bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Risk Factor for Para-Aortic Lymph Node Recurrence After Definite Pelvic Radiotherapy in Stage IIIB Cervical Cancer
Authors: Zhang Guangyu , Wang Cong , Ma Changdong , Miao Li , He Fangfang , Fu Chunli
Published: November 2022

Background: Studies determining which patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIB disease benefit from prophylactic extended-field irradiation (EFRT), which can reduce para-aortic lymph node (PALN) failure rates, are limited. The study was designed to evaluate the value of the controlling nutritional status (CONUT) score as a risk factor for predicting PALN recurrence and identifying potential indications of prophylactic EFRT. Methods: From 2010 to 2015, a retrospective review was conducted among patients with FIGO stage IIIB cervical cancer who were treated with definitive pelvic radiotherapy or concurrent chemoradiotherapy. We analyzed para-aortic lymph node metastasis-free survival (PALNMFS) using Kaplan-Meier curves. Multivariate analyses were performed using Cox regression models. Results: A total of 116 patients with FIGO stage IIIB cervical cancer were included in the study and the median follow-up was 42.2 months (range: 3.5-104.2 months). Multivariate analysis revealed that the CONUT score (HR: 3.141; 95% CI: 2.321-5.436; P < .001) and ≥3 pelvic lymph node metastases (HR: 2.235; 95% CI: 1.428-11.242; P < .001) were independent risk predictors of PALNMFS. Compared with the low CONUT group (score<3), the high CONUT group (score≥3) was associated with a significantly worse 3-year disease-free survival rate (46.9 vs 69.5%, P = .001), a significantly lower 3-year overall survival rate (68.5 vs 79.7%, P = .016) and a significantly lower PALNMFS rate (74.8 vs 96.4%, P < .001). Conclusions: A high CONUT score (score≥3) and ≥3 pelvic metastatic lymph nodes were significant predictors of PALNMFS after pelvic radiation in FIGO stage IIIB cervical cancer patients. Patients with these risk factors might benefit from prophylactic EFRT.
Safety Planning in Context: A Case Study Integrating DBT Techniques and ACT for Overlapping Suicide and Psychosis Risk
Authors: Ceccolini Christopher J. , Friedman-Yakoobian Michelle S. , Yen Shirley , West Michelle L.
Published: November 2022

Suicide risk is markedly higher for clients at clinical high risk for psychosis (CHR-p) compared to the general population. Dialectical behavior therapy (DBT) has a strong evidence base supporting its utility for managing suicide risk. Meanwhile, acceptance and commitment therapy (ACT) has been shown to effectively treat individuals with psychosis symptoms, as well as comorbid anxiety and mood disorders in CHR-p clients. Despite the robust evidence for each of these modalities in addressing concerns around suicidality and psychosis risk independently, there is a paucity of literature on how to support clients experiencing co-occurring suicide and psychosis risk. Such overlapping risk is often central to presenting concerns in CHR-p clients. Our manuscript presents a case example of an integrated DBT-ACT approach to managing risk surrounding both suicide and psychosis symptoms in an outpatient setting. We highlight how an integrated approach may help outpatient providers to implement and modify effective treatment that promotes continued outpatient care focused on goals beyond immediate risk management of both suicide and emerging psychosis. We provide specific examples of DBT techniques and ACT interventions used by a supervised doctoral-level student clinician in treatment with a CHR-p client and discuss implications for future clinical research.
Pyoderma Gangrenosum Triggered by COVID-19 Vaccination in a Patient with Ulcerative Colitis: A Case Report
Authors: Kim Yoon-Chung , Shim Hyung Sup , Jeong Howon , Park Yune-Jung
Published: November 2022

Pyoderma gangrenosum (PG) is a rare inflammatory skin disease that is difficult to diagnose. PG may be an extra-intestinal manifestation of ulcerative colitis (UC). In recent times, coronavirus disease (COVID-19) vaccines have caused various adverse cutaneous reactions. However, to the best our knowledge, combinations thereof have not been reported. We encountered a case of PG triggered by COVID-19 vaccination in a patient with UC. A 40-year-old woman developed severe pain and an abscess in the dorsum of the left foot after receiving the first dose of the messenger RNA (mRNA)-based Pfizer/BioNTech BNT162b2 COVID-19 vaccine. Severe painful ulcers with purulent necrosis and gaseous gangrene progressed rapidly along the extensor tendons and muscles to the toes and ankle. Although surgical debridement can worsen PG by triggering pathergy, we nonetheless performed wide debridement including partial extensor tenotomy with abscess drainage to prevent progression to pyogenic ankle arthritis and to rescue the toes. Antibiotics, corticosteroids, and anticoagulants were prescribed during surgical wound management via negative pressure therapy. After the lesion improved, the skin and soft tissue defect were covered using a superficial circumflex iliac artery perforator free flap and a split-thickness skin graft. The patient was satisfied with the foot salvage, and could walk unaided (without a brace or cane) from 8 weeks after the final surgery. PG may be rare even in UC patients, but mRNA-based COVID-19 vaccines may find an immunosuppressive niche. A high level of caution and suspicion of skin manifestations after vaccination is essential.
Conducting a Large, Longitudinal, Multi-Site Qualitative Study Within a Mixed Methods Evaluation of a UK National Health Policy: Reflections From the GPED Study
Authors: Scantlebury Arabella , Adamson Joy
Published: November 2022

