bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients
Authors: Elkasaby Mohamed Hamouda , Khalefa Basma Badrawy , Yassin Mazen Negmeldin Aly , Alabdallat Yasmeen Jamal , Atia Ahmed , Altobaishat Obieda , Omar Islam , Hussein Amany
Published: January 2024

Introduction

The published studies comparing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in pure aortic regurgitation (AR) are conflicting. We conducted this systematic review and meta-analysis to compare TAVI with SAVR in pure AR.

Methods

We searched PubMed, Embase, Web of Science (WOS), Scopus, and the Cochrane Library Central Register of Controlled Trials (CENTRAL) from inception until 23 June 2023. Review Manager was used for statistical analysis. The risk ratio (RR) with a 95% confidence interval (CI) was used to compare dichotomous outcomes. Continuous outcomes were compared using the mean difference (MD) and 95% CI. The inconsistency test (I2) assessed the heterogeneity. We used the Newcastle-Ottawa scale to assess the quality of included studies. We evaluated the strength of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scale.

Results

We included six studies with 5633 patients in the TAVI group and 27,851 in SAVR. In-hospital mortality was comparable between TAVI and SAVR (RR = 0.89, 95% CI [0.56, 1.42], P = 0.63) (I2 = 86%, P < 0.001). TAVI was favored over SAVR regarding in-hospital stroke (RR = 0.50; 95% CI [0.39, 0.66], P < 0.001) (I2 = 11%, P = 0.34), in-hospital acute kidney injury (RR = 0.56; 95% CI: [0.41, 0.76], P < 0.001) (I2 = 91%, P < 0.001), major bleeding (RR = 0.23; 95% CI: [0.17, 0.32], P < 0.001) (I2 = 78%, P < 0.001), and shorter hospital say (MD = − 4.76 days; 95% CI: [− 5.27, − 4.25], P < 0.001) (I2 = 88%, P < 0.001). In contrast, TAVI was associated with a higher rate of pacemaker implantation (RR = 1.68; 95% CI: [1.50, 1.88], P < 0.001) (I2 = 0% P = 0.83).

Conclusion

TAVI reduces in-hospital stroke and is associated with better safety outcomes than SAVR in patients with pure AR.
Clinical characteristics and outcome of cardiac resynchronization therapy for heart failure in National Hospital of Sri Lanka from year 2005 to 2020 – a retrospective observational study
Authors: Iddagoda Hewage Don Sandun Prabath , Kuruppu Kuruppumullage Chamini Nuwansika , Dunuwille Asunga , Wijewardena Asanka , Gunawardena Rohan
Published: January 2024

Background

Cardiac resynchronization therapy (CRT) has been a well-established treatment modality for moderate to severe left ventricular systolic dysfunction with left ventricular desynchrony. This is the pioneering study that analyses the cohort who underwent CRT implantation at the National Hospital of Sri Lanka (NHSL) in Colombo from 2005 to 2020.

Objectives

This study was carried out to describe socio-demographic factors, improvements in clinical outcome (symptoms, electrocardiographic, and echocardiographic features), and post-CRT complications in the study population, as well as to determine the efficacy of CRT in heart failure.

Method

A retrospective observational study was conducted on all the living patients who had undergone CRT implantation from 2005 to 2020. The data was gathered from all the consented patients who visited the device programming clinic using a physician-administered questionnaire and clinical records. Data was analyzed using SPSS 25, and significant statistics were assessed with the McNemer test, the Student T test, and the Chi-Squared test.

Results

The study included 50 patients with a mean age of 52.82+/− 11.66 years and female predominance (56%, n = 28). Idiopathic dilated cardiomyopathy (50%, n = 25) was the leading etiological factor, followed by ischemic cardiomyopathy (28%, n = 14). Clinical symptoms have improved significantly with CRT implantation (p < 0.001). A significant improvement was found in NYHA functional class (p < 0.001, 95% CI = 0.072 to 0.284), QRS width (p < 0.001, 95% CI = 0.229 to 0.534), ejection fraction (p < 0.001, 95% CI = − 16.437 to − 8.504), and LV EDD (p < 0.001, 95% CI = 2.89 to 9.24). Post-CRT complications included lead malfunction (6%, n = 3) and chronic (14%, n = 7), bleeding or hematoma (2%, n = 1), pocket erosion or infection (6%, n = 3), and infective endocarditis (2%, n = 1).

Conclusion

According to the study, CRT significantly improves both clinical and functional outcomes in patients with moderate to severe heart failure.
Exploring trial publication and research waste in COVID-19 randomised trials of hydroxychloroquine, corticosteroids, and vitamin D: a meta-epidemiological cohort study
Authors: Fincham Lisa , Hohlfeld Ameer , Clarke Mike , Kredo Tamara , McCaul Michael
Published: January 2024

Background

The global research response to the COVID-19 pandemic was impressive, but also led to an infodemic and considerable research waste. Registered, but unpublished trials added to this noise. We aimed to determine the proportion of registered randomised trials of common COVID-19 treatments that were published and to describe the characteristics of these trials to examine the association between trial characteristics, publication status and research waste.

