bluuebunny/crossref_metadata_2025 huggingface dataset:
Bedside ultrasonography prior to abdominal paracentesis is associated with low complication and high success rate: Experience in a National Health Service District General Hospital in the United Kingdom from 2013 to 2019
Authors: Droste Jan C , Riggott Christy , Maxfield Tracey , Zoltowski Anna
Published: June 2022

Aims/Background:

To analyse data from a bedside ultrasound-assisted ascites procedure service in a National Health Service District General Hospital and compare them to results of studies in the medical literature.

Methods:

A retrospective review of audit data collected (January 2013 to December 2019) of the practice of paracentesis in a National Health Service District General hospital. All adult patients referred to the ascites assessment service were included. Bedside ultrasound detected location and volume of ascites, if present. Abdominal wall diameters were determined in order to select the appropriate needle length for procedures. Results and scan images were recorded on a pro-forma. Patients who underwent a procedure were followed up for 7 days, with complications documented.

Results:

Seven hundred and two scans were performed on 282 patients – 127 (45%) male and 155 (55%) female. In 127 (18%) patients, an intervention was avoided. Five hundred forty-five (78%) patients underwent a procedure: 82 (15%) were diagnostic aspirations and 463 (85%) were therapeutic (large volume) paracentesis. Most scans were performed between 08:00–17:00. Average time from patient assessment to diagnostic aspiration was 4 hours 21 minutes. Complications included three failed procedures (0.6%) and one iatrogenic peritonitis (0.2%), but no bowel perforation, no major haemorrhage or death.

Conclusion:

It is possible to introduce a bedside ultrasound-assisted ascites procedure service to a National Health Service District General Hospital with a high success and low complication rate.
Phytohormone abscisic acid ameliorates neuropathic pain via regulating LANCL2 protein abundance and glial activation at the spinal cord
Authors: Maixner Dylan W , Christy David , Kong Lingwei , Viatchenko-Karpinski Viacheslav , Horner Kristen A , Hooks Shelley B , Weng Han-Rong
Published: June 2022

Spinal neuroinflammation plays a critical role in the genesis of neuropathic pain. Accumulating data suggest that abscisic acid (ABA), a phytohormone, regulates inflammatory processes in mammals. In this study, we found that reduction of the LANCL2 receptor protein but not the agonist ABA in the spinal cord is associated with the genesis of neuropathic pain. Systemic or intrathecal administration of ABA ameliorates the development and pre-existence of mechanical allodynia and heat hyperalgesia in animals with partial sciatic nerve ligation (pSNL). LANCL2 is expressed only in microglia in the spinal dorsal horn. Pre-emptive treatment with ABA attenuates activation of microglia and astrocytes, ERK activity, and TNFα protein abundance in the dorsal horn in rats with pSNL. These are accompanied by restoration of spinal LANCL2 protein abundance. Spinal knockdown of LANCL2 gene with siRNA recapitulates the behavioral and spinal molecular changes induced by pSNL. Activation of spinal toll-like receptor 4 (TLR4) with lipopolysaccharide leads to activation of microglia, and over production of TNFα, which are concurrently accompanied by suppression of protein levels of LANCL2 and peroxisome proliferator activated-receptor γ. These changes are ameliorated when ABA is added with LPS. The anti-inflammatory effects induced by ABA do not requires Gi protein activity. Our study reveals that the ABA/LANCL2 system is a powerful endogenous system regulating spinal neuroinflammation and nociceptive processing, suggesting the potential utility of ABA as the management of neuropathic pain.
Long-term outcomes after extension block pinning for fracture-dislocations of the proximal interphalangeal joint
Authors: Nordback Panu H. , Westman Marjut , Waris Eero
Published: June 2022

The long-term outcomes of extension block pinning used to treat unstable dorsal fracture-dislocations of the proximal interphalangeal joint have been investigated in a single centre. Thirty-one patients (33 fingers) had a clinical and radiological assessment at a mean follow-up of 16 years. Excluding one joint salvaged with an arthrodesis, the mean active range of motion of the joints was 80° with a mean 5° extension deficit. The mean active range of motion of the distal interphalangeal joint was 64°. The mean Patient-Rated Wrist and Hand Evaluation score was 6, indicating, minimal disability. The mean numeric rating scale for overall subjective pain on a scale of 0–10 was 1 and was not associated with the active range of movement. The Kallman osteoarthritis score and the range of movement of the proximal interphalangeal joint had a negative association. The long-term outcomes were satisfactory and similar to the mid-term follow-up results of the same patient cohort reported 11 years earlier.

