bluuebunny/crossref_metadata_2025 huggingface dataset:
Information needs on type 1 diabetes mellitus (T1DM) and its management in children and adolescents: a qualitative study
Authors: Muhammed Elamin Sasha , Muhamad Arshad Nur Fitrah , Md Redzuan Adyani , Abdul Aziz Siti Azdiah , Hong Joyce , Chua Xin Yun , Bin-Abbas Bassam Saleh , Alsagheir Afaf , Mohamed Shah Noraida
Published: April 2024

Objective

The objective of this study is to explore the information needs related to insulin therapy in children and adolescents with type 1 diabetes mellitus (T1DM) from the children’s perspectives as well as their caregivers.

Design

Qualitative study; semistructured interviews. To identify emerging themes relating to information needs, open coding and thematic analysis were employed.

Setting

Participants were recruited from a tertiary care children’s hospital in Kuala Lumpur, Malaysia and a specialist hospital in Riyadh, Saudi Arabia.

Participants

Thirty one children with a mean age of 11.5 years (SD=1.9) and their caregivers were interviewed. Seventeen participants were from Malaysia and 14 were from Saudi Arabia.

Results

Four themes of information emerged from the interviews, including information related to (1) hypoglycaemia and hyperglycaemia, (2) insulin therapy, (3) injection technique and (4) other information needs pertaining to continuous glucose monitoring, access to peer groups and future advances in insulin therapy.

Conclusion

This study provided valuable insights into the information needs related to T1DM and insulin therapy among children and adolescents with T1DM that should be considered by stakeholders in the development of age-appropriate education materials. Such materials will assist children and adolescents to better manage their life-long T1DM condition from adolescence until adulthood.
Optimising HIV drug resistance testing laboratory networks in Kenya: insights from systems engineering modelling
Authors: Wang Yinsheng , Kingwara Leonard , Wagner Anjuli Dawn , Yongo Nashon , Hassan Shukri A , Liu Shan , Oyaro Patrick , Patel Rena C
Published: April 2024

Background

HIV drug resistance (DR) is a growing threat to the durability of current and future HIV treatment success. DR testing (DRT) technologies are very expensive and specialised, relying on centralised laboratories in most low and middle-income countries. Modelling for laboratory network with point-of-care (POC) DRT assays to minimise turnaround time (TAT), is urgently needed to meet the growing demand.

Methods

We developed a model with user-friendly interface using integer programming and queueing theory to improve the DRT system in Kisumu County, Kenya. We estimated DRT demand based on both current and idealised scenarios and evaluated a centralised laboratory-only network and an optimised POC DRT network. A one-way sensitivity analysis of key user inputs was conducted.

Results

In a centralised laboratory-only network, the mean TAT ranged from 8.52 to 8.55 working days, and the system could not handle a demand proportion exceeding 1.6%. In contrast, the mean TAT for POC DRT network ranged from 1.13 to 2.11 working days, with demand proportion up to 4.8%. Sensitivity analyses showed that expanding DRT hubs reduces mean TAT substantially while increasing the processing rate at national labs had minimal effect. For instance, doubling the current service rate at national labs reduced the mean TAT by only 0.0%–1.9% in various tested scenarios, whereas doubling the current service rate at DRT hubs reduced the mean TAT by 37.5%–49.8%. In addition, faster batching modes and transportation were important factors influencing the mean TAT.

Conclusions

Our model offers decision-makers an informed framework for improving the DRT system using POC in Kenya. POC DRT networks substantially reduce mean TAT and can handle a higher demand proportion than a centralised laboratory-only network, especially for children and pregnant women living with HIV, where there is an immediate push to use DRT results for patient case management.
Mental health inequalities, challenges and support needs during COVID-19: a qualitative study of 14-to-25-year-olds in London
Authors: Lee Jasmine , Wong Keri Ka-Yee
Published: April 2024

Objectives

The impact of the COVID-19 pandemic on adolescent’s mental health and relationships has received growing attention, yet the challenges and support needs of adolescents living in existing deprivation are not well understood. The current qualitative study, part of a broader project cocreating mental health and life-skill workshops with young people, documents adolescents’ lived experience and support needs 4 years on from the COVID-19 pandemic.

Design

20 semi-structured interviews and 6 focus groups were transcribed and thematically analysed in NVivo V.12 to inform codesigned workshops to support adolescents’ needs.

Setting

Islington borough in North London, United Kingdom.

Participants

20 adolescents aged 14–25 years (mean=18.3; 60% female, 60% white) from Islington with a history of difficulties (eg, mental health, deprivation, court order) were referred by Islington local authority teams to our study.

Results

Thematic analyses revealed eight themes on adolescents’ COVID-19 experiences and five associated suggestions on ‘support needs’: health challenges and support; relationships and support; routines and support; educational challenges and learning support; inequality and support; distrust; loss of opportunities and grief.

Conclusions

In our qualitative study, adolescents spoke of positive reflections, challenges, and need for support 4 years on from the COVID-19 pandemic. Many adolescents shared their lived experiences for the first time with someone else and wished they would have the space and time to acknowledge this period of loss. Adolescents living with existing inequality and deprivation before the pandemic have reported sustained and exacerbated impacts during the pandemic, hence coproduced support for adolescents should be a priority.
Disparities in awareness and utilisation of National Essential Public Health Services between the floating population and the registered residents: a cross-sectional study in China
Authors: Wang Jin , Bai Lan , Xu Xinpeng
Published: April 2024

Objective

There are differences between the floating population and the registered population in the awareness and use of the National Essential Public Health Services (NEPHS) due to the influence of China’s household registration system. The Equalization of Basic Public Health and Family Planning Services (EBPHFPS) policy aims to reduce disparities among populations by enhancing the migrant population’s access to basic public health services. The aim of this study is to examine the relationship between the EBPHFPS targeted at the floating population and the disparities in access to and utilisation of NEPHS between registered residents and the floating population.

