bluuebunny/crossref_metadata_2025 huggingface dataset:
The Experience of Being the First Client of Novice Counselors in Turkiye From the Client’s Perspective
Authors: Erçevik Ayşegül , Türk Kurtça Tuğba
Published: July 2023

In this study, we aim to understand the clients’ experiences with counselor candidates in Turkiye by examining the meanings that clients attribute to their counseling experiences. Using a qualitative survey, we asked 13 participating clients (2 males, 11 females) questions about meaning attributed to counseling before, during, and after the counseling and their thoughts about the counselor as a candidate and the effects of supervision. A thorough thematic analysis identified four key themes: “the counselor being a counselor candidate,”“before counseling,”“counseling process,” and “counseling outcomes.” The study showed that the clients were unaffected by the fact that their counselor was being supervised. In addition, we also observed that receiving service from a counselor candidate was seen as an advantage rather than a disadvantage, the counselor candidate was perceived as a competent expert, and the outcome of the counseling process was found satisfactory.
Cultural Intelligence, Flourishing, and Thriving in the South African Work Context
Authors: Lezar Lucien.W.P. , van der Walt Freda
Published: July 2023

There is increased interest in the field of cultural intelligence (CI) internationally, owing to globalization. CI seems to be a particularly important field in a country such as South Africa, which is regarded as one of the most diverse societies in the world. In this article, the relationship between CI, flourishing at work, and thriving at work is analyzed in the context of South African organizations. The purpose of the article is to establish whether CI positively influences flourishing and thriving at work. A survey study was conducted, which was quantitative. The quantitative data was collected by means of a structured questionnaire, which was distributed to a final sample of 366 individuals working at South African organizations. The findings show that CI promotes flourishing at work, and they show that flourishing at work and thriving at work are related. They also indicate that emotional well-being and social well-being mediate the influence of CI on thriving at work, such that the indirect effects are positive and significant. The findings of the study indicate that CI is important in advancing mental health in the workplace. They also point to the importance of CI in a diverse country to promote flourishing and thriving at work. CI is thus important not only when leaders are on international assignments, but also in diverse settings. Through promotion of positive outcomes such as flourishing and thriving at work, organizations functioning in diverse settings are likely to become more effective and competitive.
Enhancing knowledge of Diabetes self-management and quality of life in people with Diabetes Mellitus by using Guru Diabetes Apps-based health coaching
Authors: Jafar Nuurhidayat , Huriyati Emy , Haryani  , Setyawati Andina
Published: July 2023

Introduction:

Virtual diabetes coaching through applications has the potential to improve self-management in people with Type 2 Diabetes Mellitus. However, applications designed for Asian’s diabetic have never been studied. Therefore, our study aimed to identify the effect of Guru Diabetes Apps-Based Health Coaching on the level of glycemic hemoglobin, knowledge, and quality of life in Indonesians, as one of Asian ethnicities.

Materials and methods:

This study used an experimental design. Participants with T2DM were recruited from three primary care health centers. The intervention included 3 months of virtual health coaching through the Guru Diabetes application. The daily monitoring of glycemic blood glucose, blood pressure, body weight, nutrition intake, and activity provided were used as baseline to conduct virtual in-person coaching. The glycemic hemoglobin level, knowledge level, and quality of life were assessed at baseline and post-enrollment. A multilevel modeling approach was used for statistical analysis.

Results:

A total of 66 respondents were enrolled, and 62 respondents (93.93%) remained in the study at 3 months. After completing the intervention, the HbA1c level decreased in all groups, however it did not differ among the groups. On the other hand, the results indicate significant improvement in the average diabetes self-management knowledge score (pre = 14.97 vs post = 19.07, p < 0.05) and quality of life score (pre = 54.34 vs post = 60.28, p < 0.05), with significant difference among the groups ( p < 0.05).

Conclusion:

Participants in the Android Application-Based Health Coaching experienced a significant improvement in diabetes self-management knowledge and quality of life scores at 3 months. In conclusion, the Guru Diabetes Apps-Based Health Coaching has the potential to support people with T2DM in performing diabetes self-management at home.
Knee Extensor Mechanism Complications After Autograft Harvest in ACL Reconstruction: A Systematic Review and Meta-analysis
Authors: Trasolini Nicholas A. , Lan Rae , Bolia Ioanna K. , Hill William , Thompson Ashley A. , Mayfield Cory K. , Knapik Derrick M. , Cole Brian J. , Weber Alexander E.
Published: July 2023

Background:

Existing systematic reviews have sought to characterize the relative donor-site morbidity of bone–patellar tendon–bone (BTB) and quadriceps tendon (QT) grafts after anterior cruciate ligament reconstruction (ACLR). However, no studies have reported the pooled proportions of patellar fractures and donor tendon ruptures across the body of literature.

Purpose:

To estimate the proportion of patellar fractures, patellar tendon ruptures, and QT ruptures associated with BTB or QT autograft harvest during ACLR using published data.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using 3 online databases (PubMed, Scopus, and Web of Science). A total of 800 manuscripts were included in the initial research of peer-reviewed articles in English that reported extensor mechanism complications associated with graft harvest in patients after ACLR. Pooled proportions of patellar fractures, patellar tendon ruptures, and QT ruptures were calculated for each graft type (BTB, QT) using a random-effects model for meta-analysis.

