bluuebunny/crossref_metadata_2025 huggingface dataset:
Robot-Assisted Vascular Shunt Insertion with the dVRK Surgical Robot
Authors: Dharmarajan Karthik , Panitch Will , Shi Baiyu , Huang Huang , Chen Lawrence Yunliang , Moghani Masoud , Yu Qinxi , Hari Kush , Low Thomas , Fer Danyal , Garg Animesh , Goldberg Ken
Published: November 2023

Vascular shunt insertion is a common surgical procedure performed to restore blood flow to damaged tissues temporarily. It usually requires a surgeon and a surgical assistant. We consider three scenarios: (1) a surgeon is available locally; (2) a remote surgeon is available via teleoperation; (3) no surgeon is available. In each scenario, a minimally invasive surgical-assistant da Vinci robot operates in a different mode either by teleoperation or automation. Robotic assistance for this procedure is challenging due to precision and control uncertainty. The role of the robot in this task depends on the availability of a human surgeon. We propose a trimodal framework for vascular shunt insertion assisted by a da Vinci Research Kit (dVRK) robotic surgical assistant (RSA). To help further study for the community, we also present a physics-based simulated environment for shunt insertion built on top of the NVIDIA Isaac ORBIT simulator. We collect a large dataset of trajectories for the shunt insertion environment using ORBIT and implement these trajectories to show the simulator’s realism, showcasing the possibility for future work to use the simulator for policy learning. Physical experiments demonstrate a success rate of 65–100% for mode (1), 100% for mode (2), and 75–95% for mode (3) across vessel phantoms with different sizes, color, and material properties. For dataset and videos, see https://sites.google.com/berkeley.edu/ravsi .
Deletion of the Aryl Hydrocarbon Receptor in Endothelial Cells Improves Ischemic Angiogenesis in Chronic Kidney Disease
Authors: Palzkill Victoria R. , Tan Jianna , Yang Qingping , Morcos Juliana H. , Laitano Orlando , Ryan Terence E.
Published: November 2023

Rationale: Chronic kidney disease (CKD) is a strong risk factor for peripheral artery disease (PAD) that is associated with worsened clinical outcomes. CKD leads to accumulation of tryptophan metabolites that associate with adverse limb events in PAD and are ligands of the aryl hydrocarbon receptor (AHR) which may regulate ischemic angiogenesis. Objectives: To test if endothelial cell-specific deletion of the AHR (AHRecKO) alters ischemic angiogenesis and limb function in mice with CKD subjected to femoral artery ligation. Findings: Male AHRecKO mice with CKD displayed better limb perfusion recovery and enhanced ischemic angiogenesis compared to wildtype mice with CKD. However, the improved limb perfusion did not result in better muscle performance. In contrast to male mice, deletion of the AHR in female mice with CKD had no impact on perfusion recovery or angiogenesis. Using primary endothelial cells from male and female mice, treatment with indoxyl sulfate uncovered sex-dependent differences in AHR activating potential and RNA sequencing revealed wide ranging sex-differences in angiogenic signaling pathways. Conclusion: Endothelium-specific deletion of the AHR improved ischemic angiogenesis in male, but not female, mice with CKD. There are sex-dependent differences in Ahr activating potential within endothelial cells that are independent of sex hormones.
Adverse pregnancy outcomes and renal-vascular function in the early years after delivery
Authors: Lane Abbi , Jiles Marcey , Ramey Kaitlyn , McLean Marnie , Whitney Jamie Alexis , Brunson Abigail , Cardaci Thomas , Liu Jihong , Wilcox Sara , Catov Janet , Fernhall Bo
Published: November 2023

Background: Adverse pregnancy outcomes (APOs: hypertensive disorders, gestational diabetes, preterm birth, placental disorders) are associated with cardiovascular disease risk or blood volume abnormalities. Traditional risk factors might not identify highest risk people in the early years after APO deliveries. Purpose: Test the hypothesis that vascular function is worse and plasma volume-regulating renal hormones lower after delivery in people who did versus did not have an APO. Methods: Adult participants 6 months-3 years post-delivery of a singleton infant participated in this cross-sectional study. Exclusion criteria included current smoking, current use of certain medications, and diabetes outside of pregnancy. Differences in measurements between participants with versus without APOs were determined with t-tests or Wilcoxon tests. Associations of renal hormones with APO history were assessed with linear regression, adjusted for age, race, BMI, and sodium consumption. Results: Of 86 participants, 38 (44%) had an APO history. Those with APOs were more likely to identify as Black and had a higher BMI: 34.0 kg/m2 (IQR:24.6, 39.3) versus 24.2 kg/m2 (IQR:21.2, 31.3), p<0.05. Most brachial and all aortic blood pressures were higher in those with APOs: median aortic blood pressure was 102/74 versus 96/68 mmHg, p≤0.05. There were no differences in arterial stiffness or endothelial function between groups. Aldosterone was lower (54 (IQR:28-84) versus 80 (IQR:39-150) pmol/L) in participants with past APOs. Conclusions: Blood pressures were higher, and aldosterone was lower, in participants with past APOs. Associations of aldosterone with APO history persisted after adjustment. Neither renin nor aldosterone were related to vascular function.
Using Vhavenda Traditional Entertainment to Curb HIV Spread in the Rural South African District
Authors: Ndou-Mammbona Avhatakali Allga , Moyo Idah , Tshivhase Livhuwani , Mavhandu-Mudzusi Azwihangwisi Helen
Published: November 2023