Over the past decade, there has been a growing trend towards the use of ‘big qualitative data’ in applied health research, particularly when used as part of mixed methods evaluations of health policy in England. These ‘big qualitative’ studies tend to be longitudinal, complex (multi-site and multi-stakeholder) and involve the use of multiple methods (interviews, observations, documents) and large numbers of participants ( n = 100+). Despite their growing popularity, there is no methodological guidance or methodological reflection on how to undertake such studies. Qualitative researchers are therefore faced with a series of unknowns when designing large qualitative studies, particularly in terms of knowing whether existing qualitative sampling and analysis methods are appropriate in this context. In this paper, we use our experience of undertaking a big qualitative study, as part of a national mixed methods evaluation of a health policy in England to reflect on some of the key challenges that we faced in our qualitative study, which broadly related to: sample size, data analysis and the role of patient and public engagement. Underpinning these difficulties was the challenge of being flexible and innovative within the largely positivist research climate of applied health research and being comfortable with uncertainty relating to the three issues outlined. The reflections we present are not to be viewed as a method ‘how to’ guide, but rather as a platform to raise key issues relating to the qualitative methods that we found challenging, in order to stimulate discussion and debate amongst the qualitative community. Through this paper, we therefore hope to demystify what it is like to undertake such a study and hope to spark much needed discussion and innovation to support the future design and conduct of qualitative research at scale.
LncRNA MEG3-TRPV1 signaling regulates chronic inflammatory pain in rats
Authors: Peng Jing-Wei , Gu Yin-Yin , Wei Jia , Sun Ye , Zhu Chun-Long , Zhang Ling , Song Yu , Chen Long , Chen Xia , Wang Qian , Zhang Hai-Long
Published: November 2022

Osteoarthritis (OA) is a common osteoarthropathy with chronic inflammatory pain as the core symptom in middle-aged and elderly people. LncRNA MEG3 (Maternally expressed gene 3) is involved in the development of OA via regulation of angiogenesis, which causes the activation and overexpression of transient receptor potential vanilloid type-1 (TRPV1). In this study, we investigated the mechanism of MEG3-TRPV1 signaling in chronic inflammatory pain (CIP) of rat model. Chronic inflammatory pain was modeled using subcutaneous microinjection of complete Freund’s adjuvant (CFA) into the left hind paw of rats. We showed that TRPV1 mRNA and protein were significantly increased, while MEG3 mRNA was significantly decreased, in the DRG and SDH of CFA-induced rats. In addition, intrathecal injection of MEG3-overexpressing lentivirus significantly downregulated TRPV1 expression and alleviated chronic inflammatory pain in CFA-induced rats. Treatment with a TRPV1 antagonist also significantly relieved chronic inflammatory pain in CFA-induced rats. In general, our results reveal that MEG3 alleviates chronic inflammatory pain by downregulating TRPV1 expression. These findings may provide new therapeutic targets in the treatment of patients with OA.
New Mechanistic Insight into the Protective Effects of Ganoderma lucidum Polysaccharides Against Palmitic Acid-Induced Cell Damage in Porcine Intestinal Epithelial Cell Line IPEC-J2
Authors: Liang Zengenni , Yuan Zhi-Hang , Wang Yan , Du Zhong-Hua , Guo Jia-Jing , Xia Ling-Li , Shan Yang
Published: November 2022

Ganoderma lucidum ( G. lucidum) is one of the well-known mushrooms in China, which has G. lucidum polysaccharides (GLP) that have been widely studied for various biological activities, such as antioxidant, antitumor, antiinflammatory, antiviral, antidiabetes, and immunomodulatory activities. A signal transducer and activator of transcription (STAT) signaling pathway is related to cell proliferation and apoptosis. The relationship between STAT and intestinal protection of GLP is still unknown. We studied the inhibitors AG490 in the STAT pathway and its downstream molecules to analyze the unique effects in the protection of GLP against palmitic acid (PA)-induced porcine intestinal epithelial cells (IPEC-J2) injury. Compared to PA treatment, GLP + PA obviously decreased Ca2+ concentration, H2O2 production, NF-E2-related factor 2 (Nrf2) nuclear translocation, STAT1 and STAT2 protein levels, and increased nuclear factor kappa-B (NF-κB) nuclear translocation and p-STAT3/STAT3 ratio in IPEC-J2 cells. After inhibition of STAT3 signaling, p-STAT3/STAT3 ratio, NF-κB nuclear translocation obviously decreased and Nrf2 nuclear translocation significantly increased in the GLP + PA group. The protection of GLP on proliferation and apoptosis of PA-induced IPEC-J2 cells was suppressed by inhibiting STAT3. The STAT3 pathway regulated the enterocyte-protective effects of GLP by modulating the nuclear translocation of Nrf2 and NF-κB. We provide new insights into the mechanism of STAT signaling for the protection of GLP on PA-induced intestinal epithelial cell injury.
Identification of Taohong Siwu Decoction in Treating Chronic Glomerulonephritis Using Network Pharmacology and Molecular Docking
Authors: Du Guoxia , Qu Xiaohan , Hu Jing , Zhang Yuzhen , Cai Yongming
Published: November 2022