Results:

A total of 28 studies were analyzed. The pooled proportion of patellar fractures was 0.57% (95% CI, 0.34%-0.91%) for the BTB harvest and 2.03% (95% CI, 0.78%-3.89%) for the QT harvest. The proportion of patellar tendon ruptures was 0.22% (95% CI, 0.14%-0.33%) after the BTB harvest, and the proportion of QT ruptures was 0.52% (95% CI, 0.06%-1.91%) after the QT harvest. The majority of included studies (16/28 [57.1%]) had an evidence level of 4.

Conclusion:

Based on the current literature, the proportion of extensor mechanism complications after ACLR using either a BTB or a QT autograft is low, indicating that the extensor mechanism harvest remains a safe option. A higher proportion of patellar fractures was noted for QT grafts and a higher proportion of donor tendon ruptures was noted for QT grafts compared with BTB grafts.
Physical Burden and Perceived Stress of Personal Protective Equipment During COVID-19 Pandemic: A Retrospective Study in the United Arab Emirates
Authors: Alshehi Mariam Mohamed Hasan , Ilesanmi Rose Ekama , Dabou Eman Abdelaziz Rashad
Published: July 2023

Introduction

Over the course of the COVID-19 pandemic, personal protective equipment (PPE) has become necessary. According to published research, PPE-related physical impacts were probably underreported during the pandemic.

Objective

To examine the physical burden and perceived stress associated with prolonged PPE wearing among nurses during the COVID-19 pandemic in the United Arab Emirates (UAE).

Methods

This was a cross-sectional retrospective study of 209 nurses working in two hospitals in the UAE. A convenience sampling technique was applied, and the data were collected using an online questionnaire. Data collection was completed within three months (April 2022 to June 2022). The completed questionnaires were analyzed using SPSS version 21. Chi-square statistics was used to test the association of categorical variables at a 5% level of significance.

Results

A total of 209 nurses had a mean age of 38.4 ± 8.7 years. More than 65.1% wore PPE continuously for 4 hrs per day. The most common physical burdens reported were difficulty in breathing (62.2%), excessive thirst (41.6%), and facial itchiness (39.2%). Most participants (95.2%) reported high-stress levels. There was no significant association between the level of stress and the duration of wearing PPE ( p = .43 > .05). However, the authors found a statistically significant association between breathing difficulty with face masks and the duration of wearing them ( p < .05). In addition, itchiness/rash related to gloves was significantly associated with wearing duration ( p < .05).

Conclusion

Findings show that nurses experienced adverse effects from PPE use, which increased with the number of hours of wearing. Further studies with a larger sample size will allow for generalization of the study results.
Serum cystatin C level can be used to estimate GFR in patients with solid tumors: PRO
Authors: Torres Verônica
Published: July 2023

An accurate assessment of glomerular filtration rate (GFR) is a fundamental aspect of cancer care and research. Recent studies have demonstrated that, in patients with solid tumors, GFR estimation based on serum creatinine combined with serum cystatin C presented minimal bias compared to measured GFR, may reduce race disparity when applied to race free GFR estimating equations, and improve the prediction of carboplatin clearance.
Bacterial AsmA-Like Proteins: Bridging the Gap in Intermembrane Phospholipid Transport
Authors: Kumar Sujeet , Ruiz Natividad
Published: July 2023

In eukaryotic cells, nonvesicular lipid transport between organelles is mediated by lipid-transfer proteins. Recently, a new class of these lipid transporters has been described to facilitate the bulk of inter-organelle lipid transport at contact sites by forming bridge-like structures with a hydrophobic groove through which lipids travel. Because their predicted structure is composed of repeating β-groove (RBG) domains, they have been named the RBG protein superfamily. Early studies on RBG proteins VPS13 and ATG2 recognized the resemblance of their predicted structures to that of the bacterial Lpt system, which transports newly synthesized lipopolysaccharides (LPS) between the inner and the outer membranes (IMs and OMs) of Gram-negative bacteria. In these didermic bacteria, the IMs and OMs are separated by an aqueous periplasmic compartment that is traversed by a bridge-like structure built with β-jelly roll domains from several Lpt proteins that provides a hydrophobic groove for LPS molecules to travel across the periplasm. Despite structural and functional similarities between RBG proteins and the Lpt system, the bacterial AsmA-like protein family has recently emerged as the likely ancestor of RBG proteins and long sought-after transporters that facilitate the transfer of phospholipids from the IM to the OM. Here, we review our current understanding of the structure and function of bacterial AsmA-like proteins, mainly focusing on recent studies that have led to the proposal that AsmA-like proteins mediate the bulk of phospholipid transfer between the IMs and OMs.
Peritonsillar Abscess: A Cohort Study of an Unusual Imaging and Needle Guidance Approach
Authors: Gibbs Tim S. , Birnbaum Jonathan
Published: July 2023

Objective:

The purpose of this study was to establish a noninvasive, safe, and reliable sonographic technique for evaluating peritonsillar abscess and subsequent drainage. Also, of paramount interest to the emergency physicians was to determine whether this imaging technique could assist in localization and drainage of a tonsillar abscess, minimizing the risk of patient complications.