Purpose. This study explored the use of traditional entertainment as a means of curbing human immunodeficiency virus (HIV) spread in the Vhembe district of South Africa. Engaging in cultural dances like tshikona, tshifasi, tshigombela, malende, davha, and musangwe keeps the youth grounded, making it less likely that they will engage in unprotected sexual intercourse. Methods. This qualitative study utilized an ethnographic design. The study was conducted in rural villages in Vhembe district, Limpopo province in South Africa. Eighteen participants consisted of Vhavenda traditional leaders and chiefs who met the selection criteria were purposively selected to participate in the study. The sample size was determined by data saturation. Semistructured face-to-face interviews were used to collect data, guided by an interview guide. Four observations were done concurrently with the interviews. Interviews were audio-recorded, and field notes were taken. Ethnographic content analysis was used to analyze the data collected. Results. The results indicate that Vhavenda traditional entertainments like tshigombela and tshikona can be used in reducing and managing the spread of HIV, whereas malende, tshifasi, davha, and musangwe have the potential to spread and increase incidences of HIV. Conclusion. The traditional entertainment such as tshigombela and tshikona can be utilized as they instill good morals. Malende, tshifasi, davha, and musangwe can be repatterned and modified. Traditional entertainments, if properly utilized, can add to the strategies of reducing the new incidences of HIV.
Evidence-Based Guideline on the Prevention and Management of Perioperative Pain for Breast Cancer Peoples in a Low-Resource Setting: A Systematic Review Article
Authors: Tageza Ilala Tajera , Teku Ayano Gudeta , Ahmed Kedir Yesuf , Tamiru Mamo Selam
Published: November 2023

Background. Breast surgery for breast cancer is associated with significant acute and persistent postoperative pain. Surgery is the primary type of treatment, but up to 60% of breast cancer patients experience persistent pain after surgery, and 40% of them develop acute postmastectomy pain syndrome. Preoperative stress, involvement of lymph nodes while dissecting, and the postoperative psychological state of the patients play vital roles in managing the postoperative pain of the patients. The objective of this study is to develop evidence-based guideline on the prevention and management of perioperative pain for breast cancer surgical patients. Methods. An exhaustive literature search was made from PubMed, Cochrane Review, PubMed, Google Scholar, Hinari, and CINAHIL databases that are published from 2012 to 2022 by setting the inclusion and exclusion criteria. After data extraction, filtering was made based on the methodological quality, population data, interventions, and outcome of interest. Finally, one guideline, two meta-analyses, ten systematic reviews, 25 randomized clinical trials and ten observational studies are included in this review, and a conclusion was made based on their level of evidence and grade of recommendation. Results. A total of 38 studies were considered in this evaluation. The development of this guideline was based on different studies performed on the diagnosis, risk stratification and risk reduction, prevention of postoperative pain, and treatments of postoperative pain. Conclusion. The management of postoperative pain can be categorized as risk assessment, minimizing risk, early diagnosis, and treatment. Early diagnosis is the mainstay to identify and initiate treatment. The perioperative use of a nonpharmacological approach (including preoperative positive inspirational words and positive expectation) as an adjunct to the intraoperative regional anesthetic technique with general anesthesia with proper dosage of the standard pharmacological multimodal regimens is the first-line treatment. For postoperative analgesia, an extended form of intraoperative regional technique, nonpharmacologic technique, and NSAIDs can be used with the opioid-sparing anesthesia technique.
Self-Care Behavior and Associated Factors of Nursing Students with Dysmenorrhea: A Structural Equation Model
Authors: Chen Jinpei , Duan Yajing , Zhang Yongai , Zhang Xiaona , Chu Miao , Shi Yurun , Zhang Xinmin
Published: November 2023

Objective. To assess the factors influencing the self-care behavior among nursing students with dysmenorrhea. Background. The practice of self-care behavior for dysmenorrhea has gradually attracted immense attention from society; however, thus far, only a few studies have been conducted to predict this behavior and analyze the associated factors by creating a structural equation model. Methods. A cross-sectional multistage cluster sampling study was conducted among nursing students within six universities in Shaanxi province, China. A model was constructed, and structured questionnaires were adopted to measure model variables, including e-health literacy, negative emotion, self-efficacy, self-care agency, degree of dysmenorrhea, and self-care behavior for dysmenorrhea. Descriptive data analysis was performed using SPSS 23.0 software, and AMOS 23.0 was used to verify and analyze the structural model. Results. In total, 1851 valid questionnaires were collected; the effective recovery rate was 93.15%, and the prevalence of dysmenorrhea was 64.51%. e-Health literacy (B = 0.171,