Methods

This meta-epidemiological cohort study used a sample of randomised trials of corticosteroids, hydroxychloroquine or vitamin D as treatments for COVID-19, registered between 1 November 2019 and 31 December 2021 and available via the WHO ICTRP portal. We searched for the trials’ published results up to 20 October 2022. We extracted the trial characteristics, analysing with descriptive statistics. We performed univariate logistic regression to examine the association between trials’ characteristics and publication status, followed by multiple logistic regression using significant characteristics to assess the association between trial characteristics and publication status.

Results

We identified 357 eligible trials on ICTRP. Of these, 107 (30%) had published or made their results available publicly by 20 October 2022, while 250 (70%) had not been published or shared their results publicly. Multiple logistic regression analysis showed that a larger target sample size was a significant positive predictor of publication with target sample sizes above 300 almost tripling the odds of publication (aOR: 2.75, 95% CI: 1.35 to 5.62).

Conclusions

Less than one third of registered trials made their results public and our findings identified that many trialists had not updated their trial registry entry with the trial status, results or both. Failure to share trial results publicly is a disservice to patients, clinicians and policy makers and adds to research waste.
The impact of endoscopist performance and patient factors on distal adenoma detection and colorectal cancer incidence
Authors: Power Sharon , Wooldrage Kate , Saunders Brian P. , Cross Amanda J.
Published: January 2024

Background

High quality endoscopy is key for detecting and removing precursor lesions to colorectal cancer (CRC). Adenoma detection rates (ADRs) measure endoscopist performance. Improving other components of examinations could increase adenoma detection.

Aims

To investigate how endoscopist performance at flexible sigmoidoscopy (FS) affects adenoma detection and CRC incidence.

Methods

Among 34,139 participants receiving FS screening by the main endoscopist at one of 13 centres in the UK FS Screening Trial, median follow-up was 17 years. Factors examined included family history of CRC, bowel preparation quality, insertion and withdrawal time, bowel segment reached, patient pain and ADR. Odds ratios (OR) for distal adenoma detection were estimated by logistic regression. Hazard ratios (HR) for distal CRC incidence were estimated by Cox regression.

Results

At screening, 4,104 participants had distal adenomas detected and 168 participants developed distal CRC during follow-up. In multivariable models, a family history of CRC (yes vs. no: OR 1.40, 95%CI 1.21–1.62), good or adequate bowel preparation quality (vs. excellent: OR 0.84, 95%CI 0.74–0.95; OR 0.56, 95%CI 0.49–0.65, respectively) and longer insertion and withdrawal times (≥ 4.00 vs. < 2.00 min: OR 1.96, 95%CI 1.68–2.29; OR 32.79, 95%CI 28.22–38.11, respectively) were associated with adenoma detection. Being screened by endoscopists with low or intermediate ADRs, compared to high ADRs, was positively associated with CRC incidence (multivariable: HR 4.71, 95%CI 2.65–8.38; HR 2.16, 95%CI 1.22–3.81, respectively).

Conclusions

Bowel preparation quality and longer insertion and withdrawal time are key for improving distal adenoma detection. Higher ADRs were associated with a lower risk of distal CRC.
Targeted metabolomics reveals plasma short-chain fatty acids are associated with metabolic dysfunction-associated steatotic liver disease
Authors: Thing Mira , Werge Mikkel Parsberg , Kimer Nina , Hetland Liv Eline , Rashu Elias Badal , Nabilou Puria , Junker Anders Ellekaer , Galsgaard Elisabeth Douglas , Bendtsen Flemming , Laupsa-Borge Johnny , McCann Adrian , Gluud Lise Lotte
Published: January 2024

Background

Alterations in the production of short-chain fatty acids (SCFAs) may reflect disturbances in the gut microbiota and have been linked to metabolic dysfunction-associated steatotic liver disease (MASLD). We assessed plasma SCFAs in patients with MASLD and healthy controls.

Methods

Fasting venous blood samples were collected and eight SCFAs were measured using gas chromatography-tandem mass spectrometry (GC-MS/MS). Relative between-group differences in circulating SCFA concentrations were estimated by linear regression, and the relation between SCFA concentrations, MASLD, and fibrosis severity was investigated using logistic regression.