Materials and Methods:

This was a prospective nonrandomized study, conducted in a small urban community hospital. All sonographic examinations were performed by the staff sonographers. Imaging procedures were performed using a GE Logiq 9 or E9 ultrasound equipment system (GE Medical, Waukesha, Wisconsin). A broad-band curved linear array transducer (9L) was used to visualize the affected tonsil through a submandibular approach. An endocavity transducer (5 to 9 MHz) was used for all trans-oral cavity imaging. All aspirations were performed with an 18-G 20-cm Trocar needle (Cook Medical LLC. Bloomington, IN) inserted through a commercially available needle guide attachment (CIVCO Medical Solutions. Kalona, IA).

Results:

A total of 91 patients (N = 50 males and N = 41 females) are included in this cohort study. The patients ranged in age from 10 to 80 years of age and the average age was 34 years. In this patient cohort, 87 abscesses were found, and five patients had bilateral peritonsillar abscess. Of the remaining patients, one had inflammatory lymph nodes and four inflamed tonsils without abscess. All abscesses were successfully drained without complications.

Conclusion:

This level of evidence demonstrates a possible method is safer, which may be more effective than a nonimaging approach for needle aspiration. This technique is easily applied by both physician and sonographer with minimal training.
A key role for platelet GPVI in neutrophil recruitment, migration, and NETosis in the early stages of acute lung injury
Authors: Burkard Philipp , Schonhart Charlotte , Vögtle Timo , Köhler David , Tang Linyan , Johnson Denise , Hemmen Katherina , Heinze Katrin G. , Zarbock Alexander , Hermanns Heike M. , Rosenberger Peter , Nieswandt Bernhard
Published: July 2023

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are associated with high morbidity and mortality. Excessive neutrophil infiltration into the pulmonary airspace is the main cause for the acute inflammation and lung injury. Platelets have been implicated in the pathogenesis of ALI/ARDS, but the underlying mechanisms are not fully understood. Here, we show that the immunoreceptor tyrosine-based activation motif–coupled immunoglobulin-like platelet receptor, glycoprotein VI (GPVI), plays a key role in the early phase of pulmonary thrombo-inflammation in a model of lipopolysaccharide (LPS)-induced ALI in mice. In wild-type (WT) control mice, intranasal LPS application triggered severe pulmonary and blood neutrophilia, hypothermia, and increased blood lactate levels. In contrast, GPVI-deficient mice as well as anti-GPVI–treated WT mice were markedly protected from pulmonary and systemic compromises and showed no increased pulmonary bleeding. High-resolution multicolor microscopy of lung sections and intravital confocal microcopy of the ventilated lung revealed that anti-GPVI treatment resulted in less stable platelet interactions with neutrophils and overall reduced platelet–neutrophil complex (PNC) formation. Anti-GPVI treatment also reduced neutrophil crawling and adhesion on endothelial cells, resulting in reduced neutrophil transmigration and alveolar infiltrates. Remarkably, neutrophil activation was also diminished in anti-GPVI–treated animals, associated with strongly reduced formation of PNC clusters and neutrophil extracellular traps (NETs) compared with that in control mice. These results establish GPVI as a key mediator of neutrophil recruitment, PNC formation, and NET formation (ie, NETosis) in experimental ALI. Thus, GPVI inhibition might be a promising strategy to reduce the acute pulmonary inflammation that causes ALI/ARDS.
Burden of chronic cough in the UK: results from the 2018 National Health and Wellness Survey
Authors: McGarvey Lorcan , Morice Alyn H. , Martin Ashley , Li Vicky W. , Doane Michael J. , Urdaneta Eduardo , Schelfhout Jonathan , Ding Helen , Fonseca Eileen
Published: July 2023

Background

Chronic cough, defined as daily cough for at least 8 weeks, negatively affects quality of life and work productivity and increases healthcare resource utilisation. We aimed to determine the prevalence and burden of chronic cough in the UK.

Methods

Study participants were general population respondents to the 2018 UK National Health and Wellness Survey (NHWS). Respondents completed survey questions relating to health, quality of life, work productivity and activity impairment, and use of healthcare resources. Prevalence estimates were projected to the UK population using post-stratification sampling weights to adjust for sampling bias. The population with chronic cough was matched 1:3 with a group without chronic cough, using propensity score matchingon age, sex and the modified Charlson Comorbidity Index.

Results

Of 15 000 NHWS respondents, 715 reported chronic cough in the previous 12 months and 918 during their lifetime. Weighted to the UK adult population, the 12-month prevalence of chronic cough was 4.9% and lifetime prevalence was 6.2%. Prevalence of chronic cough was higher among older respondents and those with smoking histories. Chronic cough respondents experienced higher rates of severe anxiety and depression in the past 2 weeks than matched controls. Poor sleep quality and loss of work productivity were also observed. More chronic cough respondents visited a healthcare provider in the past 6 months than respondents without chronic cough with a mean of 5.8 and 3.7 visits per respondent, respectively.