Background: Based on network pharmacology and molecular docking technology, the pharmacological mechanism of Taohong Siwu Decoction (THSWD) in the treatment of chronic glomerulonephritis (CGN) was analyzed to provide a theoretical basis for the subsequent development of new drugs and the clinical application of Traditional Chinese Medicine (TCM). Methods: Active ingredients of drugs and disease target genes were obtained from Traditional Chinese Medicine Database and Analysis Platform (TCMSP) database and GeneCards database. The “drug component target” network of THSWD was constructed using Cytoscape version 3.8.2 software. The protein interaction was analyzed using STRING platform, the protein–protein interaction (PPI) network was constructed, and the potential protein function modules in the network were mined. Metascape platform was used to analyze “drug component target” and its biological processes and pathways. The clusterProfiler R package was called to perform kyoto encyclopedia of genes and genomes (KEGG) pathway and gene ontology (GO) function enrichment analysis on CGN-related targets regulated by THSWD. Molecular docking verification was performed by AutoDock Vina software. Results: THSWD has 205 target genes and 45 active components, 104 of which are cross with the CGN inflammatory gene. Its main active ingredients, stigmasterol, kaempferol, and sitosterol, have positive relationships with the inflammatory targets of CGN, tumor necrosis factor (TNF), IL-6, AKT1, and MAPK14. THSWD modulates the biological pathway of CGN and mainly acts on TNF-α signal pathway, interleukin-17 signal pathway, etc., whose main functions are response to lipid sugar, heme binding, G protein-coupled amine receptor activity, etc. The results of molecular docking showed that the main active compounds could bind to the core targets and showed good affinity. Conclusion: The molecular mechanism of THSWD in the treatment of CGN from the perspective of network pharmacology are components such as beta-sitosterol, kaempferol, and quercetin and key action targets such as TNF, IL-6, AKT1 protein kinase, and MAPK14 protein kinase play a synergistic role in autoimmune, infection, and inflammatory response-related pathways.
A systematic review of subcutaneous versus intramuscular or intravenous routes of opioid administration on pain outcomes in cancer and post-surgical clinical populations – challenging current assumptions in palliative care practice
Authors: Fairbairn Lorna , Schuberth Anna , Deacon Laura , Gilkes Hazel , Montgomery Victoria , Bennett Michael I , Mulvey Matthew R
Published: November 2022

Objective

The objective of this review is to investigate the use of the subcutaneous route of administration of analgesics, common practice within palliative medicine.

Design

Systematic review using consensus approach, direct comparison of subcutaneous route with intravenous and intramuscular routes.

Results

The limited available evidence demonstrates non-inferiority of the subcutaneous route in both cancer patients and those post-surgery. Pain management is comparable to other routes. Route-related side effects are rare and systemic side effects are comparable.

Conclusion

Pain management is a critical role of palliative medicine. The subcutaneous route of administration offers a viable option for the delivery of parenteral analgesia within all settings, including the community. This review supports current practice, demonstrating equivalence with more invasive routes of administration.
Curiosity Disturbed the Cat: Instagram’s Sensitive-Content Screens Do Not Deter Vulnerable Users From Viewing Distressing Content
Authors: Bridgland Victoria M. E. , Bellet Benjamin W. , Takarangi Melanie K. T.
Published: November 2022

In an attempt to mitigate the negative impact of graphic online imagery, Instagram has introduced sensitive-content screens—graphic images are obfuscated with a blur and accompanied by a warning. Sensitive-content screens purportedly allow “vulnerable people” with mental-health concerns to avoid potentially distressing content. However, no research has assessed whether sensitive-content screens operate as intended. Here we examined whether people, including vulnerable users (operationalized as people with more severe psychopathological symptoms, e.g., depression), use the sensitive-content screens as a tool for avoidance. In two studies, we found that the majority of participants (80%–85%) indicated a desire (Study 1) or made a choice (Study 2) to uncover a screened image. Furthermore, we found no evidence that vulnerable users were any more likely to use the screens to avoid sensitive content. Therefore, warning screens appear to be an ineffective way to deter vulnerable users from viewing negative content.
Mood Symptom Dimensions and Developmental Differences in Neurocognition in Adolescence
Authors: Kaiser Roselinde H. , Moser Amelia D. , Neilson Chiara , Peterson Elena C. , Jones Jenna , Hough Christina M. , Rosenberg Benjamin M. , Sandman Christina F. , Schneck Christopher D. , Miklowitz David J. , Friedman Naomi P.
Published: November 2022