Design

A cross-sectional study.

Setting

8 cities (regions, autonomous prefectures) in China.

Participants

13 998 floating population and 14 000 registered residents in eight cities (regions, autonomous prefectures) were included in the analysis.

Outcome measures

Three binomial variables, including awareness of NEPHS, acceptance of health education and establishment of health records, were used as outcome indicators to examine the relationship between the EBPHFPS and the disparities between the floating and registered populations.

Methods

A linear regression model, fairness gap calculation and propensity score matching were used to explore the associations.

Results

The areas that implemented EBPHFPS exhibited an 8.3% increase in awareness of the NEPHS (p<0.01) and a 4.0% increase (p<0.05) in the likelihood of individuals having received health education within the previous year compared with the areas without the policy implementation. In contrast to registered residents, however, the floating population still faces significant disparities in NEPHS awareness and utilisation. Compared with areas without the equalisation policy, the inequality of opportunity in health education of the floating population in implementation areas is significantly lower (p<0.01), whereas no significant difference is observed in the inequality of opportunity regarding NEPHS awareness among the floating population (p>0.1). The floating population in the pilot areas of the policy encountered greater disparities in the establishment of health records (p<0.01).

Conclusions

Positive associations between the EBPHFPS policy and NEPHS awareness and utilisation among the floating population were demonstrated to some extent; however, the floating population was still confronted with a degree of inequality of opportunity. The government needs to develop target-oriented policies and a guaranteed mechanism to ensure access to NEPHS among the floating population.
Measurement properties of the Mental Health Literacy Scale (MHLS) validation studies: a systematic review protocol
Authors: ElKhalil Rouwida , AlMekkawi Mohamad , O'Connor Matt , Sherif Moustafa , Masuadi Emad , Ahmed Luai A , Al-Rifai Rami H , Belfakir Messaouda , Bayoumi Rasha , Elbarazi Iffat
Published: April 2024

Introduction

Mental Health Literacy (MHL) is important for improving mental health and reducing inequities in treatment. The Mental Health Literacy Scale (MHLS) is a valid and reliable assessment tool for MHL. This systematic review will examine and compare the measurement properties of the MHLS in different languages, enabling academics, clinicians and policymakers to make informed judgements regarding its use in assessments.

Methods and analysis

The review will adhere to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology for systematic reviews of patient-reported outcome measures and the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and will be presented following the Preferred Reporting Items for Systematic reviews and Meta-Analysis 2020 checklist. The review will be conducted in four stages, including an initial search confined to PubMed, a search of electronic scientific databases PsycINFO, CINAHL, Scopus, MEDLINE, Embase (Elsevier), PubMed (NLM) and ERIC, an examination of the reference lists of all papers to locate relevant publications and finally contacting the MHLS original author to identify validation studies that the searches will not retrieve. These phases will assist us in locating studies that evaluate the measurement properties of MHLS across various populations, demographics and contexts. The search will focus on articles published in English between May 2015 and December 2023. The methodological quality of the studies will be evaluated using the COSMIN Risk of Bias checklist, and a comprehensive qualitative and quantitative data synthesis will be performed.

Ethics and dissemination

Ethics approval is not required. The publication will be in peer-reviewed journals and presented at national and international conferences.

PROSPERO registration number

CRD42023430924.
Inter-facility transfers for emergency obstetrical and neonatal care in rural Madagascar: a cost-effectiveness analysis
Authors: Franke Mara Anna , Nordmann Kim , Frühauf Anna , Ranaivoson Rinja Mitolotra , Rebaliha Mahery , Rapanjato Zavaniarivo , Bärnighausen Till , Muller Nadine , Knauss Samuel , Emmrich Julius Valentin
Published: April 2024

Context

There is a substantial lack of inter-facility referral systems for emergency obstetrical and neonatal care in rural areas of sub-Saharan Africa. Data on the costs and cost-effectiveness of such systems that reduce preventable maternal and neonatal deaths are scarce.

Setting

We aimed to determine the cost-effectiveness of a non-governmental organisation (NGO)-run inter-facility referral system for emergency obstetrical and neonatal care in rural Southern Madagascar by analysing the characteristics of cases referred through the intervention as well as its costs.

Design

We used secondary NGO data, drawn from an NGO’s monitoring and financial administration database, including medical and financial records.

Outcome measures

We performed a descriptive and a cost-effectiveness analysis, including a one-way deterministic sensitivity analysis.

Results

1172 cases were referred over a period of 4 years. The most common referral reasons were obstructed labour, ineffective labour and eclampsia. In total, 48 neonates were referred through the referral system over the study period. Estimated cost per referral was US$336 and the incremental cost-effectiveness ratio (ICER) was US$70 per additional life-year saved (undiscounted, discounted US$137). The sensitivity analysis showed that the intervention was cost-effective for all scenarios with the lowest ICER at US$99 and the highest ICER at US$205 per additional life-year saved. When extrapolated to the population living in the study area, the investment costs of the programme were US$0.13 per person and annual running costs US$0.06 per person.

