings highlight interactions between infectious diseases, particularly malaria, and NCD risk factors. Monitoring NCD risk and infectious disease comorbidity in LMIC paediatric populations simultaneously is essential to better understand the dual diseases burden and apply early prevention measures.
Time change in the distribution of physical activity and its correlates among retired older Swedish adults: a repeated cross-sectional study from a national survey
Authors: Vilhelmson Bertil , Thulin Eva , Elldér Erik
Published: November 2022

Background

Understanding how older adults spend time in moderate- to vigorous-intensity physical activity (MVPA) is crucial to understanding healthy ageing. This study connects 24-h time-use diary records of the daily activities of a sample of Swedish older adults to energy intensities. The aim was to: i) estimate the prevalence of Swedish older adults (aged 65–84 years) who achieved recommended daily levels of physical activity; ii) identify what domains of everyday life contribute to MVPA; and iii) explore socio-demographic factors affecting rates of active living.

Methods

We draw on two Swedish nationally representative samples of time-use diary data from 2000/2001 and 2010/2011. Data covering the duration of all activities performed over two days were combined with activity-intensity information (metabolic equivalent of task [MET] values) to estimate the energy expenditure (MET min) originating from MVPA.

Results

Results indicate that 94.1% of Swedish older adults achieved the WHO-recommended minimum level of daily MVPA in 2010/2011; the share remained unchanged over the period. MVPA performed in natural environments (24.2%), during housework (22.8%), and on everyday walks in one’s local area (18.1%) were dominant domains contributing to energy expenditure. Home maintenance and repairs (8.8%), active transport (9.9%), and physical exercise (8.2%) contributed to a lesser extent. In 2000/2001, total MVPA energy expenditure was associated with gender, housing, living region, and disability; in 2010/2011, except for disability, these associations were no longer significant.

Conclusions

The high proportion of older adults who achieved the recommended level of MVPA, their allocation of MVPA time to diverse domains, and the reduced social distribution over time suggest that elderly people increasingly find their own paths to everyday physical activity. This indicates a need to promote MVPA not only in established ways, such as prescribed training programmes. The importance of active physical activities in natural environments, and of regular walks in the vicinity of home, indicates a need to incorporate healthy ageing considerations in wider urban and regional planning, for example, to increase access to natural environments and urban walkability. Also, older adults’ involvement in household chores, maintenance and repairs, and active transport extends responsibility to new policy areas.
Chronic rhinosinusitis associated with chronic bronchitis in a five-year follow-up: the Telemark study
Authors: Bergqvist Joel , Bove Mogens , Andersson Anders , Schiöler Linus , Klepaker Geir , Abrahamsen Regine , Fell Anne Kristin M. , Hellgren Johan
Published: November 2022

Background

Chronic rhinosinusitis (CRS) is associated with generalised airway inflammation. Few studies have addressed the relationship between CRS and chronic bronchitis (CB).

Methods

This prospective study over a five-year period aims to investigate the risk of developing CB in subjects reporting CRS at the beginning of the study. A random sample of 7393 adult subjects from Telemark County, Norway, answered a comprehensive respiratory questionnaire in 2013 and then 5 years later in 2018. Subjects reporting CB in 2013 were excluded from the analyses. New cases of CB in 2018 were analysed in relation to having CRS in 2013 or not.

Results

The prevalence of new-onset CB in 2018 in the group that reported CRS in 2013 was 11.8%. There was a significant increase in the odds of having CB in 2018 in subjects who reported CRS in 2013 (OR 3.8, 95% CI 2.65–5.40), adjusted for age, sex, BMI, smoking and asthma.

Conclusion

In this large population sample, CRS was associated with increased odds of developing CB during a five-year follow-up. Physicians should be aware of chronic bronchitis in patients with CRS.
Comparison between magnetic resonance imaging and electrical impedance myography for evaluating lumbar skeletal muscle composition
Authors: Albano Domenico , Gitto Salvatore , Vitale Jacopo , Bernareggi Susan , Aliprandi Alberto , Sconfienza Luca Maria , Messina Carmelo
Published: November 2022

Background

To compare electrical impedance myography (EIM) and MRI in assessing lumbar skeletal muscle composition.