P

 < 0.001), self-efficacy (B = 0.416,

P

 < 0.001), self-care agency (B = 1.177,

P

 < 0.001), and degree of dysmenorrhea (B = 0.310,

P

 < 0.001) significantly influenced self-care behavior for dysmenorrhea. The total, direct, and indirect effects of e-health literacy and self-efficacy on self-care behavior for dysmenorrhea were 0.158 and 0.492, 0.128 and 0.248, and 0.030 and 0.244, respectively. Conclusion. The self-care behavior for dysmenorrhea is affected by several factors and self-efficacy has the greatest effect on it. To promote girls to actively implement self-care behavior for dysmenorrhea, educators should strengthen the training of self-efficacy and self-care agency of the nursing students to alleviate the uncomfortable experience brought by dysmenorrhea and decrease the harm of dysmenorrhea. Implications for Nursing Management. Nursing managers should work with constant efforts to explore and optimize the management model for dysmenorrhea, encouraging young women to actively engage in self-care behavior for dysmenorrhea, to alleviate the discomfort experienced by individuals and improve women’s overall health.
TABLE 2 from Concordance and Clinical Significance of Genomic Alterations in Progressive Tumor Tissue and Matched Circulating Tumor DNA in Aggressive-variant Prostate Cancer
Authors: Wang Ruiliang , Xu Qiufan , Guo Hanxu , Yang Guanjie , Zhang Jun , Wang Hong , Xu Tianyuan , Guo Changcheng , Yuan Jing , He Yanyan , Zhang Xiaoying , Fu Hongliang , Xu Guang , Zhao Binghui , Xie Jun , Zhao Tingting , Huang Longfei , Zhang Jiansheng , Peng Bo , Yao Xudong , Yang Bin
Published: November 2023

Univariate and multivariate logistic regression to identify associations between high positive concordance and clinical characteristics
FIGURE 3 from Concordance and Clinical Significance of Genomic Alterations in Progressive Tumor Tissue and Matched Circulating Tumor DNA in Aggressive-variant Prostate Cancer
Authors: Wang Ruiliang , Xu Qiufan , Guo Hanxu , Yang Guanjie , Zhang Jun , Wang Hong , Xu Tianyuan , Guo Changcheng , Yuan Jing , He Yanyan , Zhang Xiaoying , Fu Hongliang , Xu Guang , Zhao Binghui , Xie Jun , Zhao Tingting , Huang Longfei , Zhang Jiansheng , Peng Bo , Yao Xudong , Yang Bin
Published: November 2023

Patients with AVPC demonstrate improved survival outcomes during Chemo compared with NHT. PFS (A) and OS (B) of patients with AVPC stratified of NHT or Chemo.
The Origin of Electoral Absenteeism in Early Italy: New Evidence to Explain North–South Diverging Trends
Authors: Brosio Giorgio , Zanola Roberto
Published: November 2023

Low turnout rates with high geographical disparities characterized Italian national elections in the first six decades after the country’s founding in 1861. Historians have largely overlooked these regional voting differences and their potential economic implications. A multiple-group interrupted time series analysis regression model demonstrates distinct electoral trends between the Center-North and the South, coinciding with electoral reforms in 1894 that affected electoral competition, particularly in the South. Furthermore, a random effect panel regression model reveals determinants of regional abstention rates, which indicate that different factors influenced abstention rates in the Center-North than in the South, emphasizing the relevance of political factors in the creation and widening of regional divergences in Italy.
A Cluster Randomized Controlled Trial on the Effectiveness of the Building Educators’ Skills in Adolescent Mental Health (BEAM) Program for Improving Secondary School Educators’ Confidence, Behavior, Knowledge, and Attitudes Toward Student Mental Health
Authors: O’Dea Bridianne , Parker Belinda , Batterham Philip J. , Chakouch Cassandra , Mackinnon Andrew J. , Whitton Alexis E. , Newby Jill M. , Subotic-Kerry Mirjana , Gayed Aimee , Harvey Samuel B.
Published: November 2023

Secondary school educators are well placed to recognize and respond to mental illness in adolescents; however, many report low confidence and skills in doing so. A confirmatory cluster randomized controlled trial involving 295 educators (Mean age: 40.10 years, SD: 10.47; 76.6% female, 2.7% Aboriginal or Torres Strait Islander) from 73 Australian secondary schools (22 in rural-regional locations) evaluated the effectiveness of a new professional development training program that aimed to improve secondary school educators’ confidence, behavior, knowledge, and attitudes toward student mental health. Relative to the control, training participants reported significantly greater levels of confidence in recognizing and responding to student mental health issues, perceived mental health knowledge and mental health awareness, and mental health literacy, at post-intervention (10-weeks post-baseline; d = 0.26–0.35) and at 3-month follow-up ( d = −0.21 to 0.41). Findings indicate that the Building Educators’ skills in Adolescent Mental health (BEAM) program improves important training outcomes for educators in the domain of student mental health.
Assembling high-rise: The uneven agencies of air in suburban densification in the Anthropocene
Authors: Cook Nicole T , Kerr Sophie-May
Published: November 2023