Conclusions

In our study, the inter-facility referral system was a very cost-effective intervention. Our findings may inform policies, decision-making and implementation strategies for emergency obstetrical and neonatal care referral systems in similar resource-constrained settings.
Head impact differences in blind football between Rio 2016 and Tokyo 2020 Paralympic Games: video-based observational study
Authors: Tsutsumi Shogo , Sasadai Junpei , Maeda Noriaki , Tamura Yuki , Nagao Takumi , Watanabe Tomoya , Arima Satoshi , Kaneda Kazuki , Yoshimi Mitsuhiro , Mizuta Rami , Ishihara Honoka , Shimizu Reia , Fukui Kazuki , Tashiro Tsubasa , Komiya Makoto , Suzuki Akira , Urabe Yukio
Published: April 2024

Objective

In Tokyo 2020 Paralympic Games, there were the rule and goal size changes at the blind football competition. This study aimed to compare the scoring and head impact characteristics during blind football competition between the Rio 2016 and Tokyo 2020 Paralympic Games using the official videos.

Design

Video-based observational study.

Participants

In total, 36 blind football (men’s football 5-a-side) game videos were obtained from the official International Paralympic Committee.

Primary and secondary outcome measures

Head impact was defined as the sudden contact of any object with the head. Videos were analysed to assess the number of scores and head impacts along with their corresponding details (ie, round, playing phase, scoring situation, impact situation, occurrence area, impact object, head impact site, fall and foul).

Results

The total number of goals scored at the Tokyo 2020 Paralympic Games was nearly double that at the Rio 2016 Paralympic Games. Regarding head impacts, a total of 2036 cases (Rio 2016, n=1105; Tokyo 2020, n=931) were evaluated. Significant differences were observed in head impact characteristics between the Rio 2016 and Tokyo 2020 Paralympic Games among seven outcomes (round, scoring situation, impact situation, occurrence area, impact object, site of head impact and fall).

Conclusions

Compared with the Rio 2016 Paralympic Games, the Tokyo 2020 Paralympic Games showed an increase in the number of points scored and different head impact characteristics.
Relationship among core competency, self-efficacy and transition shock in Chinese newly graduated nurses: a cross-sectional study
Authors: Tong Yahui , Wang Ting , Tong Shuping , Tang Zhaofang , Mao Lifen , Xu Lan , Shi Xiaoqing
Published: April 2024

Objectives

To investigate how core competency and self-efficacy of newly graduated nurses affect their experience of transition shock, and to determine the relationship between these factors.

Design

A cross-sectional study.

Methods

262 newly graduated nurses participated in a cross-sectional study by using demographic data, the transition shock scale, the competency inventory for registered nurses scale and the self-efficacy scale.

Results

Among newly graduated nurses, the score of transition shock was 77.641±24.140, the score of core competency was 125 (109.5, 163.5) and the score of self-efficacy was 2.5 (2,3), all of which were at a moderate level. The core competency and self-efficacy of the newly graduated nurses had a negative impact on the transition shock (β=−0.151, p=0.026; β=−0.379, p<0.001). Additionally, self-efficacy played a mediating role in the relationship between core competency and transition shock, with a mediating effect accounting for 57.34% of the total effect.

Conclusions

The transition shock of newly graduated nurses was at a moderate level, with the highest level of transition shock occurring within the first year of employment. Self-efficacy plays a mediating role in the relationship between core competency and transition shock. Nursing managers should create standardised training for newly graduated nurses within the first year of employment to reduce their transition shock. This will help improve newly graduated nurses’ core competency, enhance self-efficacy and support the graduates. This will alleviate the impact of transition shock on newly graduated nurses, helping them transition smoothly and successfully.
Analysis on the willingness and influencing factors of choosing hospice care service institutions among among older people in Wuhu, China: a cross-sectional study
Authors: Yang Liu , Zhou Quan , Hong Ting , Zhang Lin , Che Hengying
Published: April 2024

Objective

The purpose of this study was to evaluate the inclination and determinants influencing the selection of hospice care service institutions among elderly individuals in China.

Design

The study conducted has a cross-sectional design.

Setting

The study was conducted at four urban community centres in Wuhu, Anhui Province, China.

Participants

The sample consisted of 642 older adults, with ages ranging from 60 to over (mean age=71.03 years, SD=7.18).

Method

This study, based on the Anderson model, developed a questionnaire after conducting a preliminary survey and engaging in several group discussions. The final questionnaire encompassed the basic information, health status, attitude towards hospice care, choice of hospice care institutions and reasons of the older people. A regional population study was conducted using the Logistic regression model to estimate the ORs (OR) of influencing factors selected by hospice services.

Results

38.5% of respondents expressed their willingness to receive hospice care, while 22.3% were unwilling and 39.3% felt ambivalent towards it. The acceptance rate of older people in hospice care increases with higher levels of education and monthly income. 47.0% of older people opted for hospice care in a general hospital ward, indicating that demand for hospice services among older people in Wuhu City is primarily focused on such wards. The univariate analysis revealed significant differences in the willingness of older individuals to accept hospice care services based on gender, age, educational attainment and income levels. Regardless of the location of hospice care, older men had a lower likelihood of being willing to use hospice services compared with older women. The proportion of older women choosing a hospice ward or general hospital was 53.8%, which was higher than that of older men at 42.0%. The proportion of older men choosing a community health service institution was 31.6%, higher than 23.3% of women. The educational level differences significantly influence the older people’s inclination towards receiving hospice care.