Methods

One hundred forty-one patients (78 females, mean age 57 ± 19 years) were prospectively enrolled and underwent lumbar spine MRI, EIM with Skulpt®, and clinical evaluation including the questionnaire SARC-F. MRIs were reviewed to assess the Goutallier score of paravertebral muscles at L3 level and to calculate the cross sectional area (CSA) of both psoas, quadratus lumborum, erector spinae, and multifidus muscles on a single axial slice at L3 level, in order to calculate the skeletal muscle index (SMI=CSA/height2). We tested the correlation between EIM-derived parameters [body fat percentage (BF%) and muscle quality] and body mass index (BMI), Goutallier score (1–4), SMI, and SARC-F scores (0–10) using the Pearson correlation coefficient. The strength of association was considered large (0.5 to 1.0), medium (0.3 to 0.5), small (0.1 to 0.3).

Results

Pearson’s correlation coefficient showed small (0.26) but significant (p < 0.01) positive correlation between BF% obtained with EIM and Goutallier score. Small negative correlation (− 0.22, p < 0.01) was found between EIM muscle quality and Goutallier Score. Large negative correlation (− 0.56, p < 0.01) was found between SMI and Goutallier Score, while SMI showed small negative correlation with SARC-F (− 0.29, p < 0.01). Medium positive correlation was found between Goutallier Score and SARC-F (0.41, p < 0.01). BMI showed medium positive correlation with SMI (r = 0.369, p < 0.01) and small correlation with EIM muscle quality (r = − 0.291, p < 0.05) and BF% (r = 0.227, p < 0.05). We found a substantial increase of the strength of associations of BF% and muscle quality with Goutallier in the 18–40 years (r = 0.485 and r = − 0.401, respectively) and in the 41–70 years group (r = 0.448 and r = − 0.365, respectively).

Conclusions

Muscle quality and BF% measured by EIM device showed only small strength of correlation with other quantitative parameters for assessing muscle mass and fat infiltration. Interesting results have been found in younger patients, but Skulpt Chisel™ should be applied cautiously to assess lumbar skeletal muscle composition. This point deserves further investigation and other studies are warranted.

Trial registration

The registration number of this study is 107/INT/2019.
Development of an assessment technique for basic science retention using the NBME subject exam data
Authors: Matus Alexandra R. , Matus Lyndsey N. , Hiltz Adam , Chen Tian , Kaur Bhavneep , Brewster Pamela , Sun Zhen , Mukundan Deepa , DeShetler Lori M. , Laukka Jeremy J. , Menon Bindu
Published: November 2022

Introduction

One of the challenges in medical education is effectively assessing basic science knowledge retention. National Board of Medical Examiners (NBME) clerkship subject exam performance is reflective of the basic science knowledge accrued during preclinical education. The aim of this study was to determine if students’ retention of basic science knowledge during the clerkship years can be analyzed using a cognitive diagnostic assessment (CDA) of the NBME subject exam data.

Methods

We acquired a customized NBME item analysis report of our institution’s pediatric clerkship subject exams for the period of 2017–2020 and developed a question-by-content Q-matrix by identifying skills necessary to master content. As a pilot study, students’ content mastery in 12 major basic science content areas was analyzed using a CDA model called DINA (deterministic input, noisy “and” gate).

Results

The results allowed us to identify strong and weak basic science content areas for students in the pediatric clerkship. For example: “Reproductive systems” and “Skin and subcutaneous tissue” showed a student mastery of 83.8 ± 2.2% and 60.7 ± 3.2%, respectively.