Results

The study includes 100 patients with MASLD (51% with mild/no fibrosis and 49% with significant fibrosis) and 50 healthy controls. Compared with healthy controls, MASLD patients had higher plasma concentrations of propionate (21.8%, 95% CI 3.33 to 43.6, p = 0.02), formate (21.9%, 95% CI 6.99 to 38.9, p = 0.003), valerate (35.7%, 95% CI 4.53 to 76.2, p = 0.02), and α-methylbutyrate (16.2%, 95% CI 3.66 to 30.3, p = 0.01) but lower plasma acetate concentrations (− 30.0%, 95% CI − 40.4 to − 17.9, p < 0.001). Among patients with MASLD, significant fibrosis was positively associated with propionate (p = 0.02), butyrate (p = 0.03), valerate (p = 0.03), and α-methylbutyrate (p = 0.02). Six of eight SCFAs were significantly increased in F4 fibrosis.

Conclusions

In the present study, SCFAs were associated with MASLD and fibrosis severity, but further research is needed to elucidate the potential mechanisms underlying our observations and to assess the possible benefit of therapies modulating gut microbiota.
Activities of daily living limitations and the use of physical examination among older adults with informal care in China: do gender and residence make differences?
Authors: Luo Jingjing , Zhao Dan , Gao Tingting , Sun Jingjie , Li Peilong , Wang Xuehong , Wang Xueqing , Chai Shujun , Li Jiayan , Zhou Chengchao
Published: January 2024

Background

This study investigated the relationship between activities of daily living (ADL) limitations and the use of physical examination among older adults receiving informal care, and to further examine whether this relationship varies by gender and urban-rural areas.

Methods

The data in this study were obtained from the sixth Health Service of Shandong province, China. In total, 8,358 older adults aged 60 years or older who received informal care were included in the analysis. Binary logistic regression models were conducted to explore the association between ADL limitations and the use of physical examination and examine the differences between gender and urban-rural areas.

Results

The prevalence of limitations in ADL and physical examination utilization rate among older adults receiving informal care in Shandong Province were 14.12% and 72.31%, respectively. After adjusting for confounders, ADL limitations were negatively correlated with the utilization of physical examination services among older adults receiving informal care (OR = 0.74, 95% CI: 0.64, 0.87, P < 0.001), and there were gender and rural-urban differences. The association between ADL limitations and the use of physical examination was statistically significant in older women receiving informal care (OR = 0.65, 95% CI: 0.53, 0.80, P < 0.001). And only among urban older adults receiving informal care, those with ADL limitations had lower utilization of physical examination services than participants without ADL limitations (OR = 0.59, 95% CI: 0.47, 0.74, P < 0.001).

Conclusions

Our study suggested that the relationship between ADL limitations and the use of physical examination among older adults receiving informal care differed by gender and urban-rural areas in Shandong, China. These findings implied that the government should provide more health resources and personalized physical examination service programs, especially to meet the differential needs of women and urban old adults receiving informal care, to contribute to the implementation of healthy aging strategies.
Comparison of anticholinergic burden with chronic polypharmacy on functional decline and mortality in Korean older people: a retrospective nationwide cohort study
Authors: Huh Youn , Kim Ye-Jee , Choi Jung-Yeon , Lee Ji Eun , Jung Hee-Won , Shin Cheol Min , Won Chang Won , Son Ki Young
Published: January 2024

Background

We aimed to evaluate the association of anticholinergic burden and chronic polypharmacy with the incidence of functional decline and all-cause mortality, and to determine the difference between anticholinergic burden and chronic polypharmacy among Korean older people.

Methods

This nationwide cohort study included 42,132 older people aged ≥ 65 years who underwent Korean National Health Insurance Service health examinations from 2007 to 2008. Odds ratios (ORs) and 95% confidence intervals (CIs) for abnormal Timed Up and Go (TUG) test results were assessed using multivariate logistic regression analyses. Hazard ratios (HRs) and 95% CIs for all-cause mortality until the end of 2015 were estimated using multivariable Cox proportional hazards regression analysis.

Results

Of the participants, 37.19% had abnormal TUG test results, and 7.66% of those died during the 5.7-year mean follow-up. The abnormal TUG test results OR increased by 27% among individuals with Korean Anticholinergic Burden Scale (KABS) scores ≥ 3 (OR 1.27, 95% CI 1.02–1.58) compared to those with KABS scores of 0. The HRs for all-cause mortality increased for individuals with higher KABS scores (P for trend < 0.001) or chronic polypharmacy (P for trend < 0.001) compared to those for individuals without these conditions. The combination of a higher KABS or chronic polypharmacy and abnormal TUG test results increased the risk of all-cause mortality (All P for trend < 0.001).

Conclusion

Anticholinergic drug burden shows a better association with functional decline than chronic polypharmacy, and the use of medications and functional decline may be important risk factors for all-cause mortality among older people.
Association between psychiatric disorders and glioma risk: evidence from Mendelian randomization analysis
Authors: Yang Wenzhuo , Han Yu , He Changjia , Zhong Sheng , Ren Fei , Chen Zhongping , Mou Yonggao , Sai Ke
Published: January 2024

Background

Observational studies have explored the association of psychiatric disorders and the risk of brain cancers. However, the causal effect of specific mental illness on glioma remains elusive due to the lack of solid evidence.