Conclusion

Adults with chronic cough report lower quality of life, reduced work productivity and greater healthcare resource utilisation than matched controls without chronic cough.
Measuring spirometry in a lung cancer screening cohort highlights possible underdiagnosis and misdiagnosis of COPD
Authors: Bradley Claire , Alexandris Panos , Baldwin David R. , Booton Richard , Darby Mike , Eckert Claire J. , Gabe Rhian , Hancock Neil , Janes Sam , Kennedy Martyn , Lindop Jason , Neal Richard D. , Rogerson Suzanne , Shinkins Bethany , Simmonds Irene , Upperton Sara , Vestbo Jorgen , Crosbie Philip A.J. , Callister Matthew E.J.
Published: July 2023

Introduction

COPD is underdiagnosed, and measurement of spirometry alongside low-dose computed tomography (LDCT) screening for lung cancer is one strategy to increase earlier diagnosis of this disease.

Methods

Ever-smokers at high risk of lung cancer were invited to the Yorkshire Lung Screening Trial for a lung health check (LHC) comprising LDCT screening, pre-bronchodilator spirometry and a smoking cessation service. In this cross-sectional study we present data on participant demographics, respiratory symptoms, lung function, emphysema on imaging and both self-reported and primary care diagnoses of COPD. Multivariable logistic regression analysis identified factors associated with possible underdiagnosis and misdiagnosis of COPD in this population, with airflow obstruction defined as forced expiratory volume in 1 s/forced vital capacity ratio <0.70.

Results

Out of 3920 LHC attendees undergoing spirometry, 17% had undiagnosed airflow obstruction with respiratory symptoms, representing potentially undiagnosed COPD. Compared to those with a primary care COPD code, this population had milder symptoms, better lung function and were more likely to be current smokers (p≤0.001 for all comparisons). Out of 836 attendees with a primary care COPD code who underwent spirometry, 19% did not have airflow obstruction, potentially representing misdiagnosed COPD, although symptom burden was high.

Discussion

Spirometry offered alongside LDCT screening can potentially identify cases of undiagnosed and misdiagnosed COPD. Future research should assess the downstream impact of these findings to determine whether any meaningful changes to treatment and outcomes occur, and to assess the impact on co-delivering spirometry on other parameters of LDCT screening performance such as participation and adherence. Additionally, work is needed to better understand the aetiology of respiratory symptoms in those with misdiagnosed COPD, to ensure that this highly symptomatic group receive evidence-based interventions.
Prevalence of small airway dysfunction in the Swiss PneumoLaus Cohort
Authors: Touilloux Brice , Bongard Cedric , Lechartier Benoit , Truong Minh Khoa , Marques-Vidal Pedro , Vollenweider Peter , Vaucher Julien , Casutt Alessio , von Garnier Christophe
Published: July 2023

Background

Recent evidence identified exposure to particulate matter of size ≤2.5 µm (PM2.5) as a risk factor for high prevalence of small airway dysfunction (SAD). We assessed the prevalence of SAD in a European region with low air pollution levels.

Methods

SAD was defined as a maximum mid-expiratory flow (MMEF) <65% of predicted value (PV) or MMEF <lower limit of normal (LLN) measured by spirometry in the Swiss PneumoLaus cohort. We performed bivariate and multivariable analysis with MMEF criteria, age, sex, body mass index, respiratory symptoms and smoking status. Mean PM2.5values were obtained from a Swiss national database.

Results

Among 3351 participants (97.6% Caucasian, 55.7% female sex, mean age 62.7 years), we observed MMEF <65% PV in 425 (12.7%) and MMEF <LLN in 167 (5.0%) individuals. None of the participants had both MMEF <LLN and ≥65% PV. MMEF <65% PV and MMEF <LLN were significantly associated with age, smoking status, cough, sputum and dyspnoea, whereas a positive association with MMEF <65% PV was observed for individuals aged >65 years only. In an area where ambient PM2.5concentration was <15 µg·m−3during the observation period (2010 and 2020), ≥72% of participants with SAD were ever-smokers.

Conclusions

The observed low prevalence of SAD of 5.0–12.7% depending on criteria employed may be related to lower PM2.5exposure. Smoking was the main factor associated with SAD in an area with low PM2.5exposure. Employing a MMEF threshold <65% PV carries a risk of SAD overdiagnosis in elderly individuals.
iEnhancer-DCSA: identifying enhancers via dual-scale convolution and spatial attention
Authors: Wang Wenjun , Wu Qingyao , Li Chunshan
Published: July 2023

Background

Due to the dynamic nature of enhancers, identifying enhancers and their strength are major bioinformatics challenges. With the development of deep learning, several models have facilitated enhancers detection in recent years. However, existing studies either neglect different length motifs information or treat the features at all spatial locations equally. How to effectively use multi-scale motifs information while ignoring irrelevant information is a question worthy of serious consideration. In this paper, we propose an accurate and stable predictor iEnhancer-DCSA, mainly composed of dual-scale fusion and spatial attention, automatically extracting features of different length motifs and selectively focusing on the important features.

Results

Our experimental results demonstrate that iEnhancer-DCSA is remarkably superior to existing state-of-the-art methods on the test dataset. Especially, the accuracy and MCC of enhancer identification are improved by 3.45% and 9.41%, respectively. Meanwhile, the accuracy and MCC of enhancer classification are improved by 7.65% and 18.1%, respectively. Furthermore, we conduct ablation studies to demonstrate the effectiveness of dual-scale fusion and spatial attention.