The COVID-19 pandemic brought to the surface the critical qualities of air – airflow, ventilation, particulates etc. – in relation to the well-being of people living in high-rise. Engineering and architectural research has burgeoned in response. However, in focusing on models of airflow, ventilation and particulates as discrete variables, engineering and architectural discourse fails to capture the diverse ways that air enters into and shapes the everyday lived experience of high-rise dwelling. Drawing on research in Sydney’s Southwestern suburbs, we reveal high-rise as an assemblage that links apartment dwelling with air, via car-dependent suburbanisation, pollution and climate-change induced temperature extremes in the Anthropocene. In addition to viruses, air teems with carbon, insects, noise and pollutants, while viscerally mediating human encounters with fluctuating temperatures. Multiple relations between people, buildings and air unfold simultaneously, confounding attempts to account for air’s elemental milieu through single variables like greenhouse gas or COVID-19. While embedded in relations of power, high-rise assemblages unleash vernacular adaptation that through low-tech and low-cost technologies work to connect suburban high-rise with evolving ecological systems. Recognising the pharmacological quality of air, as both ‘poison’ and ‘cure’, we contrast models of high-rise as encapsulated environments with resident (and other) experiments that orient high-rise to the elements, and the interlinked challenges of urban living in the Anthropocene.
The Role of School Context Factors for Gender Role Attitudes: General and Differential Associations Between Female and Male Adolescents
Authors: Taraszow Tatjana , Gresch Cornelia , Kempert Sebastian
Published: November 2023

During adolescence, socialization of gender role attitudes (GRA) shifts from parents to peers, friends, and classmates; thus, it takes place primarily in the school context. Accordingly, previous studies identified school-related factors associated to adolescents’ GRA. However, little is known about the relative importance of these factors as well as about the factors’ differences between females’ and males’ GRA. This study investigates the relevance of several school factors on adolescents’ GRA and gender differences. Using data from the German National Educational Panel Study ( N = 10,866), the results show that attending a higher educational school type, higher classmates’ socio-economic background, lower proportion of female classmates, and more egalitarian classmates’ GRA are related to more individual egalitarian GRA. Furthermore, the relation between classmates’ GRA and individual GRA is more pronounced for males than females. The study further discusses starting points for possible interventions.
The Association Between Witnessing Interparental Violence and Adolescents’ Anger Expression Styles
Authors: Ayhan Fatma
Published: November 2023

The purpose of this research was to determine the association between witnessing interparental violence and anger expression styles in adolescents. Previous studies have generally focused on the attitudes to violence of individuals witnessing it. However, the present research specifically investigated the association between witnessing interparental violence and anger. The research was performed as a descriptive and correlational study. The research sample consisted of 1,000 adolescents aged 15 to 19 contacted via social media platforms using the convenience sample method. An online data collection form containing questions was prepared to determine adolescents’ sociodemographic characteristics and contained questions from the Witnessing Interparental Violence Scale and Trait Anger Expression Inventory. Statistical analysis was performed on SPSS 21.0 software. In all, 446 (44.6%) adolescents had witnessed interparental violence. Trait, externalized, and internalized anger scores were higher among adolescents who had witnessed interparental violence compared to those who had not. This research shows that witnessing interparental violence has significant effects on the individual’s trait anger and anger expression styles. We recommend that the effects of exposure to violence and witnessing interparental violence be compared and that witnessing violence in different cultural environments be evaluated in future studies.
Impact of telemedicine on disease activity assessment: A case-crossover study nested within a cohort of patients with systemic lupus erythematosus
Authors: Almaghlouth Ibrahim , Almalag Haya M. , Alzuhair Hajer , Alsaigh Rafif , Bedaiwi Asma , Hassen Lena M. , Alzomia Sulaiman , Alanazi Boshra , Alabdulkareem Abdulaziz Mohammed , Alahmari Saud , Asfina Kazi Nur , Khalil Najma , Omair Mohammed A. , Bedaiwi Mohamed
Published: November 2023

Introduction

The utilisation of telemedicine has been rapidly growing among patients with rheumatic diseases, especially following the corona virus disease 2019 pandemic. Ease and convenience appear to dominate the reasons for this growth. However, the effects of this approach in patients with systemic lupus erythematosus (SLE) are yet to be revealed. In this study, we examined the effect of telemedicine on disease activity assessment and damage scores in patients with SLE.

Methods

This case-crossover study was nested within a national prospective cohort of patients with SLE in Saudi Arabia. Patients with SLE were included if they fulfilled the Systemic Lupus International Collaborating Clinics classification criteria between March 2020 and March 2021 and were assessed at three time points with 3 months between assessments, according to the standardised protocol of this cohort. Telemedicine was conducted for the first evaluation, while in-person assessments were used at the second and third visits. The primary outcome was the difference in the SLE disease activity index 2000 (SLEDAI-2K) score. The primary analysis was conducted using the repeated measure model and adjusted for potential confounders, including demographics, medications, and changes in steroid doses. Several sensitivity analyses were conducted to mitigate selection and time-varying confounders.

Results

A total of 92 participants were included in this study. Most patients were females (88%), with a mean (±standard deviation [SD]) age of 36 (±13) years. The mean (±SD) disease activity scores at baseline were as follows: SLEDAI-2K, 5 (±5); SLE responder index, 3.8 (±3.5); Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index, 1 (±1). The mean difference in SLEDAI-2K score was −1.641 (95% confidence interval −2.773 to −0.510, p = 0.005*) between telemedicine and follow-up visits. The results were consistent in all sensitivity analyses.