Level of evidence

IV
Triterpene Tetraglycosides From Stichopus Herrmanni Semper, 1868
Authors: Vien Le Thi , Hanh Tran Thi Hong , Quang Tran Hong , Thanh Nguyen Van , Thao Do Thi , Cuong Nguyen Xuan , Nam Nguyen Hoai , Thung Do Cong , Van Kiem Phan
Published: June 2022

Using various column chromatographic methods, 5 triterpene tetraglycosides (1−5), including one new compound, namely holothurin A6 (1), were obtained from the water soluble part of the methanol extract of the sea cucumber Stichopus herrmanni. Their structures were confirmed by careful analysis of the 1D and 2D NMR, and HR ESI QTOF mass spectra. Noteworthily, 24-dehydroechinoside A (3) showed potent cytotoxicity to 5 human cancer cell lines {HepG2 (hepatoma cancer), KB (epidermoid carcinoma), LNCaP (prostate cancer), MCF7 (breast cancer), and SK-Mel2 (melanoma)} with IC50 values ranging from 0.19 ± 0.03 to 1.17 ± 0.18 µM.
Roll on that day: A dialectical poetry
Authors: Chatterjee Ipsita
Published: June 2022

Phil O’ Keefe’s Roll on that day is not just poetry, but a dialectical materialist rendition of reality. In this tribute, I refer to his poetry as “rendition,” rather than, interpretation. O’ Keefe renders nature, time, and space not as separate and discrete, but as a complete assemblage of hope and fear; second, he renders resources, labor, and landscape as simultaneously “nature(al)” and produced. “Rendering” as opposed to “interpreting” is O’Keefe’s Marxist poetic justice because “rendition” is reality communicated, expressed, viewed, and revealed in the richness of its relationality. Rendition is poetic and dialectical. Interpretation, on the other hand, involves the treatment of data collected through externalization and segmentation, a prosaic analysis that externalizes nature as an environment to be prodded, tabulated, experimented, and fixed. Inspired by O’ Keefe’s poetry, I trace Marxist concepts of alienation and commodification of nature, arguing that O’Keefe’s poetry provides a dialectical ebb and flow which disrupts teleology and provides a conceptual lens to understand modes of production not as discrete or ahistorical, but instead, as containing seeds of the previous modes of production. This tribute concludes by emphasizing O’Keefe’s contention that development has to be decolonized, that uneven development is the death of dialectical poetry and the victory of analytical prose, that theorists must begin with an honest acceptance that development theory is simultaneously a response to the effects of capital and are conditioned by it.
Clinical Guideline for Management of Down Syndrome in Singapore
Authors: Sothirasan Kavitha , Anand Amudha Jayanthi , Chua Melvin Peng Wei , Khoo Poh Choo , Chien Chua Mei
Published: June 2022

Physicians play a pivotal role in the management of children and adults with Down Syndrome. Achieving full developmental potential in a child with Down Syndrome depends on prompt treatment of medical complications, family support and early establishment of intervention programmes. The presence of evidence-based guidelines support the physician both in the community and in restructured hospitals to provide timely and appropriate management recommendations. It will also aid in counselling parents and caregivers. Although most co-morbidity characteristics are common for the syndrome, the prevalence of different morbidities can be region specific, hence it is useful to have recommendations tailored to suit local population. Here we share the clinical guideline for children and adults with Down Syndrome in Singapore.
Fostering Ecosystem Services for Mitigating Climate Change and Sustaining Food Production Systems in Developing Economies
Authors: Etowa Egbe B. , Effa Emmanuel B. , Nzogbu Ugochukwu I. , Badiru Evilla Olabiyi
Published: June 2022

Among the greatest challenges of the 21st century is maintaining biodiversity and ecosystem services (ESs) to sustainably feed the projected 9–10 billion people of the world by 2050. Presently, incentives to preserve ESs in developing economies are limited, implying that there are no direct market mechanisms to signal the scarcity or degradation of a service until it fails. ESs are public goods with no direct owners. Hence, payment for ecosystem services (PES) is a voluntary transaction that aims at filling this gap by creating a new market for services, including carbon sequestration, biodiversity conservation, watershed protection and landscape values. Emerging PES has challenged the culture of natural resource depletion without consideration of sustainability. Sustainability is core of climate change vortex, and developing economies are worst hit. Food insecurity and failing agricultural systems will further endanger the fragile balance of life in the region. Until the right approaches to de-risking ecosystem sustainability emerge, the perpetrators of climate change will keep getting away with the harmful effects to our corporate existence. This treatise critically examined how ESs can foster sustainable food production given their holistic inter-relatedness to the subject of climate change mitigation, in the light of global development goals.
Critical Care Nurses’ Experiences Caring for Patients When Relatives Were not Allowed in the ICUs due to COVID-19 Pandemic
Authors: Stenman Lina , Högberg Lisa , Engström Åsa
Published: June 2022

Introduction

Health care workers faced new challenges during the COVID-19 pandemic when physical contact with relatives more or less disappeared.

Objectives

The aim of this study is to describe the experiences of critical care nurses (CCNs) working in intensive care units (ICUs) under the visiting restrictions imposed as a result of COVID-19.

Method

This study followed a qualitative design. The purposive sample included CCNs with at least 1 year of experience working in an ICU with a visiting policy affected by the pandemic. Data collection was carried out via semi-structured interviews and analyzed through a qualitative content analysis with an inductive approach.

Results

The study results are presented in three categories with 10 subcategories. CCNs value the presence of patients’ relatives at the bedside and described many challenges when relatives could not be present with the patient during the pandemic.