Conclusions

iEnhancer-DCSA will be a valuable computational tool in identifying and classifying enhancers, especially for those not included in the training dataset.
Prevalence of five treatable sexually transmitted infections among women in Lower River region of The Gambia
Authors: Butcher Robert , Jarju Sheikh , Obayemi Dolapo , Bashorun Adedapo Olufemi , Vasileva Hristina , Bransbury-Hare Hannah , Agboghoroma Orighomisan , Drammeh Lamin , Holland Martin , Harding-Esch Emma , Clarke Ed
Published: July 2023

Background

The prevalence of sexually transmitted infections (STIs) in sub-Saharan Africa is poorly described. We aimed to determine the prevalence of five treatable STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, Treponema pallidum) in a sample of Gambian women from the general population.

Methods

Archived specimens from 420 women aged 15 − 69 years living in The Gambia enrolled in a clinical trial of human papilloma virus vaccine schedules were tested in this study. Urine samples were tested for C. trachomatis, N. gonorrhoeae, T. vaginalis and M. genitalium using a commercially available, open-platform multiplex PCR kit. A fragment of the ompA gene was amplified from C. trachomatis-positive samples and sequenced. Serum samples were tested for T. pallidum using the Chembio DPP Syphilis Screen and Confirm test.

Results

Overall, 41/420 (9.8%) women tested positive for at least one STI. 32 (7.6%), 9 (2.1%), 1 (0.2%), 1 (0.2%) and 0 (0.0%) tested positive for T. vaginalis, C. trachomatis, N gonorrhoeae, M. genitalium and T. pallidum, respectively. ompA gene sequence was available from five C. trachomatis infections: four were genovar D,one was genovar G and one was genovar F.

Conclusions

STIs are endemic in The Gambia. Monitoring systems should be established.
Percutaneous transhepatic cholangial drainage or antibiotic therapy worsens response to immunotherapy in advanced cholangiocarcinoma
Authors: Huang Qingyu , Wang Fuhao , Zhang Xiang , Liu Jing , Dou Xue , Feng Rui , Zhu Kunli , Jiang Shumei , Zhang Yun , Yue Jinbo
Published: July 2023

Background

Bile duct obstruction is a common issue for patients with advanced cholangiocarcinoma (CCA). Percutaneous transhepatic cholangial drainage (PTCD) is often required to relieve the obstruction. However, PTCD may alter the intestinal microbiota, which can affect the efficacy of immunotherapy. Antibiotics (ATB) can also have significant immunomodulatory effects by perturbing the gut microbiota. Therefore, this study aimed to investigate whether PTCD or ATB therapy is associated with overall survival (OS) or progression-free survival (PFS) in patients with advanced CCA receiving first-line chemotherapy plus immune checkpoint blockade (ICB) in clinical practice. We also explored whether the gut microbiota changes after receiving PTCD.

Methods

We conducted a single-center retrospective analysis of PTCD and ATB therapy in patients with advanced CCA. PTCD was performed before ICB initiation, and ATB was administered within 1 month before and 6 weeks after ICB initiation. Our primary outcomes were PFS and OS. Moreover, we used 16s rRNA sequencing to analyze fecal and bile samples obtained from patients who underwent PTCD.

Results

In total, 107 patients with CCA were included. Among patients who did not undergo PTCD, ICB plus chemotherapy significantly improved OS vs. chemotherapy alone (hazard ratio [HR] 0.21, 95% confidence interval [CI] 0.09–0.45, p < 0.0001). PFS was also significantly improved in patients who received ICB plus chemotherapy compared with chemotherapy alone (HR 0.36, 95% CI 0.16–0.80, p = 0.0024). However, ICB plus chemotherapy did not improve survival compared with chemotherapy alone among patients who received PTCD. Overall changes in the fecal microbiota of patients after PTCD involved significant reductions in which Escherichia − Shigella.

Conclusions

The use of ATB or PTCD in patients with CCA receiving ICB was associated with worse OS compared with chemotherapy alone, and PTCD affects the gut microbiota. Escherichia − Shigella was significantly reduced in feces of patients after PTCD.
Screening for parent and child ADHD in urban pediatric primary care: pilot implementation and stakeholder perspectives
Authors: Lui Joyce H. L. , Danko Christina M. , Triece Tricia , Bennett Ian M. , Marschall Donna , Lorenzo Nicole E. , Stein Mark A. , Chronis-Tuscano Andrea
Published: July 2023

Background

ADHD commonly co-occurs in children and parents. When ADHD is untreated in parents, it contributes to negative child developmental and treatment outcomes. Screening for parent and child ADHD co-occurrence in pediatric primary care may be an effective strategy for early identification and treatment. There is no data on whether this screening model can be implemented successfully and there exists limited guidance on how to effectively approach parents about their own ADHD in pediatric settings. Even greater sensitivity may be required when engaging with families living in urban, low SES communities due to systemic inequities, mistrust, and stigma.

Methods

The current pilot study described the first 6 months of implementation of a parent and child ADHD screening protocol in urban pediatric primary care clinics serving a large population of families insured through Medicaid. Parents and children were screened for ADHD symptoms at annual well-child visits in pediatric primary care clinics as part of standard behavioral health screening. Independent stakeholder group meetings were held to gather feedback on factors influencing the implementation of the screening and treatment strategies. Mixed methods were used to examine initial screening completion rates and stakeholder perspectives (i.e., parents, primary care office staff, pediatricians, and behavioral health providers) on challenges of implementing the screening protocol within urban pediatric primary care.