Conclusion

We found that telemedicine assessment was associated with a much higher disease activity score than subsequent assessments, which may suggest an overestimation of disease activity and later assessment accuracy. Cautious adoption has been suggested for SLE patients with active disease.
Thrombosis and APS: Lessons Learned from Another Black Swan Tale
Authors: Camerlo Sofia , Cecchi Irene , Foddai Silvia Grazietta , Radin Massimo , Barinotti Alice , Morotti Alessandro , Roccatello Dario , Sciascia Savino
Published: November 2023

Antiphospholipid syndrome (APS) is a chronic systemic autoimmune disease characterized by venous, arterial, and microvascular thromboses and/or recurrent pregnancy morbidity, that occur in the persistent presence of antiphospholipid antibodies (aPL). APS can present with a wide range of clinical manifestations often reffered as “extra-criteria”. These features, although apparently less common, can severely impact patients’ outcome. Here, we report the case of a patient with a newly diagnosed APS. He previously experienced a recurrence of venous thrombosis after discontinuation of anticoagulant therapy in association with cutaneous ulcerations as presenting symptoms. Interestingly, skin lesions did not improve with full anticoagulant treatment. Due to concomitant presence of thrombotic and microvascular involvement, immunomodulatory therapy with steroid pulses followed by intravenous injections of belimumab was started, with progressive and significant amelioration, leading to complete recovery. Following the presentation of the current case report, we highlight the importance of suspecting APS in young patients experiencing unprovoked thrombosis. We also emphasized the critical issue of testing aPL during anticoagulant treatment and focused on the need of aPL retesting in patients with positivity at high titers. We also highlight the double nature of aPL-mediated clinical manifestations. While most patients presented with pure thrombotic complications, one should always remember that APS is an autoimmune-mediated disease, which can benefit from alternative therapeutic approaches beyond anticoagulation.
Cooperation sustainability in small groups: Exogenous and endogenous dynamics of the sustainability of cooperation
Authors: Kirgil Zeynep Melis , Wittek Rafael
Published: November 2023

Cooperation sustainability presents a complex social phenomenon. Two common approaches have been used to study the sustainability of cooperation in small groups: endogenous processes (dynamic) and exogenous factors (static approaches). The present study integrates existing research by investigating how the interplay between exogenous and endogenous conditions affects cooperation in small groups. To uncover endogenous group dynamics in an online Public Goods experiment ( n = 353), we performed multilevel latent Markov models on Bayesian estimation that allowed us to estimate latent classes on the level of rounds, individuals, and groups. We studied exogenous factors by investigating the effects of situational tightness versus looseness, and monetary versus symbolic frames on cooperation sustainability. Our key findings show that both endogenous and exogenous factors are critical to explain the variation of cooperation sustainability between groups. Second, groups exposed to tight situations reveal higher levels of cooperation sustainability than groups exposed to loose situations. Money primes did not have an impact. Among the control variables, collective intentionality showed the strongest association with cooperation. Future research may develop a more sophisticated measure of tight versus loose situations and examine the causal relationship between collective intentionality and cooperation.
Oct biomarkers for early prognosis in diabetic macular edema treatment with ranibizumab
Authors: Pessoa Bernardete , Leite João , Ferreira André , Ramalhão João , Poças João , José Diana , Coelho Constança , Figueira João , Meireles Angelina , Beirão João Melo
Published: November 2023

Background

Diabetic macular edema is the main cause of vision loss in patients with diabetic retinopathy. In this work, we aimed to assess the role of Optical Coherence Tomography (OCT) biomarkers in patients treated with ranibizumab.

Methods

A prospective study enrolling 46 eyes with DME under ranibizumab intravitreal therapy with 12 months of follow-up. The primary endpoint was to assess the association between OCT biomarkers at baseline and the type of treatment response.

Results

Good responders, compared with partial/non responders, had lower number of inner nuclear layer cysts (INLc) at baseline, (26.5% vs 73.5%, p = 0.035) and presented, at 12 months of follow-up, lower percentage of disorganization of retinal inner layers (12.0% vs 88.0%, p = 0.001), lower disruption of outer plexiform layer (8.7% vs 91.3%, p < 0.001) and lower outer nuclear layer cysts (17.4% vs 82.6%, p = 0.013). At the end of follow-up, it was observed a higher frequency of inner nuclear layer cysts in patients with higher glycated haemoglobin ( p = 0.028).

Conclusion

This study showed the value and importance of OCT parameters, such as absence of INLc, as a prognostic therapeutic response. A normalization of the macular anatomy with ranibizumab is more likely to happen in early complete responders. The association between INLc and higher glycated haemoglobin levels showed the importance of systemic metabolic control in systemic diabetic manifestations. Clinicaltrials.gov NCT04387604.
Smaller-Incision new-generation implantable miniature telescope: Three-months follow-up study
Authors: Savastano Alfonso , Ferrara Silvia , Sasso Paola , Savastano Maria Cristina , Crincoli Emanuele , Caporossi Tomaso , De Vico Umberto , Vidal Aroca Faustino , Francione Giuseppe , Sammarco Leonardo , Gambini Gloria , Fedeli Chiara , Di Nardo Emiliana , Rizzo Stanislao
Published: November 2023

Purpose

To evaluate three months follow-up of SING IMT implant in patients affected by late-stage AMD

Design

Prospective cohort study

Subjects

In a total of 80 eyes of 40 patients who underwent the enrollment tests, 11 patients’ eyes affected by late-stage AMD matched the inclusion criteria and underwent SING IMT implant from February to June 2022.