Adolescence is a critical period of neurocognitive development and increased prevalence of mood pathology. In this cross-sectional study, we replicated developmental patterns of neurocognition and tested whether mood symptoms moderated developmental effects. Participants were 419 adolescents ( n = 246 with current mood disorders) who completed reward-learning and executive-functioning tasks and reported on age, puberty, and mood symptoms. Structural equation modeling revealed a quadratic relationship between puberty and reward-learning performance that was moderated by symptom severity: In early puberty, adolescents reporting higher manic symptoms exhibited heightened reward-learning performance (better maximizing of rewards on learning tasks), whereas adolescents reporting elevated anhedonia showed blunted reward-learning performance. Models also showed a linear relationship between age and executive functioning that was moderated by manic symptoms: Adolescents reporting higher mania showed poorer executive functioning at older ages. Findings suggest neurocognitive development is altered in adolescents with mood pathology and suggest directions for longitudinal studies.
Incidental Durotomy Repair in Lumbar Spine Surgery: Institutional Experience and Review of Literature
Authors: Albayar Ahmed , Spadola Michael , Blue Rachel , Saylany Anissa , Dagli Mert Marcel , Santangelo Gabrielle , Wathen Connor , Ghenbot Yohannes , Macaluso Dominick , Ali Zarina S. , Ozturk Ali K. , Welch William C.
Published: November 2022

Study Design

: Retrospective Chart Review.

Objectives

Incidental durotomies (IDs) are common spine surgery complications. In this study, we present a review on the most commonly utilized management strategies, report our institutional experience with case examples, and describe a stepwise management algorithm.

Methods

A retrospective review was performed of the electronic medical records of all patients who underwent a thoracolumbar or lumbar spine surgery between March 2017 and September 2019. Additionally, a literature review of the current management approaches to treat IDs and persistent postoperative CSF leaks following lumbar spine surgeries was performed.

Results

We looked at 1133 patients that underwent posterior thoracolumbar spine surgery. There was intraoperative evidence of ID in 116 cases. Based on our cohort and the current literature, we developed a progressive treatment algorithm for IDs that begins with a primary repair, which can be bolstered by dural sealants or a muscle patch. If this fails, the primary repair can be followed by a paraspinal muscle flap, as well as a lumbar drain. If the patient cannot be weaned from temporary CSF diversion, the final step in controlling postoperative leak is longterm CSF diversion via a lumboperitoneal shunt. In our experience, these shunts can be weaned once the patient has no further clinical or radiographic signs of CSF leak.

Conclusions

There is no standardized management approach of IDs and CSF leaks in the literature. This article intends to provide a progressive treatment algorithm and contribute to the development process of a treatment consensus.
Paradoxical Politics? Partisan Politics, Ethnoracial Ideologies, and the Assimilated Consciousnesses of Latinx Republicans
Authors: Cadena Roger Sargent
Published: November 2022

Because of the Republican Party’s racist rhetoric, Latinx Republicans are considered paradoxes as their partisanship contradict perceptions of Latinxs’ sociopolitical interests. Methodologically departing from prior Latinx politics research, this study employs qualitative methods to understand how Latinx Republicans interpretively link ethnoracial and partisan identities. Drawing on original interviews with Latinx Republicans, I argue that respondents are not paradoxes but strategic actors engaging in politics that align with respondents’ interpretations of their social identities. Specifically, I develop the concept of “assimilated consciousness”—how Latinx Republicans politicize ethnoracial identity by disaggregating Latinx groupness and positioning themselves in opposition to other racialized people. I show how most respondents reject seeing racism as systemic, perceive themselves as assimilated, and subsequently use interpretive tools to distance themselves from other Latinxs and Black Americans; minimize racist Republican rhetoric; and maximize problematic Democratic rhetoric. In doing so, respondents reconcile the relationship between their ethnoracial and partisan identifications. I further employ the concept of assimilated consciousness to show how a minority of respondents rejected the Republican Party due to Trump’s and Trump supporters’ racist rhetoric. Overall, I contend my findings provide a better understanding of how racialized immigration processes shape ethnoracial and political identities.
Dark-coloured Mn-rich overgrowths in an elbaitic tourmaline crystal from the Rosina pegmatite, San Piero in Campo, Elba Island, Italy: witness of late-stage opening of the geochemical system
Authors: Altieri Alessandra , Pezzotta Federico , Skogby Henrik , Hålenius Ulf , Bosi Ferdinando
Published: November 2022