Results

Screening completion rates were low (19.28%) during the initial 6-month implementation period. Thematic analysis of stakeholder meetings provided elaboration on the low screening completion rates. Identified themes included: 1) divergence between provider enthusiasm and parent hesitation; 2) parent preference versus logistic reality of providers; 3) centering the experiences of people with marginalized identities; and 4) sensitivity when discussing parent mental health and medication.

Conclusions

Findings highlight the importance of developing flexible approaches to screening parent and child ADHD in urban pediatric health settings and emphasize the importance of cultural sensitivity when working with marginalized and under-resourced families.

Trial registration

NCT04240756 (27/01/2020).
Cross-sectional study of characteristics of body composition of 24,845 children and adolescents aged 3–17 years in Suzhou
Authors: Zhao Yan , Gong Jin-xin , Ji Yi-ting , Zhao Xiao-yun , He Lu , Cai Shi-zhong , Yan Xiang-ming
Published: July 2023

Background

We aimed to analyze the characteristics of the body composition of children and adolescents aged 3–17 in Suzhou, China.

Methods

A cross-sectional study between January 2020 and June 2022 using bioelectrical impedance was conducted to determine the fat mass (FM), fat-free mass (FFM), skeletal muscle mass, and protein and mineral contents of 24,845 children aged 3–17 who attended the Department of Child and Adolescent Healthcare, Children’s Hospital of Soochow University, China. Measurement data was presented in tables as mean ± SD, and groups were compared using the independent samples t-test.

Results

FM and fat-free mass increased with age in both boys and girls. The fat-free mass of girls aged 14–15 decreased after reaching a peak, and that of boys in the same age group was higher than that of the girls (p < 0.05). There were no significant differences in FM between boys and girls younger than 9- and 10-years old. The percentage body fat (PBF) and FM index of girls increased rapidly between 11 and 15 years of age (p < 0.05), and those of boys aged 11–14 were significantly lower (p < 0.05), suggesting that the increase in body mass index (BMI) was mainly contributed by muscle mass (MM) in boys.

Conclusions

The body composition of children and adolescents varies according to their age and sex. A misdiagnosis of obesity made on the basis of BMI alone can be avoided if BMI is used in combination with FM index, percentage body fat, and other indexes.
Conceptualising social media addiction: a longitudinal network analysis of social media addiction symptoms and their relationships with psychological distress in a community sample of adults
Authors: Tullett-Prado Deon , Doley Jo R. , Zarate Daniel , Gomez Rapson , Stavropoulos Vasileios
Published: July 2023

Background

Problematic social media use has been identified as negatively impacting psychological and everyday functioning and has been identified as a possible behavioural addiction (social media addiction; SMA). Whether SMA can be classified as a distinct behavioural addiction has been debated within the literature, with some regarding SMA as a premature pathologisation of ordinary social media use behaviour and suggesting there is little evidence for its use as a category of clinical concern. This study aimed to understand the relationship between proposed symptoms of SMA and psychological distress and examine these over time in a longitudinal network analysis, in order better understand whether SMA warrants classification as a unique pathology unique from general distress.

Method

N = 462 adults (Mage = 30.8, SDage = 9.23, 69.3% males, 29% females, 1.9% other sex or gender) completed measures of social media addiction (Bergen Social Media Addiction Scale), and psychological distress (DASS-21) at two time points, twelve months apart. Data were analysed using network analysis (NA) to explore SMA symptoms and psychological distress. Specifically, NA allows to assess the ‘influence’ and pathways of influence of each symptom in the network both cross-sectionally at each time point, as well as over time.

Results

SMA symptoms were found to be stable cross-sectionally over time, and were associated with, yet distinct, from, depression, anxiety and stress. The most central symptoms within the network were tolerance and mood-modification in terms of expected influence and closeness respectively. Depression symptoms appeared to have less of a formative effect on SMA symptoms than anxiety and stress.

Conclusions

Our findings support the conceptualisation of SMA as a distinct construct occurring based on an underpinning network cluster of behaviours and a distinct association between SMA symptoms and distress. Further replications of these findings, however, are needed to strengthen the evidence for SMA as a unique behavioural addiction.
Muslim parents’ beliefs and factors influencing complete immunization of children aged 0–5 years in a Thai rural community: a qualitative study
Authors: Jinarong Taqwa , Chootong Rattanaporn , Vichitkunakorn Polathep , Songwathana Praneed
Published: July 2023

Purpose

Vaccine-preventable diseases have decreased globally. However, measles and diphtheria outbreaks still occur in Southern Thailand, where Muslims are predominant with a documented low vaccine coverage. The purpose of this study was to investigate Muslim parents’ beliefs and factors influencing them to complete immunization of children aged 0–5 years in Y.L. province, Thailand.

Method

A descriptive qualitative study was conducted, using focus group discussion with 26 participants. They are parents whose children had complete or incomplete vaccination and community/religious leaders. Data were analyzed using content-analysis and triangulation method was used to ensure trustworthiness.