Conclusions

Our pilot study demonstrates how this new technique can be applicable in quantitatively measuring students’ basic science knowledge retention during any clerkship. Combined data from all the clerkships will allow comparisons of specific content areas and identification of individual variations between different clerkships. In addition, the same technique can be used to analyze internal assessments thereby creating an opportunity for the longitudinal tracking of student performances. Detailed analyses like this can guide specific curricular changes and drive continuous quality improvement in the undergraduate medical school curriculum.
Sequential gene expression analysis of cervical malignant transformation identifies RFC4 as a novel diagnostic and prognostic biomarker
Authors: Zhang Jianwei , Meng Silu , Wang Xiaoyan , Wang Jun , Fan Xinran , Sun Haiying , Ning Ruoqi , Xiao Bing , Li Xiangqin , Jia Yao , Kong Dongli , Chen Ruqi , Wang Changyu , Ma Ding , Li Shuang
Published: November 2022

Background

Cervical squamous cell carcinoma (SCC) is known to arise through increasingly higher-grade squamous intraepithelial lesions (SILs) or cervical intraepithelial neoplasias (CINs). This study aimed to describe sequential molecular changes and identify biomarkers in cervical malignant transformation.

Methods

Multidimensional data from five publicly available microarray and TCGA-CESC datasets were analyzed. Immunohistochemistry was carried out on 354 cervical tissues (42 normal, 62 CIN1, 26 CIN2, 47 CIN3, and 177 SCC) to determine the potential diagnostic and prognostic value of identified biomarkers.

Results

We demonstrated that normal epithelium and SILs presented higher molecular homogeneity than SCC. Genes in the region (e.g., 3q, 12q13) with copy number alteration or HPV integration were more likely to lose or gain expression. The IL-17 signaling pathway was enriched throughout disease progression with downregulation of IL17C and decreased Th17 cells at late stage. Furthermore, we identified AURKA, TOP2A, RFC4, and CEP55 as potential causative genes gradually upregulated during the normal-SILs-SCC transition. For detecting high-grade SIL (HSIL), TOP2A and RFC4 showed balanced sensitivity (both 88.2%) and specificity (87.1 and 90.1%), with high AUC (0.88 and 0.89). They had equivalent diagnostic performance alone to the combination of p16INK4a and Ki-67. Meanwhile, increased expression of RFC4 significantly and independently predicted favorable outcomes in multi-institutional cohorts of SCC patients.

Conclusions

Our comprehensive study of gene expression profiling has identified dysregulated genes and biological processes during cervical carcinogenesis. RFC4 is proposed as a novel surrogate biomarker for determining HSIL and HSIL+, and an independent prognostic biomarker for SCC.
Rapid elimination of cervical cancer while maintaining the harms and benefits ratio of cervical cancer screening: a modelling study
Authors: Jansen Erik E. L. , de Kok Inge M. C. M. , Kaljouw Sylvia , Demirel Erhan , de Koning Harry J. , Hontelez Jan. A. C.
Published: November 2022

Background

Human papillomavirus (HPV) vaccination and intensifying screening expedite cervical cancer (CC) elimination, yet also deteriorate the balance between harms and benefits of screening. We aimed to find screening strategies that eliminate CC rapidly but maintain an acceptable harms-benefits ratio of screening.

Methods

Two microsimulation models (STDSIM and MISCAN) were applied to simulate HPV transmission and CC screening for the Dutch female population between 2022 and 2100. We estimated the CC elimination year and harms-benefits ratios of screening for 228 unique scenarios varying in vaccination (coverage and vaccine type) and screening (coverage and number of lifetime invitations in vaccinated cohorts). The acceptable harms-benefits ratio was defined as the number of women needed to refer (NNR) to prevent one CC death under the current programme for unvaccinated cohorts (82.17).

Results

Under current vaccination conditions (bivalent vaccine, 55% coverage in girls, 27.5% coverage in boys), maintaining current screening conditions is projected to eliminate CC by 2042, but increases the present NNR with 41%. Reducing the number of lifetime screens from presently five to three and increasing screening coverage (61% to 70%) would prevent an increase in harms and only delay elimination by 1 year. Scaling vaccination coverage to 90% in boys and girls with the nonavalent vaccine is estimated to eliminate CC by 2040 under current screening conditions, but exceeds the acceptable NNR with 23%. Here, changing from five to two lifetime screens would keep the NNR acceptable without delaying CC elimination.