Multicoloured tourmalines from Elba Island, commonly display dark-coloured terminations due to incorporation of Fe, and also occasionally Mn. The mechanisms which led to the availability of these elements in the late-stage residual fluids are not yet completely understood. For this purpose, we investigated a representative tourmaline crystal found naturally in two fragments within a wide miarolitic cavity in the Rosina pegmatite (San Piero in Campo, Elba Island, Italy), and characterised by late-stage dark-coloured overgrowths. Microstructural and paragenetic observations, together with compositional and spectroscopic data (electron microprobe and optical absorption spectroscopy), provide evidence which shows that the formation of the dark-coloured Mn-rich overgrowths are the result of a pocket rupture. This event caused alteration of the cavity-coating spessartine garnet by highly-reactive late-stage cavity fluids by leaching processes, with the subsequent release of Mn to the residual fluids. We argue that the two fragments were originally a single crystal, which underwent natural breakage followed by the simultaneous growth of Mn-rich dark terminations at both breakage surfaces. This conclusion supports the evidence for a pocket rupture event, responsible for both the shattering of the tourmaline crystal and the compositional variation of the cavity-fluids related to the availability of Mn, which was incorporated by the tourmaline crystals. Additionally, a comparison of the dark overgrowths formed at the analogous and the antilogous poles, provides information on tourmaline crystallisation at the two different poles. The antilogous pole is characterised by a higher affinity for Ca, F and Ti, and a selective uptake of Mn2+, even in the presence of a considerable amount of Mn3+ in the system. This uneven uptake of Mn ions resulted in the yellow–orange colouration of the antilogous overgrowth (Mn2+ dependent) rather than the purple-reddish colour of the analogous overgrowths (Mn3+ dependent).
CARD9 contributes to ovarian cancer cell proliferation, cycle arrest, and cisplatin sensitivity
Authors: Wang Yanming , Wang Chao , Zhu Yan
Published: November 2022

Background

Ovarian cancer recurrence and chemotherapy resistance are still urgent issues, and exploring the mechanisms of metastasis and chemotherapy resistance is beneficial to the development of therapeutic methods. Caspase recruitment domain family member 9 (CARD9) and homeobox B5 (HOXB5) are related and both are upregulated in ovarian cancer. This study aimed to define their functions in ovarian cancer cell proliferation, migration, and cisplatin sensitivity.

Results

The levels of CARD9 were detected in acquired ovarian cancer tissues and cell lines. CARD9 was indeed abnormally upregulated in them. CARD9 knockdown significantly suppressed cell proliferation, colony formation, migration, cycle arrest, and cisplatin sensitivity. HOXB5 bound to the CARD9 promoter, and HOXB5 overexpression reversed the regulation by CARD9 knockdown in cells, as well as the activation of NF-κB signaling. This indicated that CARD9 was positively regulated by HOXB5 in ovarian cancer cells.

Conclusion

Together, CARD9 is involved in ovarian cancer cell proliferation, migration, and cisplatin sensitivity via NF-κB signaling after transcriptional activation by HOXB5.
The mitochondrial genome sequence of Abies alba Mill. reveals a high structural and combinatorial variation
Authors: Kersten Birgit , Rellstab Christian , Schroeder Hilke , Brodbeck Sabine , Fladung Matthias , Krutovsky Konstantin V. , Gugerli Felix
Published: November 2022

Background

Plant mitogenomes vary widely in size and genomic architecture. Although hundreds of plant mitogenomes of angiosperm species have already been sequence-characterized, only a few mitogenomes are available from gymnosperms. Silver fir (Abies alba)is an economically important gymnosperm species that is widely distributed in Europe and occupies a large range of environmental conditions. Reference sequences of the nuclear and chloroplast genome ofA. albaare available, however, the mitogenome has not yet been assembled and studied.

Results

Here, we used paired-end Illumina short reads generated from a single haploid megagametophyte in combination with PacBio long reads from high molecular weight DNA of needles to assemble the first mitogenome sequence ofA. alba. Assembly and scaffolding resulted in 11 mitogenome scaffolds, with the largest scaffold being 0.25 Mbp long. Two of the scaffolds displayed a potential circular structure supported by PCR. The total size of theA. albamitogenome was estimated at 1.43 Mbp, similar to the size (1.33 Mbp) of a draft assembly of theAbies firmamitogenome. In total, 53 distinct genes of known function were annotated in theA. albamitogenome, comprising 41 protein-coding genes, nine tRNA, and three rRNA genes. The proportion of highly repetitive elements (REs) was 0.168. The mitogenome seems to have a complex and dynamic structure featured by high combinatorial variation, which was specifically confirmed by PCR for the contig with the highest mapping coverage. Comparative analysis of all sequenced mitogenomes of gymnosperms revealed a moderate, but significant positive correlation between mitogenome size and proportion of REs.

Conclusions

TheA. albamitogenome provides a basis for new comparative studies and will allow to answer important structural, phylogenetic and other evolutionary questions. Future long-read sequencing with higher coverage of theA. albamitogenome will be the key to further resolve its physical structure. The observed positive correlation between mitogenome size and proportion of REs will be further validated once available mitogenomes of gymnosperms would become more numerous. To test whether a higher proportion of REs in a mitogenome leads to an increased recombination and higher structural complexity and variability is a prospective avenue for future research.
Predictive values of the modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance to predict difficult laryngoscopy in pediatric elective surgical patients 5–12 years old at selected Addis Ababa governmental hospitals, Ethiopia: a multicenter cross-sectional study
Authors: Sitot Mulualem , Amare Wubayehu , Aregawi Adugna
Published: November 2022

Background

Maintaining patent airways is vital in pediatric anesthetic management. Failure to manage and anticipate difficult laryngoscopy (DL) preoperatively is the leading cause of morbidity and mortality. Data on the predictive values of screening parameters in predicting DL are limited in children. Therefore, this study aimed to assess the predictive value of the modified Mallampati test (MMT), upper lip bite test (ULBT), thyromental distance (TMD), and ratio of height to thyromental distance (RHTMD) in predicting DL in children aged 5–12 years at selected Addis Ababa governmental hospitals in Ethiopia.