Methods

Before surgery, each patient underwent the enrollment examination to verify inclusion and exclusion criteria.

Main outcome measures

BCVA for distance and for near, IOP, ACD and ECD were evaluated at 1 and 3 months follow up. Also quality of life in doing the activities of daily life was evaluated.

Results

BCVA for distance and for near improved from baseline to 3 months follow up (23.91 ± 9.418 ETDRS letters and 59.09 ± 11.58 ETDRS letters respectively (p < 0.001). An endothelial cell loss was shown (p < 0.001), with a rate of cell density reduction around 8.3% (baseline vs 3 months).

Conclusions

SING IMT could be a valid surgical device to improve patients’ sight and quality of life which have been deteriorated by late-stage macular degeneration. Further studies with more patients and longer follow up are needed to confirm our results.
Achromatopsia: Long term visual performance and clinical characteristics
Authors: Eshel Yuval Margherita , Abaev Ora , Yahalom Claudia
Published: November 2023

Background

Achromatopsia is an autosomal recessive cone dysfunction syndrome, characterized by absence of color discrimination, low visual acuity, photophobia, and nystagmus. Achromatopsia constitutes a common cause of visual impairment in children, with a prevalence of 1:30,000 worldwide.

Objective

To characterize the clinical characteristics of achromatopsia, the main genes causing the disease in our population and the clinical course of the disease, with an emphasis on visual function stability with increasing age.

Methods

Retrospective study based on medical charts of patients with achromatopsia. Patients were divided into two groups according to their age at last follow-up: older and younger than 10 years. A subset of patients with long term follow-up were analyzed separately, with patients being described in both age groups.

Results

Seventy-six patients were included in the study. The mean age was 14.28 years. Variants in the CNGA3 gene were the most common (73.6%). Clinical characteristics included photophobia (96.2%), nystagmus (93.6%), hypermetropia (72.3%) and strabismus (51.1%). In the large cohort there was no correlation of age with visual acuity ( p = 0.129). In the separate subset cohort with long follow-up there was a relative improvement in visual acuity with age ( p < 0.001).

Conclusions

CNGA3 is the main gene associated with achromatopsia in our population (around ∼ 73%), which is in contrast to the distribution worldwide (∼ 25%). Most achromats suffer from photophobia and nystagmus, and the main refractive error is hypermetropia. Achromatopsia's natural course seems to be stationary, and there may even be a slight improvement in visual acuity with time.
Pyoderma gangrenosum in ulcerative colitis patient treated with vedolizumab: adsorptive granulocyte/monocyte apheresis as a new therapeutic option refractory cases – a case report and literature review
Authors: Mastronardi Mauro , Cavalcanti Elisabetta , Labarile Nunzia , Armentano Raffaele , Gabriele Francesco , Curlo Margherita
Published: November 2023

Extraintestinal manifestations occur rather frequently in ulcerative colitis (UC) and Crohn’s disease patients and are usually related to an exacerbation of the underlying intestinal bowel disease but sometimes may run a course independent of the inflammatory bowel diseases (IBD). About one-third of patients with IBD develop extraintestinal manifestations, such as pyoderma gangrenosum (PG). PG is an uncommon inflammatory skin disorder of unknown pathogenesis. There are no specific serological or histological markers, and diagnosis is predominantly clinical. Topical and systemic therapies are both vital aspects of treatment and immune modulators have been used with increasing success in recent years, although immunosuppressive drugs raise some concerns due to an increased risk of serious and opportunistic infections and cancer, particularly in elderly and comorbid patients, underlining the unmet need for safer alternative therapies. Thus, in this case report, we highlighted an adsorptive granulocyte/monocyte apheresis (GMA) as a new therapeutic possibility in IBD patients with extraintestinal manifestations. We report a case of a 60-year woman with a history of UC with a Mayo grade 3 score which was associated with a PG. Given that the patients maintained clinical remission with vedolizumab, we preferred not to perform a combined treatment with other antitumor necrosis factor-alpha or ciclosporin, thus avoiding an increased risk of serious infections in the patient. Therefore, we performed the extracorporeal leukocyte apheresis. The patient progressed favorably, with progressive improvement of skin and bowel disease. Therefore, adsorptive GMA has a very favorable safety profile and has been confirmed in numerous studies. In this study, we underlined that an intensive regimen of GMA paves the way to an ideal option for patients with severe and refractory PG complicated with UC.
Using WhatsApp support groups to promote responsive caregiving, caregiver mental health and child development in the COVID-19 era: A randomised controlled trial of a fully digital parenting intervention
Authors: Skeen Sarah , Marlow Marguerite , du Toit Stefani , Melendez-Torres GJ , Mudekunye Lynette , Mapalala Edwick , Ngoma Kelvin , Ntanda Byamukama Michael , Maketha Moroesi , Grieve Caitlin , Hartmann Laura , Gordon Sarah , Tomlinson Mark
Published: November 2023

Objective

Digital interventions hold important potential for supporting parents when face-to-face interventions are unavailable. We assessed the feasibility and effectiveness of a digital parenting intervention in Zambia and Tanzania.