Conclusion

Close relatives are able to share essential information about the patients and provide much-needed emotional support to them, the relatives’ role is of central importance and CCNs value their presence in ICUs more than any positive consequences of them not being there.
Monitoring the well-being of vulnerable transit riders using machine learning based sentiment analysis and social media: Lessons from COVID-19
Authors: Tran Martino , Draeger Christina , Wang Xuerou , Nikbakht Abbas
Published: June 2022

Using open-source data, we show that despite significant reductions in global public transit during the COVID-19 pandemic, ∼20% of ridership continues during social distancing measures. Current urban transport data collection methods do not account for the distinct behavioural and psychological experiences of the population. Therefore, little is known about the travel experience of vulnerable citizens that continue to rely on public transit and their concerns over risk, safety and other stressors that could negatively affect their health and well-being. We develop a machine learning approach to augment conventional transport data collection methods by curating a population segmented Twitter dataset representing the travel experiences of ∼120,000 transit riders before and during the pandemic in Metro Vancouver, Canada. Results show a heightened increase in negative sentiments, differentiated by age, gender and ethnicity associated with public transit indicating signs of psychological stress among travellers during the first and second waves of COVID-19. Our results provide empirical evidence of existing inequalities and additional risks faced by citizens using public transit during the pandemic, and can help raise awareness of the differential risks faced by travellers. Our data collection methods can help inform more targeted social-distancing measures, public health announcements, and transit monitoring services during times of transport disruptions and closures.
Multimorbidity and mortality: A data science perspective
Authors: Siah Kien Wei , Wong Chi Heem , Gupta Jerry , Lo Andrew W
Published: June 2022

Background

With multimorbidity becoming the norm rather than the exception, the management of multiple chronic diseases is a major challenge facing healthcare systems worldwide.

Methods

Using a large, nationally representative database of electronic medical records from the United Kingdom spanning the years 2005–2016 and consisting over 4.5 million patients, we apply statistical methods and network analysis to identify comorbid pairs and triads of diseases and identify clusters of chronic conditions across different demographic groups. Unlike many previous studies, which generally adopt cross-sectional designs based on single snapshots of closed cohorts, we adopt a longitudinal approach to examine temporal changes in the patterns of multimorbidity. In addition, we perform survival analysis to examine the impact of multimorbidity on mortality.

Results

The proportion of the population with multimorbidity has increased by approximately 2.5 percentage points over the last decade, with more than 17% having at least two chronic morbidities. We find that the prevalence and the severity of multimorbidity, as quantified by the number of co-occurring chronic conditions, increase progressively with age. Stratifying by socioeconomic status, we find that people living in more deprived areas are more likely to be multimorbid compared to those living in more affluent areas at all ages. The same trend holds consistently for all years in our data. In general, hypertension, diabetes, and respiratory-related diseases demonstrate high in-degree centrality and eigencentrality, while cardiac disorders show high out-degree centrality.

Conclusions

We use data-driven methods to characterize multimorbidity patterns in different demographic groups and their evolution over the past decade. In addition to a number of strongly associated comorbid pairs (e.g., cardiac-vascular and cardiac-metabolic disorders), we identify three principal clusters: a respiratory cluster, a cardiovascular cluster, and a mixed cardiovascular-renal-metabolic cluster. These are supported by established pathophysiological mechanisms and shared risk factors, and largely confirm and expand on the results of existing studies in the medical literature. Our findings contribute to a more quantitative understanding of the epidemiology of multimorbidity, an important pre-requisite for developing more effective medical care and policy for multimorbid patients.
Leveraging transcriptome and epigenome landscapes to infer regulatory networks during the onset of sexual maturation
Authors: Mohamed Amin R. , Naval-Sanchez Marina , Menzies Moira , Evans Bradley , King Harry , Reverter Antonio , Kijas James W.
Published: June 2022

Background

Despite sexual development being ubiquitous to vertebrates, the molecular mechanisms underpinning this fundamental transition remain largely undocumented in many organisms. We designed a time course experiment that successfully sampled the period when Atlantic salmon commence their trajectory towards sexual maturation.

Results

Through deep RNA sequencing, we discovered key genes and pathways associated with maturation in the pituitary-ovarian axis. Analyzing DNA methylomes revealed a bias towards hypermethylation in ovary that implicated maturation-related genes. Co-analysis of DNA methylome and gene expression changes revealed chromatin remodeling genes and key transcription factors were both significantly hypermethylated and upregulated in the ovary during the onset of maturation. We also observed changes in chromatin state landscapes that were strongly correlated with fundamental remodeling of gene expression in liver. Finally, a multiomic integrated analysis revealed regulatory networks and identified hub genes includingTRIM25gene (encoding the estrogen-responsive finger protein) as a putative key regulator in the pituitary that underwent a 60-fold change in connectivity during the transition to maturation.

Conclusion

The study successfully documented transcriptome and epigenome changes that involved key genes and pathways acting in the pituitary – ovarian axis. Using a Systems Biology approach, we identified hub genes and their associated networks deemed crucial for onset of maturation. The results provide a comprehensive view of the spatiotemporal changes involved in a complex trait and opens the door to future efforts aiming to manipulate puberty in an economically important aquaculture species.
Evolution and functional diversification of catalase genes in the green lineage
Authors: Pan Luzhao , Luo Yin , Wang Jin , Li Xiumin , Tang Bingqian , Yang Huiping , Hou Xilin , Liu Feng , Zou Xuexiao
Published: June 2022

Background

Catalases (CATs) break down hydrogen peroxide into water and oxygen to prevent cellular oxidative damage, and play key roles in the development, biotic and abiotic stresses of plants. However, the evolutionary relationships of the plant CAT gene family have not been systematically reported.