Methods

A multicenter cross-sectional study was conducted on 141 elective pediatric surgical patients aged 5 to 12 years selected using a systematic random sampling technique at three governmental hospitals from December 1, 2021, to April 30, 2022. The collected data were entered and analysed by SPSS version 26. Chi-square and Fisher’s exact tests were used to compare categorical variables. The receiver operating characteristic curve analysis was used to compare the accuracy of MMT, ULBT, TMD, and RHTMD against DL. A P value < 0.05 was considered statistically significant.

Results

The magnitude of DL was 15.6%. MMT has the highest sensitivity (86.4%), specificity (91.6%), and negative predictive value (NPV) (97.3%) compared to other tests. The ULBT also has a high sensitivity (72.7%) and specificity (84%) with comparable diagnostic accuracy (90.8%) with the MMT (P < 0.05). The sensitivity, specificity, positive predictive value (PPV), NPV, and accuracy of TMD were 63.6%, 95.8%, 73.7%, 93.4%, and 82.2%, respectively. The RHTMD has the lowest specificity (63.6%), PPV (22.5%), NPV (91.4%), and accuracy (56.7%) in predicting DL.

Conclusion

The MMT and ULBT are good screening tests, followed by the TMD in predicting DL, while the RHTMD was the least accurate predictor. Because no single test has 100% predictive value, a combination of screening tests is advised in pediatrics for predicting DL.
Latent trajectories of frailty and risk prediction models among geriatric community dwellers: an interpretable machine learning perspective
Authors: Wu Yafei , Jia Maoni , Xiang Chaoyi , Fang Ya
Published: November 2022

Background

This study aimed to identify long-term frailty trajectories among older adults (≥65) and construct interpretable prediction models to assess the risk of developing abnormal frailty trajectory among older adults and examine significant factors related to the progression of frailty.

Methods

This study retrospectively collected data from the Chinese Longitudinal Healthy Longevity and Happy Family Study between 2002 and 2018 (N = 4083). Frailty was defined by the frailty index. The whole study consisted of two phases of tasks. First, group-based trajectory modeling was used to identify frailty trajectories. Second, easy-to-access epidemiological data was utilized to construct machine learning algorithms including naïve bayes, logistic regression, decision tree, support vector machine, random forest, artificial neural network, and extreme gradient boosting to predict the risk of long-term frailty trajectories. Further, Shapley additive explanations was employed to identify feature importance and open-up the black box model of machine learning to further strengthen decision makers’ trust in the model.

Results

Two distinct frailty trajectories (stable-growth: 82.54%, rapid-growth: 17.46%) were identified. Compared with other algorithms, random forest performed relatively better in distinguishing the stable-growth and rapid-growth groups. Physical function including activities of daily living and instrumental activities of daily living, marital status, weight, and cognitive function were top five predictors.

Conclusions

Interpretable machine learning can achieve the primary goal of risk stratification and make it more transparent in individual prediction beneficial to primary screening and tailored prevention.
First trend analysis of antifungals consumption in Lebanon using the World Health Organization collaborating center for drug statistics methodology
Authors: Rahme Deema , Ayoub Mayssam , Shaito Khalil , Saleh Nadine , Assaf Sara , Lahoud Nathalie
Published: November 2022

Background

Antimicrobial resistance has reached an alarming rate globally, especially in middle-income countries such as Lebanon. The development of antifungal resistance is associated with the increased population’s injudicious consumption. This study aims to measure antifungals consumption in Lebanon as a trend analysis of national data from 2004 to 2018.

Methods

This is a trend analysis of the consumption of antifungal agents in the Lebanese community. Data were obtained from the Intercontinental Marketing Statistics Database between 2004 and 2018. It measures the total consumptions per year, per drug, and the percentage of its correspondents for three routes of administration (oral, parenteral, and topical). Results were reported by Defined Daily Dose (DDD) per 1000 inhabitants per day and the total number of DDDs.

Results

Community consumption of antifungals in Lebanon has increased by approximately 18.64% between 2004 and 2018, as measured by the number of DDDs per 1000 inhabitants per day; and amplified by approximately 87.76% as measured by the number of DDDs. The highest consumption level was noted in 2017, with 1.52 DDDs/1000 inhabitants/day and 3,386,930 DDDs. Fluconazole was the most consumed antifungal while micafungin was the least with 6,723,869.2 (20.99%) and 48.5 (0.0002%) DDDs respectively. Topical antifungals ranked the first type consumed followed by oral and parenteral antifungals representing 51.72%, 48.24%, and 0.033% of the total consumption respectively.