Methods

We performed a two-sample bidirectional Mendelian randomization (MR) analysis to explore the causal relationships between 5 common psychiatric disorders (schizophrenia, major depressive disorder, bipolar disorder, autism spectrum disorder, and panic disorder) and glioma. Summary statistics for psychiatric disorders and glioma were extracted from Psychiatric Genomics Consortium (PGC) and 8 genome-wide association study (GWAS) datasets respectively. We calculated the MR estimates for odds ratio of glioma associated with each psychiatric disorder by using inverse-variance weighting (IVW) method. Sensitivity analyses such as weighted median estimator, MR-Egger and MR-PRESSO were leveraged to assess the strength of causal inference.

Results

A total of 30,657 participants of European ancestry were included in this study. After correction for multiple testing, we found that genetically predicted schizophrenia was associated with a statistically significant increase in odds of non-glioblastoma multiforme (non-GBM) (OR = 1.13, 95% CI: 1.03–1.23, P = 0.0096). There is little evidence for the causal relationships between the other 4 psychiatric disorders with the risk of glioma.

Conclusions

In this MR analysis, we revealed an increased risk of non-GBM glioma in individuals with schizophrenia, which gives an insight into the etiology of glioma.
Mini review: human clinical studies of stem cell therapy in keratoconus
Authors: Ahadi Masoumeh , Ramin Shahrokh , Abbasi Ali , Tahmouri Hanieh , Hosseini Seyed Bagher
Published: January 2024

Treatment of keratoconus is one of the most interesting research fields for researchers in the world. Regenerative medicine based on human stem cells in the treatment of keratoconus has recently received attention. Despite extensive laboratory and animal studies in regenerative medicine of cornea, there are limited clinical studies in keratoconus. These studies showed promising results of stem cell therapy. In initial studies, the transplantation of these cells into stroma was associated with increased vision and improved corneal parameters without side effects. In this article, we tried to review different aspects of keratoconus stem cell therapy, including cell extraction and culture, surgical procedure, effectiveness and safety of this method in human clinical studies.
Prevalence and correlates of generalized anxiety disorder and perceived stress among Sudanese medical students
Authors: Ibrahim Danya , Ahmed Reem Mohamed , Mohammad Ayman Zuhair , Ibrahim Basil , Mohammed Tibyan , Mohamed Mona Elfadl , Abdelgadir Tibyan , Mohammed Baraah , Ibrahim Moneib , Shaaban Kamil M. A.
Published: January 2024

Background

Generalized Anxiety Disorder (GAD) causes significant disturbance in an individual’s well-being and activity. Whereby, interfering with the dynamic progress in life. Also, anxiety is a product of stress and a major predictor of academic performance. This study aimed to assess the prevalence of Generalized Anxiety Disorder (GAD), measure levels of anxiety and perceived stress, evaluate the academic profile, identify lifestyle characteristics, and explore the relationship between these factors.

Methods

In this cross-sectional study, 340 Sudanese medical students filled out online questionnaires, composed of the sociodemographic and lifestyle characteristics, academic profile, Generalized Anxiety Disorder-2 scale (GAD-2), and Perceived Stress Scale-10 (PSS-10). Descriptive and inferential statistics were applied using Statistical Package for Social Science (SPSS) Version 20.0 for data analysis.

Results

Of 340 medical students, 3.8% of them were diagnosed with GAD, while 29.1% scored ≥ 3 in GAD-2, indicating a possible diagnosis. The study found that 9.7% of the participants used addictive substances, with 42% of them having high GAD-2 scores. Moreover, high anxiety levels were associated with high-stress scores (p-value = 0.000). Also, high GAD-2 scores were significantly associated with students who spent less than 10,000 SDG (18 USD) weekly, spent more time on entertainment using smart devices (p-value = 0.004), and had an unhealthy diet (p-value = 0.004). Low anxiety levels were associated with better sleep quality (p-value = 0.00), satisfaction with religious practices (p-value = 0.00), and increased leisure/hobby time (p-value = 0.018). High-stress levels were observed in females (p-value = 0.035), those with lower academic performance satisfaction levels, and increased hours of smart device usage for entertainment (p-value = 0.001). Reduced stress levels were associated with being ≥ 23 years old, increased leisure/hobby time (p-value = 0.002), satisfaction with religious practices [F(3, 166.6) = 10.8, p-value = 0.00)], and having a healthy diet (p-value = 0.006).