Conclusions

De-intensifying CC screening in vaccinated cohorts leads to little or no delay in CC elimination while it substantially reduces the harms of screening. Therefore, de-intensifying CC screening in vaccinated cohorts should be considered to ensure acceptable harms-benefits ratios on the road to CC elimination.
Evaluation of internal farm biosecurity measures combined with sow vaccination to prevent influenza A virus infection in groups of due-to-wean pigs
Authors: Lopez-Moreno Gustavo , Schmitt Cameron , Spronk Taylor , Culhane Marie , Torremorell Montserrat
Published: November 2022

Background

Influenza A virus (IAV) is an important respiratory pathogen of pigs that affects pig health, well-being and productivity, has zoonotic potential, and has significant economic impact for producers. The ultimate goal is to maintain herds free from IAV. Due to the probability of IAV introduction into the herds, it is also desirable for herds to have some immunity to the virus. In this study, we evaluated a protocol that combined sow vaccination with the implementation of internal biosecurity practices during the pre-weaning period with the goal to wean IAV negative pigs.

Five IAV positive breeding herds were vaccinated twice, 3 weeks apart with a herd-specific autogenous vaccine. For the subsequent 8 weeks, a biosecurity protocol was maintained, consisting of no pig movements after 3 days of age, no use of nurse sows, workers changing disposable gloves between litters, workers not stepping into farrowing crates, and daily disinfection of tools and materials used to handle pigs.

Results

Following these interventions, four of the five treatment farms had significant reductions in IAV detection (p value < 0.05). Three of the farms tested negative at all sampling points post-intervention and one farm had a 21% reduction in IAV positivity.

Conclusions

This study indicates that a protocol that combines sow vaccination and enhanced biosecurity practices may limit IAV transmission among piglets and enable the weaning of groups of pigs free from the virus.
Laparoscopic versus open distal gastrectomy for elderly patients with advanced gastric cancer: a retrospective comparative study
Authors: Yen Hung-Hsuan , Yeh Chi-Chuan , Lai I-Rue
Published: November 2022

Background

Laparoscopic radical distal gastrectomy (LDG) has been more frequently performed for locally advanced distal gastric cancer (AGC) than open distal gastrectomy (ODG). However, the benefits of LDG for elderly AGC patients (AGC-lap) remain unclear.

Methods

Patients aged ≥ 70 years who underwent D2 distal gastrectomy from July 2014 to July 2021 were enrolled consecutively. Perioperative parameters, pathological features, and oncological outcomes of AGC-lap patients (n = 39) were compared with those of elderly AGC patients receiving ODG (AGC-open; n = 37) and elderly early gastric cancer patients receiving LDG (EGC-lap; n = 41) respectively.

Results

The median age of all AGC patients was 77 years, and 28% of them had an Eastern Cooperative Oncology Group score ≥ 2. Most of the perioperative and pathological features (including the number of lymph nodes harvested) were similar between the AGC-lap and AGC-open groups. AGC-lap patients had longer median operative times (215 min versus 192 min) but significantly less surgical complications (10.3% versus 37.8%) and shorter median hospital stays (11 days versus 13 days) than did AGC-open patients (all p < 0.05). The 3-year recurrence-free and overall survival was 66.2% and 88.8% in the AGC-lap group and 51% and 66.3% in the AGC-open group (both p = 0.1). The perioperative features, including operative time, number of lymph nodes harvested, hospital stay, and complication rates, were similar between the AGC- and EGC-lap groups.

Conclusions

LDG was safely and effectively performed in elderly AGC patients, resulting in faster recovery and a lower complication rate than ODG, without compromising oncological outcomes.