Conclusion

The findings from this study indicate a marked increase in antifungal consumption in the Lebanese community. This accelerates the need of implementing disease management guidelines and national antifungal stewardship. Moreover, these findings may be used in further benchmark utilization and antimicrobial resistance studies in Lebanon.
Health information sharing on social media: quality assessment of short videos about chronic kidney disease
Authors: Yao Lan , Li Yubao , Lian Qinglou , Sun Junjun , Zhao Shuyin , Wang Pei
Published: November 2022

Introduction

Chronic kidney disease (CKD), which affects about 10% of global population, has become a global public health crisis in recent decades. It is well recognized that health information dissemination could change health behaviors, thereby greatly improving the early diagnosis and prevention of diseases. Due to fast dissemination, wide audience, intuitive and vivid, popularization through short videos has rapidly developed into the new main battlefield of health information. The objective of this study was to describe the properties of the CKD-related health information on short video apps.

Methods

Searching on short video apps with high-frequency words in kidney disease as keywords, the basic information of the uploaders was retrieved and extracted short video. Five quality dimensions, awareness, popularity, utility, validity and quality, of each video were assessed with numeric rating scale (NRS) by five volunteers with CKD and three nephrologists.

Results

From the platform of douyin, 65 uploaders and their 3973 short videos of CKD-related health information were investigated in this study. Most information of short videos had relatively high level in awareness, popularity and utility assessment, but some information had relatively low level in validity and quality assessment; 24 (36.9%) uploaders were from governmental hospital (tertiary hospital); 19 uploaders (29.2%) uploaded more than 100 short videos and 49 uploaders (75.4%) updated their videos weekly, and 16 uploaders (24.6%) didn’t update short videos more than one month. There were 4 uploaders (6.2%) have more than 1 million follows, and 39 uploaders (60%) had follows less than 10,000. “Lifestyles”, “Common symptoms of kidney disease” and “Nephritis or kidney disease” were the three main contents of these short videos. The comprehensive data of uploaders with millions of follows in nephrology specialty were much lower than that of orthopedics and other specialty.

Conclusion

The validity and quality of short video is still unsatisfactory, and CKD-related health information also need to be led and improved, although the awareness, popularity, and utility of health information about CKD is acceptable. The public should be selective and cautious in seeking CKD information on social media.
High mesothelin expression is correlated with non-squamous cell histology and poor survival in cervical cancer: a retrospective study
Authors: Takamizawa Shigemasa , Yazaki Shu , Kojima Yuki , Yoshida Hiroshi , Kitadai Rui , Nishikawa Tadaaki , Shimoi Tatsunori , Sudo Kazuki , Okuma Hitomi Sumiyoshi , Tanioka Maki , Noguchi Emi , Uno Masaya , Ishikawa Mitsuya , Kato Tomoyasu , Fujiwara Yasuhiro , Yonemori Kan
Published: November 2022

Background

Mesothelin (MSLN) is a cell-surface glycoprotein found in various solid tumours. Cancer therapies targeting MSLN have been developed in recent years; however, the available information on MSLN expression in cervical cancer is limited. This study aimed to evaluate MSLN expression in various histological types of cervical cancer and examine its relationship with prognosis.

Methods

This retrospective study included patients with cervical cancer who underwent primary surgery between January 2000 and December 2020 at our institution. MSLN expression was evaluated by immunohistochemistry using clone SP74 and defined as positive if MSLN was expressed at any intensity. High MSLN expression was defined as an intensity of ≥ 2 + in ≥ 30% of tumour cells. The association between MSLN expression and clinicopathological factors was evaluated.

Results

Overall, 123 patients were identified, and 140 tumour samples, including 17 paired primary and metastatic samples, were evaluated. Concerning histological type, 67 patients had squamous cell carcinoma (SCC), whereas 56 had non-SCC. MSLN expression was observed in 98.4% (121/123) of primary tumours. High MSLN expression was observed in 63.4% of samples (78/123), but it differed between the histological types (49.2% for SCC vs. 80.4% for non-SCC, p < 0.001). There was a significant correlation between MSLN expression in primary and metastatic lesions (Rs = 0.557, p = 0.015). In patients with common histological types, overall survival (OS) was shorter in the high MSLN expression group than in the low MSLN expression group (hazard ratio, 3.53; 95% confidence interval, 1.16–15.3, p = 0.03).

Conclusions

MSLN was highly expressed in patients with cervical cancer, especially in those with non-SCC. High MSLN expression in the primary lesion was significantly associated with poor OS, and its expression was maintained in metastatic lesions. Our findings indicate that MSLN may be an attractive therapeutic target for cervical cancer.

Trial registration

Retrospectively
registered. 2014-393.
1 June 2015
The effect of the street environment on two types of essential physical activity in industrial neighborhoods from the perspective of public health: a study from the Harbin low-income population health survey, China
Authors: Hou Yunjing , Zhai Chaofan , Chen Xiyu , Li Wen
Published: November 2022

A large number of low-income residents in industrial neighborhoods rarely engage in recreational and physical activities in green spaces in extremely cold weather. This study mainly explores the relationship between the street environment and physical activities under special industrial properties and extreme cold weather conditions. In addition, we further divide essential physical activity into two categories, life-type and traffic-type physical activity, to explore and refine the related studies.