Conclusion

With the ageing population of Wuhu City on the rise, there is an increasing demand for hospice services. In their final journey, older individuals require multilevel hospice care services, which necessitates equipping general hospitals with hospice wards and using community health service centres to meet their specific needs.
Association between breast feeding and food consumption according to the degree of processing in Brazil: a cohort study
Authors: Abreu de Carvalho Carolina , Viola Poliana Cristina de Almeida Fonseca , Magalhães Elma Izze da Silva , Machado Soraia Pinheiro , Matijasevich Alicia , Menezes Ana Maria Baptista , Tovo-Rodrigues Luciana , Santos Ina S , Goncalves Helen , Wehrmeister Fernando C , Horta Bernardo Lessa , Moura da Silva Antônio Augusto
Published: April 2024

Background

The benefits of breast feeding may be associated with better formation of eating habits beyond childhood. This study was designed to verify the association between breast feeding and food consumption according to the degree of processing in four Brazilian birth cohorts.

Methods

The duration of exclusive, predominant and total breast feeding was evaluated. The analysis of the energy contribution of fresh or minimally processed foods (FMPF) and ultra-processed foods (UPF) in the diet was evaluated during childhood (13–36 months), adolescence (11–18 years) and adulthood (22, 23 and 30 years).

Results

Those who were predominantly breastfed for less than 4 months had a higher UPF consumption (β 3.14, 95% CI 0.82 to 5.47) and a lower FMPF consumption (β −3.47, 95% CI −5.91 to −1.02) at age 22 years in the 1993 cohort. Exclusive breast feeding (EBF) for less than 6 months was associated with increased UPF consumption (β 1.75, 95% CI 0.25 to 3.24) and reduced FMPF consumption (β −1.49, 95% CI −2.93 to −0.04) at age 11 years in the 2004 cohort. In this same cohort, total breast feeding for less than 12 months was associated with increased UPF consumption (β 1.12, 95% CI 0.24 to 2.19) and decreased FMPF consumption (β −1.13, 95% CI −2 .07 to −0.19). Children who did not receive EBF for 6 months showed an increase in the energy contribution of UPF (β 2.36, 95% CI 0.53 to 4.18) and a decrease in FMPF (β −2.33, 95% CI −4 .19 to −0.48) in the diet at 13–36 months in the 2010 cohort. In this cohort, children who were breastfed for less than 12 months in total had higher UPF consumption (β 2.16, 95% CI 0.81 to 3.51) and lower FMPF consumption (β −1.79, 95% CI −3.09 to −0.48).

Conclusion

Exposure to breast feeding is associated with lower UPF consumption and higher FMPF consumption in childhood, adolescence and adulthood.
Prospective diagnostic accuracy study of history taking and physical examination for adults with vertigo in general practice: study protocol
Authors: Ross Andrew , Leemeyer Anna-Marie Rebecca , Bruintjes Tjasse D , Cals Jochen W L , Bronstein Adolfo , van Leeuwen Roeland B , Lissenberg-Witte Birgit , van Vugt Vincent Alexander , Rutgers Sandra , Maarsingh Otto R
Published: April 2024

Introduction

Vertigo is a prevalent and burdensome symptom. More than 80% of patients with vertigo are primarily treated by their general practitioner (GP) and are never referred to a medical specialist. Despite this therapeutic responsibility, the GP’s diagnostic toolkit has serious limitations. All recommended tests lack empirical evidence, because a diagnostic accuracy study on vestibular disorders (‘How well does test x discriminate between patients with or without target condition y?’) has never been performed in general practice. The VERtigo DIagnosis study aims to fill this gap.

Methods and analysis

We will perform a diagnostic accuracy study on vertigo of primary vestibular origin in general practice to assess the discriminative ability of history taking and physical examination. We will compare all index tests with a respective reference standard. We will focus on five target conditions that account for more than 95% of vertigo diagnoses in general practice: (1) benign paroxysmal positional vertigo, (2) vestibular neuritis, (3) Ménière’s disease, (4) vestibular migraine (VM) and (5) central causes other than VM. As these five target conditions have a different pathophysiology and lack one generally accepted gold standard, we will use consensus diagnosis as a construct reference standard. Data for each patient, including history, physical examination and additional tests as recommended by experts in an international Delphi procedure, will be recorded on a standardised form and independently reviewed by a neurologist and otorhinolaryngologist. For each patient, the reviewers have to decide about the presence/absence of each target condition. We will calculate sensitivity, specificity, predictive values, likelihood ratios and diagnostic ORs, followed by decision rules for each target condition.

Ethics and dissemination

The study obtained approval from the Vrije Universiteit Medical Center Medical Ethical Review Committee (reference: 2022.0817—NL83111.029.22). We will publish our findings in peer-reviewed international journals.

Trial registration number

ISRCTN97250704.
Journey of medication reconciliation compliance in a lower middle-income country: a retrospective chart review
Authors: Fatima Samar , Arshad Ainan , Zafar Amara , Farrukh Sana , Rahim Anum , Nazar Saharish , Zafar Hasnain
Published: April 2024

Objective

There were three main objectives of the study: to determine the overall compliance of medication reconciliation over 4 years in a tertiary care hospital, to compare the medication reconciliation compliance between paper entry (initial assessment forms) and computerised physician order entry (CPOE), and to identify the discrepancies between the medication history taken by the physician at the time of admission and those collected by the pharmacist within 24 hours of admission.