Methods

Using a randomised controlled trial, we evaluated the Sharing Stories digital parenting intervention for caregivers of children aged 9–32 months with access to a smartphone in their household. Caregivers were stratified based on child age and randomly assigned to the intervention or waitlist control arm. The intervention was delivered via facilitated WhatsApp groups over 6 weeks to promote caregiver wellbeing and responsive caregiving through shared reading activities. Primary outcomes were caregiver-reported responsive caregiving, child language and socio-emotional development. Secondary outcomes were caregiver mental health and parental stress. Masked assessors conducted assessments at baseline and immediate follow-up.

Results

Between October 2020 and March 2021, we randomly assigned 494 caregiver–child dyads to the intervention ( n = 248) or waitlist control ( n = 246) arm. Caregivers in the intervention group reported more responsive caregiving (OR = 2.55, 95% CI: 1.15–5.66, p = 0.02), time reading or looking at books (β = 0.45, p = 0.04) and telling stories (β = 0.72, p = 0.002). Intervention caregivers reported significantly lower symptoms of depression (β = −0.64, p = 0.05) and anxiety (β = −0.65, p = 0.02). Child development and parental stress did not differ significantly between groups.

Conclusions

Digital parenting interventions using WhatsApp can effectively promote responsive caregiving and caregiver mental health in low-resource settings, with great potential for scalability.

Trial registration

ISRCTN database, ISRCTN77689525.
A Health App for Post-Pandemic Years (HAPPY) for people with physiological and psychosocial distress during the post-pandemic era: Protocol for a randomized controlled trial
Authors: Liu Justina Yat-Wa , Man David Wai-Kwong , Lai Frank Ho-Yin , Cheung Teris Cheuk-Chi , Cheung Amy Ka-Po , Cheung Daphne Sze-Ki , Choi Thomas Kup-Sze , Fong Gabriel Ching-Hang , Kwan Rick Yiu-Cho , Lam Simon Ching , Ng Vincent To-Yee , Wong Heung , Yang Lin , Shum David Ho-Keung
Published: November 2023

Objective

This article describes a protocol for a randomized controlled trial to evaluate the effects of a three-level Health App for Post-Pandemic Years (HAPPY) on alleviating post-pandemic physiological and psychosocial distress.

Methods

Convenience and snowball sampling methods will be used to recruit 814 people aged 18+ with physiological and/or psychosocial distress. The experimental group will receive a 24-week intervention consisting of an 8-week regular supervision phase and a 16-week self-help phase. Based on their assessment results, they will be assigned to receive interventions on mindfulness, energy conservation techniques, or physical activity training. The waitlist control group will receive the same intervention in Week 25. The primary outcome will be changes in psychosocial distress, measured using the Kessler Psychological Distress Scale (K10). Secondary outcomes will include changes in levels of fatigue (Chinese version of the Brief Fatigue Inventory), sleep quality (Chinese version of the Pittsburgh Sleep Quality Index), pain intensity (Numeric Rating Scale), positive appraisal (Short version of the 18-item Cognitive Emotion Regulation Questionnaire), self-efficacy (Chinese version of the General Self-efficacy Scale), depression and anxiety (Chinese version of the 21-item Depression Anxiety Stress Scale), and event impact (Chinese version of the 22-item Impact of Event Scale–Revised). All measures will be administered at baseline (T0), Week 8 after the supervision phase (T1), and 24 weeks post-intervention (T2). A generalized estimating equations model will be used to examine the group, time, and interaction (Time × Group) effect of the interventions on the outcome assessments (intention-to-treat analysis) across the three time points, and to compute a within-group comparison of objective physiological parameters and adherence to the assigned interventions in the experimental group.

Conclusions

The innovative, three-level mobile HAPPY app will promote beneficial behavioral strategies to alleviate post-pandemic physiological and psychosocial distress.

Trial registration

ClinicalTrials.gov, NCT05459896. Registered on 15 July 2022.
Holo-omics analysis reveals the influence of gut microbiota on obesity indicators in Jinhua pigs
Authors: Liu Shuang , Lai Xueshuang , Xie Qinqin , Wang Zhen , Pan Yuchun , Wang Qishan , Zhang Zhe
Published: November 2023

Background

The mechanisms behind obesity are complex and multi-faceted, involving the interplay of both host genomics and gut microbiome. In recent years, research has largely focused on these factors separately, but rarely from the viewpoint of holo-omics, which considers the host and microbiome as an integrated entity. To address this gap in knowledge, the present study aimed to investigate the holo-omics basis of obesity in Jinhua pigs, a Chinese indigenous breed known for its high degree of fat deposition and superior meat quality.

Methods

Six pigs with extreme obesity phenotype were selected from a larger cohort of eighteen Jinhua pigs, and the contents of the jejunum, cecum, and colon regions were collected after slaughter at 240 days of age. The data obtained was processed, denoised, and annotated using QIIME2, with expression differences being analyzed using edgeR software.