Results

Here, we conducted genome-wide comparative, phylogenetic, and structural analyses ofCATorthologs from 29 out of 31 representative green lineage species to characterize the evolution and functional diversity of CATs. We found thatCATgenes in land plants were derived from core chlorophytes and detected a lineage-specific loss ofCATgenes in Fabaceae, suggesting that theCATgenes in this group possess divergent functions. AllCATgenes were split into three major groups (group α, β1, and β2) based on the phylogeny.CATgenes were transferred from bacteria to core chlorophytes and charophytes by lateral gene transfer, and this led to the independent evolution of two types ofCATgenes: α and β types. Ten common motifs were detected in both α and β groups, and βCATgenes had five unique motifs, respectively. The findings of our study are inconsistent with two previous hypotheses proposing that (i) newCATgenes are acquired through intron loss and that (ii) the Cys-343 residue is highly conserved in plants. We found that newCATgenes in most higher plants were produced through intron acquisition and that the Cys-343 residue was only present in monocots, Brassicaceae andPp_CatX7inP. patens, which indicates the functional specificity of theCATsin these three lineages. Finally, our finding thatCATgenes show high overall sequence identity but that individualCATgenes showed developmental stage and organ-specific expression patterns suggests thatCATgenes have functionally diverged independently.

Conclusions

Overall, our analyses of theCATgene family provide new insights into their evolution and functional diversification in green lineage species.
Genomic insights into positive selection during barley domestication
Authors: Tao Wenjing , Bian Jianxin , Tang Minqiang , Zeng Yan , Luo Ruihan , Ke Qinglin , Li Tingting , Li Yihan , Cui Licao
Published: June 2022

Background

Cultivated barley (Hordeum vulgare) is widely used in animal feed, beverages, and foods and has become a model crop for molecular evolutionary studies. Few studies have examined the evolutionary fates of different types of genes in barley during the domestication process.

Results

The rates of nonsynonymous substitution (Ka) to synonymous substitution (Ks) were calculated by comparing orthologous genes in different barley groups (wildvs.landrace and landracevs.improved cultivar). The rates of evolution, properties, expression patterns, and diversity of positively selected genes (PSGs) and negatively selected genes (NSGs) were compared. PSGs evolved more rapidly, possessed fewer exons, and had lower GC content than NSGs; they were also shorter and had shorter intron, exon, and first exon lengths. Expression levels were lower, the tissue specificity of expression was higher, and codon usage bias was weaker for PSGs than for NSGs. Nucleotide diversity analysis revealed that PSGs have undergone a more severe genetic bottleneck than NSGs. Several candidate PSGs were involved in plant growth and development, which might make them as excellent targets for the molecular breeding of barley.

Conclusions

Our comprehensive analysis of the evolutionary, structural, and functional divergence between PSGs and NSGs in barley provides new insight into the evolutionary trajectory of barley during domestication. Our findings also aid future functional studies of PSGs in barley.
Effect of specific training course for competency in professional oral hygiene care in the intensive care unit: a quasi-experimental study for developing a standardized learning curve
Authors: Samim Abbas , Vahedian-Azimi Amir , Fathi Jouzdani Ali , Rahimi-Bashar Farshid
Published: June 2022

Background

The development of evidence-based training standards can help improve the quality of educational programs for novice intensive care unit (ICU) nurses. This study was conducted to assess the application of a training course on competency development of nurses in relation to oral hygiene care in ICU patients and to develop a checklist for evaluating the competence performance. In addition, to achieve a certain level of oral hygiene competence, as well as to assess the relative importance of predicting factors and learning competency patterns in oral hygiene care, we used standard learning curve.

Methods

This quasi-experimental study with time series design was conducted on newly registered ICU nurses of a teaching hospital affiliated with Tehran University of Medical Sciences, Iran, between 2016 and 2018. In the first phase of this study, we designed a checklist to assess nurses' professional competence in oral hygiene care in three stages: before, during, and after care. Then, in the second phase, the level of competence of nurses in repeated times of oral hygiene care was determined based on checklist items and recorded in the learning curve.

Results

The greatest increase of oral hygiene care competency due to repetition was observed in the first and fourth times of repetition in comparison to the subsequent and previous steps. In the linear regression model, demographic variables predicted 12–19% of changes related to skill scores in repetitions.

Conclusion

According to the learning curve, newly registered ICU nurses can reach an acceptable competency after 6 repetitions of oral hygiene care.
Impact of vaccine hesitancy on secondary COVID-19 outbreaks in the US: an age-structured SIR model
Authors: de Miguel-Arribas Alfonso , Aleta Alberto , Moreno Yamir
Published: June 2022

Background

The COVID-19 outbreak has become the worst pandemic in at least a century. To fight this disease, a global effort led to the development of several vaccines at an unprecedented rate. There have been, however, several logistic issues with its deployment, from their production and transport, to the hesitancy of the population to be vaccinated. For different reasons, an important amount of individuals is reluctant to get the vaccine, something that hinders our ability to control and—eventually—eradicate the disease.