Conclusion

The low prevalence of GAD corresponded with previous literature, but 29.1% of medical students had a high probability of having GAD. The study emphasizes on providing accessible mental health services for medical students and interventions addressing modifiable risk factors.
How multiple air pollutants affect hand, foot, and mouth disease incidence in children: assessing effect modification by geographical context in multicity of Sichuan, southwest China
Authors: Luo Caiying , Ma Yue , Lu Kai , Li Ying , Liu Yaqiong , Zhang Tao , Yin Fei , Shui Tiejun
Published: January 2024

Background

Several studies have suggested a significant association of hand, foot, and mouth disease (HFMD) with ambient air pollutants. Existing studies have characterized the role of air pollutants on HFMD using only risk ratio measures while ignoring the attributable burden. And whether the geographical context (i.e., diverse topographic features) could modulate the relationships is unclear.

Methods

Daily reported childhood HFMD counts, ambient air pollution, and meteorological data during 2015–2017 were collected for each of 21 cities in Sichuan Province. A multistage analysis was carried out in different populations based on geographical context to assess effect modification by topographic conditions. We first constructed a distributed lag nonlinear model (DLNM) for each city to describe the relationships with risk ratio measures. Then, we applied a multivariate meta-regression to estimate the pooled effects of multiple air pollutants on HFMD from the exposure and lagged dimensions. Finally, attributable risks measures were calculated to quantify HFMD burden by air pollution.

Results

Based on 207554 HFMD cases in Sichuan Province, significant associations of HFMD with ambient air pollutants were observed mainly at relatively high exposure ranges. The effects of ambient air pollutants on HFMD are most pronounced on lag0 or around lag7, with relative risks gradually approaching the reference line thereafter. The attributable risks of O3 were much greater than those of other air pollutants, particularly in basin and mountain regions.

Conclusions

This study revealed significant pooled relationships between multiple air pollutants and HFMD incidence from both exposure and lag dimensions. However, the specific effects, including RRs and ARs, differ depending on the air pollution variable and geographical context. These findings provide local authorities with more evidence to determine key air pollutants and regions for devising and implementing targeted interventions.
Relationship between religiosity and HPV vaccine initiation and intention in urban black and hispanic parents
Authors: Coleman Deidra Carroll , Markham Christine , Guilamo-Ramos Vincent , Santa Maria Diane
Published: January 2024

Objective

Religion is believed to be an important sociocultural influence in the U.S., but little is known about how religiosity shapes the human papillomavirus (HPV) vaccine decision in racial/ethnic minorities. The purpose of this study was to examine the relationship between religiosity and HPV vaccine initiation and intention among urban, racial/ethnic minority parents of adolescents 11–14 years old.

Design

This study employed a descriptive, cross-sectional design using baseline data from Black and Hispanic parents (N = 175 and 285, respectively) recruited from medically underserved communities. Chi-square tests for independence and independent-samples t-tests were run to assess sociodemographic differences in vaccine initiation and vaccine intention. Binary logistic regression analyses were conducted to determine whether religious attendance and religious salience were associated with parents’ HPV vaccine decisions for their children.

Results

Approximately 47% of Black parents had vaccinated their youth against HPV. Of those who had not initiated the vaccine for their child, 54% did not intend to do so. 54% of Hispanic parents had initiated the HPV vaccine for their youth. Of those who had not initiated the vaccine for their child, 51% did not intend to do so. Frequency of attendance at religious services and the importance of religion in one’s life was not significantly correlated with HPV vaccine decision-making for Black nor Hispanic parents.

Conclusion

This study suggests that religiosity does not influence the HPV vaccine decision for urban, Black and Hispanic parents. Future studies using measures that capture the complexity of religion as a social construct are needed to confirm the findings. In addition, studies with representative sampling will enable us to make generalizations about the influence of religion on HPV vaccine decision-making for urban, racial/ethnic minority parents.
Satisfaction of people at post-working age with pharmacists’ health promotion in Poland
Authors: Raczkiewicz Dorota , Owoc Jakub , Bojar Iwona , Sarecka-Hujar Beata
Published: January 2024

Background

The study aimed to analyze how people at post-working age evaluate health promotion conducted for them by pharmacists in community pharmacies in Poland. We also assessed whether this evaluation is correlated with the frequency of health behaviors.

Methods

The study comprised 712 Polish people at post-working age (retired), including women 60 + and men 65+. Health Behaviors Inventory and authors’ Questionnaire for Evaluation of Pharmacists’ Health Promotion were used.

Results

Conducting health promotion by pharmacists in community pharmacies is relevant in the opinion of post-working-aged people (5.8 on average in the scale of 1–10). However, the patients were not satisfied with the reliability (4.7), accessibility (4.7), communicativeness (5.0), and effectiveness (4.6) of health promotion provided by pharmacists for them. The empathy and politeness of pharmacists during health promotion were rated neutrally (5.4, i.e. neither good nor bad). The evaluations of reliability, accessibility, communicativeness, empathy and politeness, relevance, and effectiveness of pharmacists’ health promotion did not correlate with age, marital status, place of residence, type of job in the past, or chronic pain currently (p > 0.05). The men evaluated accessibility higher than the women (5.1 vs. 4.6, p = 0.049), but the other domains were evaluated similarly by both genders (p > 0.05). All the domains of pharmacists’ health promotion were assessed the better the higher the frequency of health behaviors the post-working aged people was.