Methods

This study was conducted at a tertiary care hospital in a lower middle-income country. Data were gathered from two different sources. The first source involved retrospective data obtained from the Quality and Patient Safety Department (QPSD) of the hospital, consisting of records from 8776 patients between 2018 and 2021. The second data source was also retrospective from a quality project initiated by pharmacists at the hospital. Pharmacists collected data from 1105 patients between 2020 and 2021, specifically focusing on medication history and identifying any discrepancies compared with the history documented by physicians. The collected data were then analysed using SPSS V.26.

Results

The QPSD noted an improvement in physician-led medication reconciliation, with a rise from 32.7% in 2018 to 69.4% in 2021 in CPOE. However, pharmacist-led medication reconciliation identified a 25.4% (n=281/1105) overall discrepancy in the medication history of patients admitted from 2020 to 2021, mainly due to incomplete medication records in the initial assessment forms and CPOE. Physicians missed critical drugs in 4.9% of records; pharmacists identified and updated them.

Conclusion

In a lower middle-income nation where hiring pharmacists to conduct medication reconciliation would be an additional cost burden for hospitals, encouraging physicians to record medication history more precisely would be a more workable method. However, in situations where cost is not an issue, it is recommended to adopt evidence-based practices, such as integrating clinical pharmacists to lead medication reconciliation, which is the gold standard worldwide.
Patient and healthcare professional perspectives on the Practical Guide to Implementing PROMs in Gender-Affirming Care (PG-PROM-GAC): analysis of open-ended responses from patients and healthcare professionals
Authors: Kamran Rakhshan , Jackman Liam , Laws Anna , Stepney Melissa , Harrison Conrad , Jain Abhilash , Rodrigues Jeremy
Published: April 2024

Importance

Several international calls have been made for evidence-based patient-reported outcome measure (PROM) implementation for gender-affirming care. The Practical Guide to Implementing PROMs in Gender-Affirming Care (PG-PROM-GAC) is a resource which can help guide PROM implementation efforts, developed using a three-phase participatory research approach with transgender and gender-diverse (TGD) patients and gender-affirming healthcare professionals. However, thoughts and perspectives from TGD patients and gender-affirming healthcare professionals on the PG-PROM-GAC need to be investigated.

Objective

Investigate patient and healthcare professional perspectives on the PG-PROM-GAC through analysis of open-ended survey results.

Design

Qualitative study analysing open-ended responses from TGD patients and gender-affirming healthcare professionals.

Setting

Participants were recruited from a UK National Health System (NHS) gender clinic.

Participants

Patients receiving care at an NHS gender clinic and healthcare professionals working at an NHS gender clinic were eligible for participation. Eligible participants were invited to participate in this study via email.

Intervention

Participants were sent an open-ended survey to collect responses on the PG-PROM-GAC.

Main outcome(s) and measure(s)

Data were thematically analysed by two independent researchers and interpreted following guidance from established methods in implementation science.

Results

A total of 64 TGD patients and 9 gender-affirming healthcare professionals responded to the open-ended survey (mean (SD) age: 35 (16) and 48 (8), respectively). Four main themes emerged from the data: overall opinions and support for the PG-PROM-GAC, presentation of the PG-PROM-GAC, impact of gender clinic resources on PROM implementation and impact of PROM selection on implementation. Data were used to iterate the PG-PROM-GAC in response to participant feedback.

Conclusions and relevance

The PG-PROM-GAC is an acceptable and feasible resource that can be used by clinicians, researchers and policymakers to guide PROM implementation for gender-affirming care settings, helping to align gender-affirming care with patient needs.
Knockdown of KIF23 alleviates the progression of asthma by inhibiting pyroptosis
Authors: Rao Xingyu , Lei Zicheng , Zhu Huifang , Luo Kaiyuan , Hu Chaohua
Published: April 2024

Background

Asthma is a chronic disease affecting the lower respiratory tract, which can lead to death in severe cases. The cause of asthma is not fully known, so exploring its potential mechanism is necessary for the targeted therapy of asthma.

Method

Asthma mouse model was established with ovalbumin (OVA). H&E staining, immunohistochemistry and ELISA were used to detect the inflammatory response in asthma. Transcriptome sequencing was performed to screen differentially expressed genes (DEGs). The role of KIF23 silencing in cell viability, proliferation and apoptosis was explored by cell counting kit-8, EdU assay and flow cytometry. Effects of KIF23 knockdown on inflammation, oxidative stress and pyroptosis were detected by ELISA and western blot. After screening KIF23-related signalling pathways, the effect of KIF23 on p53 signalling pathway was explored by western blot.

Results

In the asthma model, the levels of caspase-3, IgG in serum and inflammatory factors (interleukin (IL)-1β, KC and tumour necrosis factor (TNF)-α) in serum and bronchoalveolar lavage fluid were increased. Transcriptome sequencing showed that there were 352 DEGs in the asthma model, and 7 hub genes includingKIF23were identified. Knockdown of KIF23 increased cell proliferation and inhibited apoptosis, inflammation and pyroptosis of BEAS-2B cells induced by IL-13 in vitro. In vivo experiments verified that knockdown ofKIF23inhibited oxidative stress, inflammation and pyroptosis to alleviate OVA-induced asthma mice. In addition, p53 signalling pathway was suppressed by KIF23 knockdown.