Materials and methods

Our aim is to explore the impact of vaccine hesitancy when highly transmissible SARS-CoV-2 variants of concern spread through a partially vaccinated population. To do so, we use age-stratified data from surveys on vaccination acceptance, together with age-contact matrices to inform an age-structured SIR model set in the US.

Results

Our results show that per every one percent decrease in vaccine hesitancy up to 45 deaths per million inhabitants could be averted. A closer inspection of the stratified infection rates also reveals the important role played by the youngest groups. The model captures the general trends of the Delta wave spreading in the US (July-October 2021) with a correlation coefficient of $$\rho =0.79$$

ρ
=
0.79

.

Conclusions

Our results shed light on the role that hesitancy plays on COVID-19 mortality and highlight the importance of increasing vaccine uptake in the population, specially among the eldest age groups.
Labor induction in China: a nationwide survey
Authors: Zhu Jing , Xue Lili , Shen Huaxiang , Zhang Lin , Lu Danni , Wang Yanlin , Zhang Yu , Zhang Jun
Published: June 2022

Background

Overmedicalization in labor management and delivery, including labor induction, is an increasing global concern. But detailed epidemiological data on labor induction in China remains unclear.

Methods

This was a cross-sectional study of data (2015–2016) from 96 hospitals in 24 (of 34) Chinese administrative divisions. Multivariable logistic regression analysis was used to assess the association between medical conditions and cesarean delivery among women undergoing induction. Linear regression analysis was performed to assess the association between the prelabor cesarean delivery and labor-induction rates in each hospital. The impacts of labor induction and prelabor cesarean delivery on maternal and neonatal outcomes were compared in low-risk women.

Results

Among 73 901 eligible participants, 48.1% were nulliparous. The overall weighted rate of labor induction in China was 14.2% (95% CI, 11.1–17.2%), with 18.4% (95% CI, 14.5–22.3%) in nulliparas and 10.2% (95% CI, 7.7–12.8%) in multiparas. Regardless of the induction method, the overall vaginal delivery rate was 72.9% (95% CI, 68.6–77.3%) in nulliparas and 86.6% (95% CI, 79.7–93.5%) in multiparas. Hospitals with a higher rate of nonmedically indicated cesarean delivery had a lower labor-induction rate in nulliparas (β =  − 0.57%; 95% CI, − 0.92 to − 0.22%; P = 0.002). Compared with prelabor cesarean delivery, labor induction in low-risk women was not associated with adverse maternal and neonatal outcomes.

Conclusion

The 2015–2016 labor-induction rate in China was 18.4% in nulliparas and 10.2% in multiparas. The proportion of prelabor cesarean delivery may contribute to regional differences in the labor-induction rate. Compared with prelabor cesarean delivery, labor induction in low-risk women may not increase severe maternal and neonatal morbidity.
Facilitating safety evaluation in maternal immunization trials: a retrospective cohort study to assess pregnancy outcomes and events of interest in low-risk pregnancies in England
Authors: Riley Megan , Lambrelli Dimitra , Graham Sophie , Henry Ouzama , Sutherland Andrea , Schmidt Alexander , Sawalhi-Leckenby Nicola , Donaldson Robert , Stoszek Sonia K.
Published: June 2022

Background

Maternal characteristics like medical history and health-related risk factors can influence the incidence of pregnancy outcomes and pregnancy-related events of interest (EIs). Data on the incidence of these endpoints in low-risk pregnant women are needed for appropriate external safety comparisons in maternal immunization trials. To address this need, this study estimated the incidence proportions of pregnancy outcomes and pregnancy-related EIs in different pregnancy cohorts (including low-risk pregnancies) in England, contained in the Clinical Practice Research Datalink (CPRD) Pregnancy Register linked to Hospital Episode Statistics (HES) between 2005 and 2017.

Methods

The incidence proportions of 7 pregnancy outcomes and 15 EIs were calculated for: (1) all pregnancies (AP) represented in the CPRD Pregnancy Register linked to HES (AP cohort;N = 298 155), (2) all pregnancies with a gestational age (GA) ≥ 24 weeks (AP24+ cohort;N = 208 328), and (3) low-risk pregnancies (LR cohort;N = 137 932) with a GA ≥ 24 weeks and no diagnosis of predefined high-risk medical conditions until 24 weeks GA.

Results

Miscarriage was the most common adverse pregnancy outcome in the AP cohort (1 379.5 per 10 000 pregnancies) but could not be assessed in the other cohorts because these only included pregnancies with a GA ≥ 24 weeks, and miscarriages with GA ≥ 24 weeks were reclassified as stillbirths. Preterm delivery (< 37 weeks GA) was the most common adverse pregnancy outcome in the AP24+ and LR cohorts (742.9 and 680.0 per 10 000 pregnancies, respectively). Focusing on the cohorts with a GA ≥ 24 weeks, the most common pregnancy-related EIs in the AP24+ and LR cohorts were fetal/perinatal distress or asphyxia (1 824.3 and 1 833.0 per 10 000 pregnancies), vaginal/intrauterine hemorrhage (799.2 and 729.0 per 10 000 pregnancies), and labor protraction/arrest disorders (752.4 and 774.5 per 10 000 pregnancies).