Results

Four major themes emerged from the analysis: (1) positive vaccine beliefs, which included knowledge and awareness of vaccination, trust in vaccine efficacy, and religious beliefs; (2) positive factors influencing positive beliefs and vaccine acceptance, which were accessibility of reliable sources, and imitation of leaders and health-community-network; (3) negative vaccine beliefs, including bias in vaccine efficacy and safety, personal beliefs about sources of vaccines, and religious misconceptions regarding the value of vaccines and Halal concerns; and (4) negative factors influencing negative beliefs and refusal of vaccination, which were perception of disadvantages of vaccines spread by word-of-mouth, trust in person over empirical evidence, religious views based on self-interpretation, and lack of public information on Halal vaccines.

Conclusion

Both positive and negative factors influencing complete immunization were found in this study. To enhance vaccine acceptance, health care providers should understand Muslim cultural beliefs by offering parents a chance to express their attitudes and encourage vaccination via religious leaders and community role models.
Investigation of a family affected by early-onset osteoarthritis – proposal of a clinical pathway and bioinformatics pipeline for the investigation of cases of familial OA
Authors: Deveza Leticia A. , Zankl Andreas , Hunter David J.
Published: July 2023

Background

Familial cases of early-onset osteoarthritis (OA) are rare although the exact prevalence is unknown. Early recognition of underlying OA-associated disorders is vital for targeted treatment, when available, and genetic counselling, in case of skeletal dysplasias. Currently, there is no clear guidance on how best to investigate families affected by early-onset OA.

Methods

We investigated a family with multiple members affected by early-onset OA (age at onset ≤ 40 years). Clinical and demographic characteristics were collected, followed by laboratory investigations screening for a range of potential OA-associated disorders, and whole genome sequencing in selected individuals.

Results

Seventeen members of the family were included (7 affected and 10 non-affected). There was an even split between the two sexes and two participants were under 18 years old. No pattern of abnormality was seen in the laboratory investigation that could explain the OA phenotype in the family. Whole-genome sequencing was perfomed in one participant and analysed for likely pathogenic variants in genes known to be associated with skeletal dysplasias. A heterozygous variant in the COL2A1 gene was identified (p.Arg519Cys). Confirmatory tests were performed in five additional participants (four affected and one unaffected).

Conclusion

The methodology used in this study, including the clinical pathway and bioinformatics pipeline, could be applied to other families affected by early-onset OA.
Differences in medical education before, during, and in the post-peak period of the COVID-19 pandemic—exploring senior medical students’ attitudes
Authors: Vaca-Cartagena Bryan F. , Quishpe-Narváez Erika , Cartagena Ulloa Heidi , Estévez-Chávez Jenny Paola
Published: July 2023

Background

The burden that COVID-19 has brought to the economy, healthcare systems, and education is unmatched. Public health and social measures were implemented to halt transmission. Thus, social gathering and in-person learning, core aspects of medical education, were interrupted. Studies have documented the detrimental impact students graduating during the pandemic have had on their confidence and skills. However, data comparing pre-pandemic, pandemic, and post-peak students still lack. This study aimed to identify senior medical students' attitudes regarding their education and compare them according to the three previously described periods.

Methods

In this cross-sectional study, the survey employed was designed based on a previous questionnaire and applied to senior medical students before graduating between January 2018 and June 2022. Answers were collected using a three-point Likert scale and Yes/No questions. Associations between variables were examined using Chi-squared, Fisher’s Exact tests, and ANOVA, employing logistic regression to calculate odds ratio (OR) when appropriate.

Results

A total of 679 responses were analyzed. Most students (59%) were women. Up to 383, 241, and 55 senior medical students answered the survey before, during, and in the post-peak period of the COVID-19 pandemic, respectively. There was a staggering decrease in the percentage of students in the post-peak compared to the pre-pandemic period that considered certain factors such as being taught about the doctor-patient relationship (62% vs 75%), practicing teamwork (33% vs 54%), preclinical & clinical subjects (44% vs 63%), and being taught to conduct research (22% vs 32%) as “very useful” to their professional traineeship. There was a significant difference between pre-pandemic, pandemic, and post-peak students when asked if the study curriculum accomplished the goal of training a professional with integrity (89% vs 66% vs 64%, p < 0.001), respectively. In a multivariate analysis graduating during the pandemic (OR 3.92; 95% CI, 2.58–5.94) and in the post-peak period (OR 4.24; 95% CI, 2.23–8.07) were independent factors for the appreciation that the study curriculum did not meet its objective.

Conclusions

The pandemic has hindered medical education. Students’ appreciation of their instruction has deteriorated. Urgent interventions that halt the negative impact on training, ensure readiness for future problems and improve schooling worldwide are needed.
Prognostic models for breast cancer: based on logistics regression and Hybrid Bayesian Network
Authors: Su Fan , Chao Jianqian , Liu Pei , Zhang Bowen , Zhang Na , Luo Zongyu , Han Jiaying
Published: July 2023

Background

To construct two prognostic models to predict survival in breast cancer patients; to compare the efficacy of the two models in the whole group and the advanced human epidermal growth factor receptor-2-positive (HER2+) subgroup of patients; to conclude whether the Hybrid Bayesian Network (HBN) model outperformed the logistics regression (LR) model.