Conclusions

People in post-working age assessed that health promotion conducted by pharmacists in community pharmacies is important, however they were not satisfied with the reliability, accessibility, communicativeness, and effectiveness of health promotion conducted by pharmacists.
Effect of mindfulness-based stress reduction (MBSR) program on depression, emotion regulation, and sleep problems: A randomized controlled trial study on depressed elderly
Authors: Javadzade Nima , Esmaeili Sayed Vahid , Omranifard Victoria , Zargar Fatemeh
Published: January 2024

Background

Entering old age is associated with various physical and psychological disabilities. Therefore, the aim of this study is to determine the effect of mindfulness-based stress reduction program on emotion regulation and sleep problems in depressed elderly.

Methods

This study was a clinical trial conducted on 60 elderly individuals with depression using purposive sampling. These elderly were referred by geriatricians and were included in the study based on the inclusion criteria. The participants were randomly assigned to two groups: the Mindfulness-Based Stress Reduction (MBSR) group and the control group. Both groups completed the Geriatric Depression Scale (GDS), the Gratz and Roemer Emotion Regulation Questionnaire, and the Pittsburgh Sleep Quality Index before and after the intervention. The MBSR sessions were held for the experimental group in 8 sessions of 90 min each, once a week. Finally, all the data were analyzed using SPSS software version 26 through descriptive and analytical statistics such as mean and standard deviation, t-tests and mixed analysis of covariance (ANCOVA) with repeated measures.

Results

The results showed that the MBSR intervention led to a significant reduction in depression symptoms (p < 0.001) and improvement in emotion regulation and sleep quality (p < 0.001) among the elderly participants with depression in the intervention group.

Discussion

The results of this study showed that MBSR can be effective in reducing depression levels, improving emotion regulation, and sleep quality among depressed elderly individuals compared to the control group. Caregivers and psychotherapists of nursing homes can use care programs such as MBSR program to improve the physical and mental condition of the elderly.

Trial registration

First Registration: 13/01/2022, Registration Number: IRCT20211118053099N1, Access: https://www.irct.ir/trial/61207.
Predicting academic achievement from the collaborative influences of executive function, physical fitness, and demographic factors among primary school students in China: ensemble learning methods
Authors: Sun Zhiyuan , Yuan Yunhao , Xiong Xuan , Meng Shuqiao , Shi Yifan , Chen Aiguo
Published: January 2024

Background

Elevated levels of executive function and physical fitness play a pivotal role in shaping future quality of life. However, few studies have examined the collaborative influences of physical and mental health on academic achievement. This study aims to investigate the key factors that collaboratively influence primary school students' academic achievement from executive function, physical fitness, and demographic factors. Additionally, ensemble learning methods are employed to predict academic achievement, and their predictive performance is compared with individual learners.

Methods

A cluster sampling method was utilized to select 353 primary school students from Huai'an, China, who underwent assessments for executive function, physical fitness, and academic achievement. The recursive feature elimination cross-validation method was employed to identify key factors that collaboratively influence academic achievement. Ensemble learning models, utilizing eXtreme Gradient Boosting and Random Forest algorithms, were constructed based on Bagging and Boosting methods. Individual learners were developed using Support Vector Machine, Decision Tree, Logistic Regression, and Linear Discriminant Analysis algorithms, followed by the establishment of a Stacking ensemble learning model.

Results

Our findings revealed that sex, body mass index, muscle strength, cardiorespiratory function, inhibition, working memory, and shifting were key factors influencing the academic achievement of primary school students. Moreover, ensemble learning models demonstrated superior predictive performance compared to individual learners in predicting academic achievement among primary school students.

Conclusions

Our results suggest that recognizing sex differences and emphasizing the simultaneous development of cognition and physical well-being can positively impact the academic development of primary school students. Ensemble learning methods warrant further attention, as they enable the establishment of an accurate academic early warning system for primary school students.
Bedtime negative affect, sleep quality and subjective health in rural China
Authors: Sun Jiyao , Zhang Nan , Carter Jackie , Vanhoutte Bram , Wang Jian , Chandola Tarani
Published: January 2024

Background

The overall level of negative affect (NeA) has been linked to impaired health. However, whether the diurnal timing of NeA matters and whether the NeA-health relationship is mediated by sleep quality remain unclear.

Methods

Using a longitudinal dataset (2006, 2009 and 2014 waves) consisting of 1959 participants, we examined the within-person impact of both bedtime NeA and non-bedtime NeA measured by Day Reconstruction Method (DRM) on subjective health measured by Visual Analogue Scale (VAS), and the mediating effect of sleep quality on the NeA-health relationships by fixed effect models.