Conclusions

This study generated incidence proportions of pregnancy outcomes and pregnancy-related EIs from the CPRD for different pregnancy cohorts, including low-risk pregnancies. The reported incidence proportions of pregnancy outcomes and pregnancy-related EIs are largely consistent with external estimates. These results may facilitate the interpretation of safety data from maternal immunization trials and the safety monitoring of maternal vaccines. They may also be of interest for any intervention studied in populations of pregnant women.
Changes in a sensorimotor network, occipital network, and psychomotor speed within three months after focal surgical injury in pediatric patients with intracranial space-occupying lesions
Authors: Guan Xue-Yi , Zheng Wen-Jian , Fan Kai-Yu , Han Xu , Li Xiang , Yan Zi-Han , Lu Zheng , Gong Jian
Published: June 2022

Background

Studies on cognition and brain networks after various forms of brain injury mainly involve traumatic brain injury, neurological disease, tumours, and mental disease. There are few related studies on surgical injury and even fewer pediatric studies. This study aimed to preliminarily explore the cognitive and brain network changes in children with focal, unilateral, well-bounded intracranial space-occupying lesions (ISOLs) in the short term period after surgery.

Methods

We enrolled 15 patients (6–14 years old) with ISOLs admitted to the Department of Pediatric Neurosurgery of the Beijing Tiantan Hospital between July 2020 and August 2021. Cognitive assessment and resting-state functional magnetic resonance imaging (rs-fMRI) were performed. Regional homogeneity (Reho), seed-based analysis (SBA) and graph theory analysis (GTA) were performed. Paired T-test was used for statistical analysis of cognitive assessment and rs-fMRI. Gaussian random-field theory correction (voxelp-value < 0.001, clusterp-value < 0.05) was used for Reho and SBA. False discovery rate correction (correctedpvalue < 0.05) for GTA.

Results

Our results showed that psychomotor speed decreased within three months after surgery. Further, rs-fMRI data analysis suggested that sensorimotor and occipital network activation decreased with low information transmission efficiency.

Conclusion

We prudently concluded that the changes in cognitive function and brain network within three months after surgery may be similar to ageing and that the brain is vulnerable during this period.
Association between smoking and postoperative delirium in surgical patients with pulmonary hypertension: a secondary analysis of a cohort study
Authors: Zhou Sai , Shi Shuqing , Xie Chang , Chen Gong
Published: June 2022

Background

Previous studies have declared that smoking was a risk factor for postoperative delirium (POD), but others have inconsistent results. Up till now, the association between smoking and POD has not been verified. This study investigates the relationship between smoking and POD in patients with pulmonary hypertension (PHTN) in the United States.

Methods

Patients with PHTN who underwent non-cardiac, non-obstetric surgery were enrolled in the original research completed by Aalap C. et al. We further excluded the patients undergoing intracranial surgery and the patients with sepsis and perioperative stroke to avoid interference with POD assessment. The generalized linear model and generalized additive model were used to explore the relationship between smoking and POD. The propensity score adjustment was used for sensitivity analyses.

Results

Five hundred thirty-nine patients were included in this study. The overall incidence of POD was 3.0% (16/539). After adjusting the potential confounders (age, systemic hypertension, coronary artery disease, COPD, length of surgery, intrathoracic surgery, vascular surgery), a positive relationship was found between smoking status and POD (OR = 4.53, 95% CI: 1.22 to 16.86, P = 0.0243). In addition, the curvilinear relationship between smoking burden (pack-years) and POD is close to a linear relationship.

Conclusion

Smoking probably shows a positive correlation with POD in patients with PHTN.
Delirium due to hip fracture is associated with activated immune-inflammatory pathways and a reduction in negative immunoregulatory mechanisms
Authors: Thisayakorn Paul , Thipakorn Yanin , Tantavisut Saran , Sirivichayakul Sunee , Maes Michael
Published: June 2022

Background

The objectives of this study were to delineate whether delirium in older adults is associated with activation of the immune-inflammatory response system (IRS) as indicated by activation of M1, T helper (Th)1, and Th17 profiles, and/or by reduced activities of the compensatory immunoregulatory system (CIRS), including Th2 and T regulatory profiles.

Methods

We recruited 65 older adult patients with a low energy impact hip fracture who underwent hip fracture operation. The CAM-ICU and the Delirium Rating Scale, Revised-98-Thai version (DRS-R-98) were assessed pre-operatively and 1, 2 and 3 days after surgery. Blood samples (day 1 and 2) post-surgery were assayed for cytokines/chemokines using a MultiPlex assay and the neutrophil/lymphocyte ratio.

Results

We found that delirium and/or the DRS-R-98 score were associated with IRS activation as indicated by activated M1, Th1, Th17 and T cell growth profiles and by attenuated CIRS functions. The most important IRS biomarkers were CXCL8, interleukin (IL)-6, and tumor necrosis factor-α, and the most important CIRS biomarkers were IL-4 and soluble IL-1 receptor antagonist. We found that 42.5% of the variance in the actual changes in the DRS-R-98 score (averaged from day 1 to day 3) was explained by T cell growth factors, baseline DRS-R-98 scores and age. An increase in the NLR reflects overall IRS, M1, Th1, Th17, and Th2 activation.