Results

The results showed significant differences in jejunal microbial diversity and composition between the two groups, with gut transcriptomics also indicating that differentially expressed genes in the jejunum were enriched in lipid metabolism pathways. These findings provide further evidence of the influence of the gut microbiome and host gene expression on fat deposition in Jinhua pigs.

Conclusions

This study provides valuable insights into the mechanisms of fat deposition in Jinhua pigs from the viewpoint of holo-omics. The integration of host transcriptomics and microbiome data helps shed light on the complex interactions between the host and gut microbiome, and highlights the importance of considering both factors in our understanding of obesity.
Factors influencing French community pharmacists’ willingness to participate in research projects: a mixed method study
Authors: Piraux Arthur , Angibaud Morgane , Nizet Pierre , Navas Dominique , Sallenave-Namont Claire , Prot-Labarthe Sonia , Huon Jean-François
Published: November 2023

Background

French community pharmacists are facing an increasing demand to provide a wider range of services to meet the needs of the population. These new missions must be evaluated by primary care research studies. This study aims to explore the factors that influence French community pharmacists’ willingness to participate in research projects.

Methods

A mixed-method design was adopted for this study, comprising an initial quantitative online survey followed by semi-directed interviews. The investigation was conducted at two French faculties of pharmacy, Angers and Nantes, involving students in their 6th and final year of pharmacy education, and their community pharmacist tutors. The survey items were based on a study by Saini et al. and participants responded using five-point Likert scales. The semi-directed interviews were conducted after the quantitative analysis, only with volunteer and already graduated community pharmacists.

Results

A total of 131 people participated in the quantitative analysis, comprising 75 students and 56 pharmacists. Pharmacists and students agreed on the significance of two key aspects: the research must possess a clear and meaningful purpose, and researchers must keep the pharmacists informed about the study’s results. Among the 27 proposed items, only three showed significantly different results between students and pharmacists. Moreover, 11 semi-structured interviews were conducted. Research in the community pharmacy domain is relatively new for many pharmacists. Despite limited training, their willingness to participate is contingent on being actively involved from the outset, receiving appropriate support and training. However, the research should be seamlessly integrated into their daily practice, without being too time-consuming and administratively burdensome. Time constraints emerged as the main obstacle, along with concerns about the availability of human resources. Pharmacists expressed strong motivation driven by the research topic’s relevance, and its potential impact on patients or the profession. While financial compensation is desirable, it did not appear to be the main criterion for participation in a study.

Conclusions

French pharmacists are willing to participate in research projects to improve patient care and develop the profession. Research teams must guide and involve from the project’s inception.
Spatial accessibility to health facilities among pregnant women with and without exposure to intimate partner violence in Uganda
Authors: Anguzu Ronald , Walker Rebekah J. , Beyer Kirsten M.M. , Zhou Yuhong , Babikako Harriet M. , Dickson-Gomez Julia , Cassidy Laura D.
Published: November 2023

Background

Poor physical access to health facilities could increase the likelihood of undetected intimate partner violence (IPV) during pregnancy. We aimed to determine sub-regional differences and associations between spatial accessibility to health facilities and IPV among pregnant women in Uganda.

Method

Weighted cross-sectional analyses were conducted using merged 2016 Uganda Demographic and Health Survey and 2014 Uganda Bureau of Statistics health facility datasets. Our study population were 986 women who self-reported being currently pregnant and responded to IPV items. Outcome was spatial accessibility computed as the near point linear distance [< 5 km (optimal) vs. ≥ 5 km (low)] between women’s enumeration area and health facility according to government reference cutoffs. Primary independent variable (any IPV) was defined as exposure to at least one of physical, emotional, and sexual IPV forms. Logistic regression models were sequentially adjusted for covariates in blocks based on Andersen’s behavioral model of healthcare utilization. Covariates included predisposing (maternal age, parity, residence, partner controlling behavior), enabling (wealth index, occupation, education, economic empowerment, ANC visit frequency), and need (wanted current pregnancy, difficulty getting treatment money, afraid of partner, and accepted partner abuse) factors.

Results

Respondents’ mean age was 26.1 years with ± 9.4 standard deviations (SD), mean number of ANC visits was 3.8 (± 1.5 SD) and 492/986 (49.9%) pregnant women experienced IPV. Median spatial accessibility to the nearest health facility was 4.1 km with interquartile range (IQR) from 0.2 to 329.1 km. Southwestern, and Teso subregions had the highest average percentage of pregnant women experiencing IPV (63.8–66.6%) while Karamoja subregion had the highest median spatial accessibility (7.0 to 9.3 km). In the adjusted analysis, pregnant women exposed to IPV had significantly higher odds of low spatial accessibility to nearest health facilities when compared to pregnant women without IPV exposure after controlling for enabling factors in Model 2 (aOR 1.6; 95%CI 1.2, 2.3) and need factors in Model 3 (aOR 1.5; 95%CI 1.1, 3.8).

Conclusions

Spatial accessibility to health facilities were significantly lower among pregnant women with IPV exposure when compared to those no IPV exposure. Improving proximity to the nearest health facilities with ANC presents an opportunity to intervene among pregnant women experiencing IPV. Focused response and prevention interventions for violence against pregnant women should target enabling and need factors.