Results

Bedtime NeA predicted poorer health, while non-bedtime NeA was unrelated to health. The deleterious impact of bedtime NeA reduced and became non-significant after sleep quality was controlled for. Bedtime NeA also significantly predicted impaired sleep quality.

Conclusions

Bedtime NeA is a stronger predictor of poorer health than non-bedtime NeA, and the deleterious influence of bedtime NeA on health seems to operate through poor sleep quality. Therefore, interventions to reduce bedtime NeA could potentially improve subsequent sleep quality, thereby protecting people to some extent from impaired health status.
Associations of five blood heavy metals with hepatitis B virus infection and immunity in adults: a cross-sectional study
Authors: Li Xinpeng , Bi Lei , Han Lu
Published: January 2024

Background

Heavy metal pollution has emerged as a significant concern for human health, prompting increased awareness of its potential adverse effects. While previous research has established a connection between heavy metals and liver function biomarkers, the specific relationship between heavy metals and HBV infection remains unexplored. This cross-sectional study aims to investigate the potential correlations between five blood heavy metals - lead, cadmium, mercury, manganese, and selenium - and the presence of HBsAg, HBsAb, and HBcAb in adults.

Methods

The study utilized data from NHANES 2007–2018. Participants were classified into four groups based on their infectious status, and the association between heavy metals and HBV infection was analyzed using multiple logistic regression and stratification analysis.

Results

A total of 8431 participants were included, with 5 436 classified as Susceptible, 1 765 as Vaccinated, 865 as Natural Infection, and 103 as Acute/Chronic HBV Infection. The Vaccinated group exhibited a lower mean age (34.52 ± 14.16 years) compared to the other groups. Statistically significant differences in heavy metal concentrations (except selenium) were observed among the groups (P < 0.001). After adjusting for covariates, lead was significantly associated with HBV infection (Q2: OR 2.37, 95%CI 1.04–5.39; Q3: OR 2.34, 95%CI 1.01–5.40), and positive trends were observed for high blood concentrations of mercury (Q4: OR 3.03, 95%CI 1.31–7.04) and manganese (Q4: OR 2.52, 95%CI 1.20–5.28). Furtherly, the presence of lead reduced the protection of HBsAb (Q2: OR 0.84, 95%CI 0.73–0.97; Q3: OR 0.77, 95%CI 0.66–0.90; Q4: OR 0.83, 95%CI 0.70–0.98). Subgroup analysis indicated that cadmium was associated with an increased risk of HBV infection in Asians (OR 1.36, 95%CI 1.03–1.78) and individuals with a BMI range of 25 to 30 (OR 1.60, 95%CI 1.17–2.18).

Conclusions

The study’s findings suggest a correlation between elevated blood Pb concentrations and reduced immunization rates against hepatitis B. Individuals with a positive HBsAg exhibit lower blood Se concentrations and higher blood Hg and Mn concentrations.
Green and environmentally friendly synthesis of silver nanoparticles with antibacterial properties from some medicinal plants
Authors: Asefian Samira , Ghavam Mansureh
Published: January 2024

Recently there have been a variety of methods to synthesize silver nanoparticles, among which the biosynthesis method is more noticeable due to features like being eco-friendly, simple, and cost-efficient. The present study aims for the green synthesis of silver nanoparticles from the extract of the three plants A. wilhelmsi, M. chamomilla, and C. longa; moreover, it pledges to measure the antibacterial activity against some variants causing a skin rash. The morphology and size of the synthesized silver nanoparticles were evaluated by UV.vis, XRD, SEM, and FTIR analyses. Then results showed a color alteration from light yellow to dark brown and the formation of silver nanoparticles. The absorption peak with the wavelength of approximately 450 nm resulting from the Spectrophotometry analysis confirmed the synthesis of silver nanoparticles. The presence of strong and wide peaks in FTIR indicated the presence of OH groups. The SEM results showed that most synthesized nanoparticles had a spherical angular structure and their size was about 10 to 20 nm. The highest inhibition power was demonstrated by silver nanoparticles synthesized from the extract combined from all three species against Gram-positive bacteria Staphylococcus aureus and Staphylococcus epidermidis (23 mm) which had a performance far more powerful than the extract. Thus, it can be understood that the nanoparticles synthesized from these three species can act as potential environment-friendly alternatives to inhibit some variations causing skin disorders; an issue that calls for further clinical studies.
Implementation and assessment of a structured curriculum for a 4-week pediatric rheumatology rotation for pediatric residents
Authors: Sukharomana Maynart , Charuvanij Sirirat
Published: January 2024

Background

General pediatricians often initially address children’s musculoskeletal (MSK) issues and play a crucial role in triaging and managing patients’ rheumatologic conditions. This study assessed the effectiveness of a structured curriculum in enhancing pediatric residents’ knowledge, MSK examination skills, and confidence during a 4-week pediatric rheumatology rotation.