We use principal component analysis to classify the street environment indicators and use multiple linear regression to analyze the impact of each indicator on different physical activities. The conclusions are as follows. For low-income people, the street environment in industrial neighborhoods has a much greater impact on life-type physical activity than traffic-type physical activity, and there is a conflict between the two. In addition, a high greening density is not conducive to either type of physical activity in the street environment. It reduces the paved area of streets and create sports conflicts between people undertaking different physical activities. The findings contribute to the development and optimization of public health research on environmental interventions in industrial neighborhood streets and enable effective recommendations for increasing outside physical activity among low-income people in severe weather conditions. In future studies, we will use the physical environment as a mediator to explore the relationship between the street environment and high-frequency chronic diseases in old industrial neighborhoods.
Study protocol for an effectiveness-implementation hybrid trial to evaluate a health promotion intervention in parents and their 5-year-old child: Saga Stories in health talks in Swedish child healthcare
Authors: Delisle Nyström Christine , Henström Maria , Andermo Susanne , Almquist-Tangen Gerd , Thomas Kristin , Löf Marie
Published: November 2022

Background

Unhealthy lifestyle behaviours such as a poor diet, inadequate physical activity, and excessive screen time have been shown to be established in childhood and track into adulthood, demonstrating the need for health promotion interventions in the pre-school years. The overall aim of this project is to: (i) evaluate the effectiveness of `Saga Stories in health talks´ within child healthcare (CHC) on parental self-efficacy to promote healthy diet, physical activity, and screen time behaviours in their child; children’s intake of key dietary indicators and screen time and (ii) evaluate and explore the implementation of `Saga Stories in health talks´ with regards to acceptability, appropriateness, feasibility, fidelity, adoption, sustainability, satisfaction, and usage.

Methods

A hybrid type I effectiveness-implementation trial will be conducted. A cluster randomized controlled trial will be used to assess the effectiveness of `Saga Stories in health talks´ in 42 CHC centers across six regions in Sweden. `Saga Stories in health talks´ consists of material for CHC nurses to use to facilitate the health talk with both the child and parent(s) and is complemented with take-home material. Parent and child dyads are recruited (n = 450) from participating CHC centers when they attend their 5-year routine visit. The intervention group receives the health talk using Saga Stories and take-home material, whereas the control group receives the standard health talk. The primary outcome is parental self-efficacy to promote healthy diet, physical activity, and screen time behaviours in their child and secondary outcomes include children’s intake of key dietary indicators and screen time. All outcomes are assessed at baseline and 2-months post-intervention. The implementation outcomes that will be assessed are: acceptability, appropriateness, feasibility, satisfaction, usage, fidelity, adoption, and sustainability (assessed quantitatively and qualitatively).

Discussion

The Swedish National Board of Health and Welfare have identified the need of more material, education, and working methods for promoting healthy lifestyle behaviours in CHC. Following this trial `Saga Stories in health talks´ has great potential to be implemented in CHC across Sweden to aid nurses to promote and support healthy lifestyle behaviours in pre-school children and their families.

Trial registration

ClinicalTrials.gov,NCT05237362. Registered 2 February 2022.
Rural urban differences in self-rated health among older adults: examining the role of marital status and living arrangements
Authors: Saha Amiya , Rahaman Margubur , Mandal Bittu , Biswas Sourav , Govil Dipti
Published: November 2022

Background

The rural–urban gap in socioeconomic and morbidity status among older adults is prevalent in India. These disparities may impact the levels and factors of self-rated health (SRH). The objective of the study is to compare the levels and determinants of SRH between rural and urban areas by considering the moderating effects of marital status and living arrangements.

Subjects and methods

The present study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017–18). A total sample of 30,633 older adults aged 60 years and above were selected for the study. Descriptive statistics, bivariate chi-square test, the interaction effect of living arrangements and marital status, and logistic estimation were applied to accomplish the study objectives.

Results

The prevalence of poor SRH was found 7% higher in rural areas compared to urban counterparts. A substantial rural–urban disparity in the patterns of poor SRH was also observed. The interaction effect of marital status and living arrangement on self-rated health suggested that older adults who were currently unmarried and living alone were 38% more likely to report poor SRH than those who were currently married and co-residing in rural India. In addition to marital status and living situation, other factors that significantly influenced SRH include age, socio-cultural background (educational attainment and religion), economic background (employment status), health status (ADLs, IADLs, multi-morbidities), and geographic background (region).

Conclusion

The present study's findings demonstrated that, notwithstanding local variations, marital status and living circumstances significantly influenced SRH in India. In the present study, unmarried older people living alone were more susceptible to poor SRH in rural areas. The present study supports the importance of reinforcing the concepts of care and support for older individuals. There is a need for special policy attention to older individuals, particularly those unmarried and living alone. Although older individuals had difficulty performing ADLs and IADLs and had multi-morbidities, they reported poorer health. Therefore, offering them social support and top-notch medical assistance is crucial.