Conclusion

Knockdown of KIF23 alleviated the progression of asthma by suppressing pyroptosis and inhibited p53 signalling pathway.
Prebiotic selection influencing inflammatory bowel disease treatment outcomes: a review of the preclinical and clinical evidence
Authors: Ariaee Amin , Koentgen Sabrina , Wardill Hannah R , Hold Georgina L , Prestidge Clive A , Armstrong Heather K , Joyce Paul
Published: April 2024

Inflammatory bowel disease (IBD) is characterised by chronic inflammation in the gastrointestinal tract, with unclear aetiology but with known factors contributing to the disease, including genetics, immune responses, environmental factors and dysbiosis of the gut microbiota. Existing pharmacotherapies mainly target the inflammatory symptoms of disease, but recent research has highlighted the capacity for microbial-accessible carbohydrates that confer health benefits (ie, prebiotics) to selectively stimulate the growth of beneficial gut bacteria for improved IBD management. However, since prebiotics vary in source, chemical composition and microbiota effects, there is a clear need to understand the impact of prebiotic selection on IBD treatment outcomes. This review subsequently explores and contrasts the efficacy of prebiotics from various sources (β-fructans, galacto-oligosaccharides, xylo-oligosaccharides, resistant starch, pectin, β-glucans, glucomannans and arabinoxylans) in mitigating IBD symptomatology, when used as either standalone or adjuvant therapies. In preclinical animal colitis models, prebiotics have revealed type-dependent effects in positively modulating gut microbiota composition and subsequent attenuation of disease indicators and proinflammatory responses. While prebiotics have demonstrated therapeutic potential in animal models, clinical evidence for their precise efficacy remains limited, stressing the need for further investigation in human patients with IBD to facilitate their widespread clinical translation as microbiota-targeting IBD therapies.
Peripheral hearing loss at age 70 predicts brain atrophy and associated cognitive change
Authors: Parker Thomas D , Hardy Chris , Keuss Sarah , Coath William , Cash David M , Lu Kirsty , Nicholas Jennifer M , James Sarah-Naomi , Sudre Carole , Crutch Sebastian , Bamiou Doris-Eva , Warren Jason D , Fox Nick C , Richards Marcus , Schott Jonathan M
Published: April 2024

Background

Hearing loss has been proposed as a modifiable risk factor for dementia. However, the relationship between hearing, neurodegeneration, and cognitive change, and the extent to which pathological processes such as Alzheimer’s disease and cerebrovascular disease influence these relationships, is unclear.

Methods

Data from 287 adults born in the same week of 1946 who underwent baseline pure tone audiometry (mean age=70.6 years) and two time point cognitive assessment/multimodal brain imaging (mean interval 2.4 years) were analysed. Hearing impairment at baseline was defined as a pure tone average of greater than 25 decibels in the best hearing ear. Rates of change for whole brain, hippocampal and ventricle volume were estimated from structural MRI using the Boundary Shift Integral. Cognition was assessed using the Pre-clinical Alzheimer’s Cognitive Composite. Regression models were performed to evaluate how baseline hearing impairment associated with subsequent brain atrophy and cognitive decline after adjustment for a range of confounders including baseline β-amyloid deposition and white matter hyperintensity volume.

Results

111 out of 287 participants had hearing impairment. Compared with those with preserved hearing, hearing impaired individuals had faster rates of whole brain atrophy, and worse hearing (higher pure tone average) predicted faster rates of hippocampal atrophy. In participants with hearing impairment, faster rates of whole brain atrophy predicted greater cognitive change. All observed relationships were independent of β-amyloid deposition and white matter hyperintensity volume.

Conclusions

Hearing loss may influence dementia risk via pathways distinct from those typically implicated in Alzheimer’s and cerebrovascular disease in cognitively unimpaired older adults.
Outcomes of subsequent pregnancy in women with peripartum cardiomyopathy: a systematic review and meta-analysis
Authors: Wijayanto Matthew Aldo , Myrtha Risalina , Lukas Graciella Angelica , Rahma Annisa Aghnia , Hanifa Shafira Nur , Zahira Hadiqa Almas , Ilyas Muhana Fawwazy
Published: April 2024

Introduction

The primary concern for women who have experienced peripartum cardiomyopathy (PPCM) is the safety of a subsequent pregnancy (SSP). To maximie decision-making, facilitate effective patient counselling, and ultimately improve maternal and fetal outcomes as a whole, it is critical to comprehend the outcomes of SSP in women who have previously experienced PPCM. This study aimed to evaluate the outcomes of SSP in women with PPCM.

Methods

Three databases (PubMed, Scopus, and ScienceDirect) were used to identify relevant studies prior to 17 October 2023. A total of 662 studies were reviewed. Following the abstract and full-text screenings, 18 observational studies were included, out of which 2 were deemed suitable for inclusion in this meta-analysis. The quality assessment was conducted using the Newcastle-Ottawa Scale.