Conclusions

Post-hip surgery delirium is associated with activated IRS pathways and appears especially in patients with lowered CIRS functions.
Influence factors analysis of COVID-19 Prevention behavior of chinese Citizens: a path analysis based on the hypothetical model
Authors: Li Yun-shan , Wang Rui , Deng Yu-qian , Jia Xiao-rong , Li Shan-peng , Zhao Li-ping , Sun Xin-ying , Qi Fei , Wu Yi-bo
Published: June 2022

Background

Under the outbreak of Coronavirus disease 2019 (COVID-19), a structural equation model was established to determine the causality of important factors that affect Chinese citizens’ COVID-19 prevention behavior.

Methods

The survey in Qingdao covered several communities in 10 districts and used the method of cluster random sampling. The research instrument used in this study is a self-compiled Chinese version of the questionnaire. Of the 1215 questionnaires, 1188 were included in our analysis. We use the rank sum test, which is a non-parametric test, to test the influence of citizens’basic sociodemographic variables on prevention behavior, and the rank correlation test to analyze the influencing factors of prevention behavior. IBM AMOS 24.0 was used for path analysis, including estimating regression coefficients and evaluating the statistical fits of the structural model, to further explore the causal relationships between variables.

Results

The result showed that the score in the prevention behavior of all citizens is a median of 5 and a quartile spacing of 0.31. The final structural equation model showed that the external support for fighting the epidemic, the demand level of health information, the cognition of (COVID-19) and the negative emotions after the outbreak had direct effects on the COVID-19 prevention behavior, and that negative emotions and information needs served as mediating variables.

Conclusions

The study provided a basis for relevant departments to further adopt epidemic prevention and control strategies.
Examining the relationship of sociodemographic factors, neighborhood cohesion and abnormal sleep duration among U.S. foreign-born subpopulations in the National Health Interview Survey
Authors: Villalobos Kevin , Ishino Francisco A. Montiel , McNeel Timothy S. , Williams Faustine
Published: June 2022

Background

Limited studies have examined the relationship of neighborhood cohesion and sleep duration between U.S. foreign-born Hispanics/Latinos and non-Hispanics/Latinos.

Methods

We conducted a multinomial logistic regression using the 2013-2018 National Health Interview Survey on U.S. foreign-born adults ≥18 (N = 27,253). The outcome variable, sleep duration, was categorized as short sleep (≤6 hours), normal sleep (7 to 8 hours), and long sleep (≥9 hours). Neighborhood cohesion was categorized using tertiles (low, medium, high) from self-reported Likert scores. Our model included sociodemographic factors (i.e., age, marital status), socioeconomic status (i.e., education, employment status), health risk behaviors (i.e., body mass index, smoking status, alcohol drinking status), ethnic identity (i.e., Mexican, Puerto Rican, Cuban, Dominican, Central or South American, other/multiple Hispanic/Latino, and non-Hispanic/Latino), and acculturation factors (i.e., years lived in the U.S.; the language of interview).

Results

Participants reporting low and medium neighborhood cohesion compared to high neighborhood cohesion had 45% (95% confidence interval [CI]:1.33-1.58) and 15% (95%CI:1.05-1.26) increased odds of short sleep (≤6 hours), compared to normal average sleep. Mexican participants had decreased odds of experiencing short sleep (adjusted odds ratio [AOR] = 0.82, 95%CI:0.73-0.92), while Puerto Ricans had increased odds of experiencing short sleep (AOR = 1.25, 95%CI:1.03-1.51) compared to non-Hispanics/Latinos.

Conclusion

Neighborhood cohesion was associated with increased odds of short sleep duration. Social determinants, acculturation, and behavioral risk factors in the context of neighborhood cohesion are critical to understand U.S. foreign-born Hispanic/Latino sleep duration, as these factors may negatively synergize to exacerbate risk, worsening mental and physical health outcomes.
Psychosocial distress and the quality of life of cancer patients in two health facilities in Cameroon
Authors: Ebob-Anya Bachi-Ayukokang , Bassah Nahyeni
Published: June 2022

Background

Psychosocial distress interferes with the ability to cope effectively with cancer, its physical symptoms and treatment. This in turn leads to poor outcomes in patients.

Objective

The aim of this study was to assess the level of psychosocial distress, emotional distress and the quality of life of cancer patients in two health facilities in Cameroon.

Methods

This study used a cross-sectional hospital-based design. The study was carried out over a period of three months from July–September 2020. The sample size was 120 cancer patients. A consecutive sampling technique was used to select participants. Three validated questionnaires were used: DT, HADS and EORTC QLQ-C30 to assess, psychosocial distress, emotional distress and quality of life respectively. Results were presented using descriptive (frequency, percentage, mean) and inferential statistics (Chi square, Pearson’s correlation, ANOVA). Data were analysed with SPSS version 21. All statistics were considered significant at an alpha value set at 0.05 level.

Results

The majority of patients 83 (69.2%) presented with clinically significant distress, with financial difficulties 87 (72.5%), fatigue 83 (69.2%), transportation 73 (60.8%) and difficulties with work/school 69(57.5%) being the most reported problems. Fifty nine (50.0%) and 56(47.5%) had moderate to severe anxiety and depression symptoms respectively. Overall on HADS, 67 patients (56.8%) presented with emotional distress. The quality of life was fair, with a mean of 52.4 ± 21.3.There was a statistically significant negative relationship (P < 0.0001), between psychosocial distress and quality of life of patients.