Methods

In this paper, breast cancer patient data were collected from the SEER database. Data processing and analysis were performed using Rstudio 4.2.0, including data preprocessing, model construction and validation. The L_DVBN algorithm in Julia0.4.7 and bnlearn package in R was used to build and evaluate the HBN model. Data with a diagnosis time of 2018(n = 23,384) were distributed randomly as training and testing sets in the ratio of 7:3 using the leave-out method for model construction and internal validation. External validation of the model was done using the dataset of 2019(n = 8128). Finally, the late HER2 + patients(n = 395) was selected for subgroup analysis. Accuracy, calibration and net benefit of clinical decision making were evaluated for both models.

Results

The HBN model showed that seventeen variables were associated with survival outcome, including age, tumor size, site, histologic type, radiotherapy, surgery, chemotherapy, distant metastasis, subtype, clinical stage, ER receptor, PR receptor, clinical grade, race, marital status, tumor laterality, and lymph node. The AUCs for the internal validation of the LR and HBN models were 0.831 and 0.900; The AUCs for the external validation of the LR and HBN models on the whole population were 0.786 and 0.871; the AUCs for the external validation of the two models on the subgroup population were 0.601 and 0.813.

Conclusion

The accuracy, net clinical benefit, and calibration of the HBN model were better than LR model. The predictive efficacy of both models decreased and the difference was greater in advanced HER2 + patients, which means the HBN model had higher robustness and more stable predictive performance in the subgroup.
Opinion research among Russian Physicians on the application of technologies using artificial intelligence in the field of medicine and health care
Authors: Orlova I.A. , Akopyan Zh.A. , Plisyuk A.G. , Tarasova E.V. , Borisov E.N. , Dolgushin G.O. , Khvatova E.I. , Grigoryan M.A. , Gabbasova L.A. , Kamalov A.A.
Published: July 2023

Background

To date, no opinion surveys has been conducted among Russian physicians to study their awareness about artificial intelligence. With a survey, we aimed to evaluate the attitudes of stakeholders to the usage of technologies employing AI in the field of medicine and healthcare and identify challenges and perspectives to introducing AI.

Methods

We conducted a 12-question online survey using Google Forms. The survey consisted of questions related to the recognition of AI and attitudes towards it, the direction of development of AI in medicine and the possible risks of using AI in medicine.

Results

301 doctors took part in the survey. 107 (35.6%) responded that they are familiar with AI. The vast majority of participants considered AI useful in the medical field (85%). The advantage of AI was associated with the ability to analyze huge volumes of clinically relevant data in real time (79%). Respondents highlighted areas where AI would be most useful—organizational optimization (74%), biopharmaceutical research (67%), and disease diagnosis (52%). Among the possible problems when using AI, they noted the lack of flexibility and limited application on controversial issues (64% and 60% of respondents). 56% believe that AI decision making will be difficult if inadequate information is presented for analysis. A third of doctors fear that specialists with little experience took part in the development of AI, and 89% of respondents believe that doctors should participate in the development of AI for medicine and healthcare. Only 20 participants (6.6%) responded that they agree that AI can replace them at work. At the same time, 76% of respondents believe that in the future, doctors using AI will replace those who do not.

Conclusions

Russian doctors are for AI in medicine. Most of the respondents believe that AI will not replace them in the future and will become a useful tool. First of all, for optimizing organizational processes, research and diagnostics of diseases.

Trial registration

This study was approved by the Local Ethics Committee of the Lomonosov Moscow State University Medical Research and Education Center (IRB00010587).
Identification of residues critical for the extension of Munc18-1 domain 3a
Authors: Wang Xianping , Gong Jihong , Zhu Le , Chen Huidan , Jin Ziqi , Mo Xiaoqiang , Wang Shen , Yang Xiaofei , Ma Cong
Published: July 2023

Background

Neurotransmitter release depends on the fusion of synaptic vesicles with the presynaptic membrane and is mainly mediated by SNARE complex assembly. During the transition of Munc18-1/Syntaxin-1 to the SNARE complex, the opening of the Syntaxin-1 linker region catalyzed by Munc13-1 leads to the extension of the domain 3a hinge loop, which enables domain 3a to bind SNARE motifs in Synaptobrevin-2 and Syntaxin-1 and template the SNARE complex assembly. However, the exact mechanism of domain 3a extension remains elusive.

Results

Here, we characterized residues on the domain 3a hinge loop that are crucial for the extension of domain 3a by using biophysical and biochemical approaches and electrophysiological recordings. We showed that the mutation of residues T323/M324/R325 disrupted Munc13-1-mediated SNARE complex assembly and membrane fusion starting from Munc18-1/Syntaxin-1 in vitro and caused severe defects in the synaptic exocytosis of mouse cortex neurons in vivo. Moreover, the mutation had no effect on the binding of Synaptobrevin-2 to isolated Munc18-1 or the conformational change of the Syntaxin-1 linker region catalyzed by the Munc13-1 MUN domain. However, the extension of the domain 3a hinge loop in Munc18-1/Syntaxin-1 was completely disrupted by the mutation, leading to the failure of Synaptobrevin-2 binding to Munc18-1/Syntaxin-1.

Conclusions

Together with previous results, our data further support the model that the template function of Munc18-1 in SNARE complex assembly requires the extension of domain 3a, and particular residues in the domain 3a hinge loop are crucial for the autoinhibitory release of domain 3a after the MUN domain opens the Syntaxin-1 linker region.