Results

This study has a total of 487 SSPs. Although recovered left ventricular (LV) function before entering SSP has the potential to be a beneficial prognostic factor, recovered LV function still has a substantial risk of relapse. The mortality rate of PPCM in an SSP ranged from 0% to 55.5%. Persistent LV dysfunction was significantly associated with an increased mortality rate (OR 13.17; 95% CI 1.54 to 112.28; p=0.02) and lower LV ejection fraction (MD −12.88; 95% CI −21.67 to −4.09; p=0.004). Diastolic and right ventricular functions remained unchanged before SSP and at follow-up. The majority of the SSP was observed alongside hypertension, while pre-eclampsia emerged as the predominant hypertensive complication in most studies.

Conclusion

SSP increases the risk of relapse and mortality in women with a previous history of PPCM. Persistent LV dysfunction prior to the SSP has a higher mortality risk compared with recovered LV function. SSP was also associated with the worsening of LV echocardiography parameters.
Intelligent cholinergic white matter pathways algorithm based on U-net reflects cognitive impairment in patients with silent cerebrovascular disease
Authors: Fei Beini , Cheng Yu , Liu Ying , Zhang Guangzheng , Ge Anyan , Luo Junyi , Wu Shan , Wang He , Ding Jing , Wang Xin
Published: April 2024

Background and objective

The injury of the cholinergic white matter pathway underlies cognition decline in patients with silent cerebrovascular disease (SCD) with white matter hyperintensities (WMH) of vascular origin. However, the evaluation of the cholinergic white matter pathway is complex with poor consistency. We established an intelligent algorithm to evaluate WMH in the cholinergic pathway.

Methods

Patients with SCD with WMH of vascular origin were enrolled. The Cholinergic Pathways Hyperintensities Scale (CHIPS) was used to measure cholinergic white matter pathway impairment. The intelligent algorithm used a deep learning model based on convolutional neural networks to achieve WMH segmentation and CHIPS scoring. The diagnostic value of the intelligent algorithm for moderate-to-severe cholinergic pathway injury was calculated. The correlation between the WMH in the cholinergic pathway and cognitive function was analysed.

Results

A number of 464 patients with SCD were enrolled in internal training and test set. The algorithm was validated using data from an external cohort comprising 100 patients with SCD. The sensitivity, specificity and area under the curve of the intelligent algorithm to assess moderate and severe cholinergic white matter pathway injury were 91.7%, 87.3%, 0.903 (95% CI 0.861 to 0.952) and 86.5%, 81.3%, 0.868 (95% CI 0.819 to 0.921) for the internal test set and external validation set. for the. The general cognitive function, execution function and attention showed significant differences among the three groups of different CHIPS score (all p<0.05).

Discussion

We have established the first intelligent algorithm to evaluate the cholinergic white matter pathway with good accuracy compared with the gold standard. It helps more easily assess the cognitive function in patients with SCD.
Childhood opportunity and appropriate use of child safety restraints in motor vehicle collisions
Authors: Chen Stephanie Y , Garcia Iris , Ourshalimian Shadassa , Lowery Chantel , Chaudhari Pradip P , Spurrier Ryan G
Published: April 2024

Objectives

Safety restraints reduce injuries from motor vehicle collisions (MVCs) but are often improperly applied or not used. The Childhood Opportunity Index (COI) reflects social determinants of health and its study in pediatric trauma is limited. We hypothesized that MVC patients from low-opportunity neighborhoods are less likely to be appropriately restrained.

Methods

A retrospective cross-sectional study was performed on children/adolescents ≤18 years old in MVCs between January 1, 2011 and December 31, 2021. Patients were identified from the Children’s Hospital Los Angeles trauma registry. The outcome was safety restraint use (appropriately restrained, not appropriately restrained). COI levels by home zip codes were stratified as very low, low, moderate, high, and very high. Multivariable regression controlling for age identified factors associated with safety restraint use.

Results

Of 337 patients, 73.9% were appropriately restrained and 26.1% were not appropriately restrained. Compared with appropriately restrained patients, more not appropriately restrained patients were from low-COI (26.1% vs 20.9%), high-COI (14.8% vs 10.8%) and very high-COI (10.2% vs 3.6%) neighborhoods. Multivariable analysis demonstrated no significant associations in appropriate restraint use and COI. There was a non-significant trend that children/adolescents from moderate-COI neighborhoods were more likely than those from very low-COI neighborhoods to be appropriately restrained (OR=1.82, 95% CI 0.78, 4.28).

Conclusion

Injury prevention initiatives focused on safety restraints should target families of children from all neighborhood types.

Level of evidence

III.
Exercise snacks are a time-efficient alternative to moderate-intensity continuous training for improving cardiorespiratory fitness but not maximal fat oxidation in inactive adults: a randomized controlled trial
Authors: Yin Mingyue , Deng Shengji , Chen Zhili , Zhang Boyi , Zheng Huakun , Bai Mingyang , Li Hansen , Zhang Xing , Deng Jianfeng , Liu Qian , Little Jonathan P. , Li Yongming
Published: April 2024