Conclusion

Cancer patients suffer from psychosocial distress, which has a negative relationship on their quality of life. It is important that healthcare professionals working in these settings, assess psychosocial distress early in patients with cancer to improve the quality of care and enhance quality of life.
The impact of covid-19 on out-of-hours adult hospice care: an online survey
Authors: Hasson Felicity , Slater Paul , Fee Anne , McConnell Tracey , Payne Sheila , Finlay Dori-Anne , McIlfatrick Sonja
Published: June 2022

Background

Globally COVID-19 has had a profound impact on the provision of healthcare, including palliative care. However, there is little evidence about the impact of COVID-19 on delivery of out-of-hours specialist palliative care services in the United Kingdom. The aim of the study is to investigate the impact of the COVID-19 pandemic on the delivery of out-of-hours community-based palliative care services.

Methods

A national online census survey of managers of adult hospices in the United Kingdom was undertaken. Survey were emailed to managers of adult hospices (n = 150) who provided out-of-hours community palliative care services. Fifteen questions related specifically to the impact of COVID-19. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using descriptive content analysis.

Results

Eighty-one responses to the survey were returned (54% response rate); 59 were complete of which 47 contained COVID-19 data. Findings indicated that COVID-19 impacted on out-of-hours community-based palliative care. To meet increased patient need, hospices reconfigured services; redeployed staff; and introduced new policies and procedures to minimize virus transmission. Lack of integration between charitably and state funded palliative care providers was reported. The interconnected issues of the use and availability of Personal Protective Equipment (n = 21) and infection control screening (n = 12) resulted in changes in nursing practices due to fear of contagion for patients, carers and staff.

Conclusions

Survey findings suggest that due to increased demand for community palliative care services, hospices had to rapidly adapt and reconfigure services. Even though this response to the pandemic led to some service improvements, in the main, out-of-hours service reconfiguration resulted in challenges for hospices, including workforce issues, and availability of resources such as Personal Protective Equipment. These challenges were exacerbated by lack of integration with wider healthcare services. More research is required to fully understand the implications of such changes on the quality of care provided.
Methods and strategies to promote academic literacies in health professions: a scoping review
Authors: Klarare A , Rydeman I-B , Kneck Å , Bos Sparén E , Winnberg E , Bisholt B
Published: June 2022

Background

Universities enroll students from diverse backgrounds every year, with 300 million students expected in higher education by 2025. However, with widening participation, increasing numbers of students enrolling in higher health education and future health professions will be underprepared to meet demands of academic literacies, i.e. ability to read, interpret and critically evaluate academic texts and communicating the understanding verbally or in writing. The aim of this scoping review was to describe and explore methods and strategies to promote development of academic literacies.

Results

Thirty-one relevant studies were included and analyzed according to scoping review guidelines. The results showed four strategies: (1) integrating learning activities to develop academic literacies in the regular curriculum, (2) changing the course design with new methods for teaching and learning, (3) establish collaborations amongst academics and librarian faculty, and (4) adding courses or foundation year focusing on development of academic literacies. The results are discussed in light of the United Nations Agenda 2030 Sustainable Development, Goal 4, Quality Education, and widening participation.

Conclusions

Aspects of widening participation and inclusion in higher education have been debated, and increasing numbers of students from diverse backgrounds are expected to enter health studies in higher education. We encourage integration of teaching and learning activities targeting parallel learning of course materials and development of academic literacies, beyond study skills. Embracing epistemic complexity and diversity as well as choosing strategic work with academic literacies may provide a starting point toward realizing sustainable development goals and widening participation.
Introducing conflict resolution and negotiation training into a biomedical sciences graduate curriculum
Authors: Schaller Michael D. , Gatesman-Ammer Amanda
Published: June 2022

Background

Analysis of the biomedical workforce and graduate education have produced recommendations for modifications of pre-doctoral training to broadly prepare trainees for wider ranging scientific careers. Development of training in professional skills is widely recommended, but details of implementation are not widely available. In alignment with these recommendations, we have incorporated professional skills training into the biomedical science graduate curriculum at West Virginia University. An important component of the training is developing conflict resolution and negotiation skills. This training will provide useful skills for academic careers, non-academic careers and life situations outside of the workplace. Conflict resolution/negotiation skills are also relevant in managing issues in diversity, equity and inclusivity. We report our experience in developing this component of the training program, provide an overview of the approach to delivery and practice of skills, and provide an analysis of the reception and effectiveness of the training.

Methods

Evaluation of effectiveness of training used the principals of the Kirkpatrick Four Level Model of Evaluation. At the end of the course, students completed a questionnaire about their perceptions of training and were asked how they would respond to different scenarios requiring conflict resolution/negotiation skills. Several months later, students were surveyed to determine if they used some of these skills and/or witnessed situations where these skills would be useful.

Results

We report our experience in developing conflict resolution/negotiation training in our graduate curriculum, provide an overview of the approach to delivery and practice of skills, and provide an analysis of the reception and effectiveness of the training. The results suggest this training meets a need and is effective. Importantly, these materials provide a template for others wishing to implement similar training in their curricula.

Conclusions

Conflict resolution and negotiation training meets a need in graduate education. A mixed approach using didactic and interactive components spaced out over time appears to be an effective method of training.