The aims of this study were (1) to determine how stair-climbing-based exercise snacks (ES) compared to moderate-intensity continuous training (MICT) for improving cardiorespiratory fitness (CRF), and (2) to explore whether ES could improve maximal fat oxidation rate (MFO) in inactive adults. Healthy, young, inactive adults ( n: 42, age: 21.6 ± 2.3 years, BMI: 22.5 ± 3.6 kg·m−2, peak oxygen uptake (VO2peak): 33.6 ± 6.3 mL·kg−1·min−1) were randomly assigned to ES, MICT, or Control. ES ( n = 14) and MICT ( n = 13) groups performed three sessions per week over 6 weeks, while the control group ( n = 15) maintained their habitual lifestyle. ES involved 3 × 30 s “all-out” stair-climbing (6 flight, 126 steps, and 18.9 m total height) bouts separated by >1 h rest, and MICT involved 40 min × 60%–70% HRmax stationary cycling. A significant group × time interaction was found for relative VO2peak ( p < 0.05) with ES significantly increasing by 7% compared to baseline (MD = 2.5 mL·kg−1·min−1 (95% CI = 1.2, 3.7), Cohen’s d = 0.44), while MICT had no significant effects (MD = 1.0 mL·kg−1·min−1 (−1.1, 3.2), Cohen’s d = 0.17), and Control experienced a significant decrease (MD = −1.7 mL·kg−1·min−1 (−2.9, −0.4), Cohen’s d = 0.26). MFO was unchanged among the three groups (group × time interaction, p > 0.05 for all). Stair climbing-based ES are a time-efficient alternative to MICT for improving CRF among inactive adults, but the tested ES intervention appears to have limited potential to increase MFO.
Validation of a delivery strategy for reducing nutrient inputs and improving nutrient use efficiency in greenhouse-grown sub-irrigated pot chrysanthemums
Authors: Shelp Barry J. , Teeter-Wood Katherine R. , Flaherty Edward J. , Schenck Lou M. , Aalbers Jamie
Published: April 2024

Two experiments were conducted in a naturally lit research greenhouse to validate our modified strategy for delivering nutrients to sub-irrigated chrysanthemum plants. A split-plot design was used with four blocks arranged randomly, three nutrient rates as the main plot, and two contrasting cultivars as the subplot. The entire nutrient supply was removed at bud break and markedly reduced during vegetative growth, compared to common commercial fertilizer formulations, without adversely affecting tissue nutrient levels and plant/inflorescence quality, indicating that the plants were functioning in the low nutrient sufficiency zone. Specific nutrients (Nt) were more likely to exhibit improved uptake efficiency (shoot Nt content/Nt supply) than improved utilization efficiency (inflorescence DM/shoot Nt content) with decreasing nutrient supply. Thus, the common practice of delivering superfluous nutrient levels to greenhouse-grown chrysanthemum has little scientific merit in terms of nutrient accumulation and plant longevity. Applying a low‐input nutrient delivery strategy to the cultivation of indoor-grown, potted ornamental plants would improve the overall sustainability of the Canadian floricultural industry.
Quadratic Rastall gravity: from low-mass HESS J1731−347 to high-mass PSR J0952−0607 pulsars
Authors: El Hanafy Waleed
Published: April 2024

Similar to Rastall gravity we introduce matter-geometry nonminimal coupling which is proportional to the gradient of quadratic curvature invariants. Those are mimicking the conformal trace anomaly when backreaction of the quantum fields to a curved spacetime geometry is considered. We consider a static spherically symmetric stellar structure with anisotropic fluid and Krori-Barua metric potentials model to examine the theory. Confronting the model with NICER + XMM-Newton observational constraints on the pulsar PSR J0740$$+$$
+
6620 quantifies the amount of the nonminimal coupling via a dimensionless parameter $$\epsilon \simeq -0.01$$

ϵ
≃
-
0.01

. We verify that the conformal symmetry is broken everywhere inside the pulsar as the trace anomaly $$\varDelta >0$$

Δ
>
0

, or equivalently the trace of the stress-energy tensor $${\mathfrak {T}}<0$$

T
<
0

, whereas the adiabatic sound speed does not violate the conjecture conformal upper limit $$v_r^2/c^2 = 1/3$$

v
r
2

/

c
2

=
1
/
3

. The maximum compactness accordingly is $$C_\text {max}=0.752$$

C
max

=
0.752

which is $$4\%$$

4
%

higher than GR. Notably, if the conformal sound speed constraint is hold, observational data excludes $$\epsilon \ge 0$$

ϵ
≥
0

up to $$\ge 1.6\sigma $$

≥
1.6
σ

. The stellar model is consistent with the self-bound structure with soft linear equation of state. Investigating possible connection with MIT bag model of strange quarks sets physical bounds from microscopic physics which confirm the negative value of the parameter $$\epsilon $$
ϵ
. We estimate a radius $$R=13.21 \pm 0.96$$

R
=
13.21
±
0.96

km of the most massive observed compact star PSR J0952−0607 with $$M=2.35\pm 0.17 M_\odot $$

M
=
2.35
±
0.17

M
⊙

. Finally, we show that the corresponding mass-radius diagram fits well lowest-mass pulsar HESS J1731−347 and highest-mass pulsar PSR J0952−0607 ever observed as well as the intermediate mass range as obtained by NICER and LIGO/Virgo observations.
Evaluation of uncertainties in atomic data on spectral lines and transition probabilities
Authors: Kramida Alexander
Published: April 2024

The present article discusses some recent advances in methods of critical evaluation of experimental data on wavelengths of spectral lines and theoretical data on transition probabilities and oscillator strengths for atoms and atomic ions. In particular, recently developed new statistical approaches to estimation of uncertainties of weighted means of multiple measurements are described, and a numerical toolbox implementing these new approaches is presented. There are also some new developments in estimation of uncertainties of theoretical transition probabilities. A short review of literature implementing these new procedures is provided, including a description of the methodology.

Graphical abstract