Methods

Pediatric residents in their either second or third year who participated in the 4-week rheumatology rotation once across three academic years (July 2020–June 2023) were enrolled. Residents’ knowledge, MSK examination skills, and confidence were assessed at pre- and post-rotation by using 25 multiple-choice questions, the Thai pediatric Gait Arms Legs Spine examination, and a questionnaire, respectively. The curriculum comprised instruction on MSK examinations, interactive lectures, case-based discussion, topic reviews, MSK radiology conference, clinical experience in rheumatology clinic and consultations, with self-guided learning with educational resources.

Results

Fifty-eight pediatric residents (48 females, 10 males) with a mean age of 28.9 ± 0.8 years participated. Significant improvements were noted postrotation. Knowledge scores rose from 63.0 ± 12.2 to 79.7 ± 9.1 (mean difference 16.7 ± 10.3, p < 0.001). Similarly, MSK examination scores increased from 67.5 ± 14.4 to 93.6 ± 8.7 (mean difference 26.1 ± 14.6, p < 0.001). Residents also reported a marked increase in confidence across all evaluated areas, including history taking, MSK examination, arthrocentesis, and diagnosing and treating rheumatologic conditions (p < 0.001).

Conclusions

The 4-week structured curriculum in the pediatric rheumatology rotation significantly enhanced pediatric residents’ knowledge, MSK examination skills, and confidence. These findings support the integration of pediatric rheumatology rotations into pediatric residency training programs.
Participant characteristics and reasons for non-consent to health information linkage for research: experiences from the ATHENA COVID-19 study
Authors: Greaves Kim , King Amanda , Bourne Zoltan , Welsh Jennifer , Morgan Mark , Tolosa M. Ximena , Bonner Carissa , Stanton Tony , Fryer Michael , Korda Rosemary
Published: January 2024

Background

The linkage of primary care, hospital and other health registry data is a global goal, and a consent-based approach is often used. Understanding the attitudes of why participants take part is important, yet little is known about reasons for non-participation. The ATHENA COVID-19 feasibility study investigated: 1) health outcomes of people diagnosed with COVID-19 in Queensland, Australia through primary care health data linkage using consent, and 2) created a cohort of patients willing to be re-contacted in future to participate in clinical trials. This report describes the characteristics of participants declining to participate and reasons for non-consent.

Methods

Patients diagnosed with COVID-19 from January 1st, 2020, to December 31st, 2020, were invited to consent to having their primary healthcare data extracted from their GP into a Queensland Health database and linked to other data sets for ethically approved research. Patients were also asked to consent to future recontact for participation in clinical trials. Outcome measures were proportions of patients consenting to data extraction, permission to recontact, and reason for consent decline.

Results

Nine hundred and ninety-five participants were approached and 842(85%) reached a consent decision. 581(69%), 615(73%) and 629(75%) consented to data extraction, recontact, or both, respectively. Mean (range) age of consenters and non-consenters were 50.6(22-77) and 46.1(22-77) years, respectively. Adjusting for age, gender and remoteness, older participants were more likely to consent than younger (aOR 1.02, 95%CI 1.01 to 1.03). The least socio-economically disadvantaged were more likely to consent than the most disadvantaged (aOR 2.20, 95% 1.33 to 3.64). There was no difference in consent proportions regarding gender or living in more remote regions. The main reasons for non-consent were ‘not interested in research’ (37%), ‘concerns about privacy’ (15%), ‘not registered with a GP’ (8%) and ‘too busy/no time’ (7%). ‘No reason’ was given in 20%.

Conclusion

Younger participants and the more socio-economically deprived are more likely to non-consent to primary care data linkage. Lack of patient interest in research, time required to participate and privacy concerns, were the most common reasons cited for non-consent. Future health care data linkage studies addressing these issues may prove helpful.
Temporal topic model for clinical pathway mining from electronic medical records
Authors: Li Wei , Min Xin , Ye Panpan , Xie Weidong , Zhao Dazhe
Published: January 2024

Background

In recent years, the discovery of clinical pathways (CPs) from electronic medical records (EMRs) data has received increasing attention because it can directly support clinical doctors with explicit treatment knowledge, which is one of the key challenges in the development of intelligent healthcare services. However, the existing work has focused on topic probabilistic models, which usually produce treatment patterns with similar treatment activities, and such discovered treatment patterns do not take into account the temporal process of patient treatment which does not meet the needs of practical medical applications.

Methods

Based on the assumption that CPs can be derived from the data of EMRs which usually record the treatment process of patients, this paper proposes a new CPs mining method from EMRs, an extended form of the traditional topic model - the temporal topic model (TTM). The method can capture the treatment topics and the corresponding treatment timestamps for each treatment day.

Results

Experimental research conducted on a real-world dataset of patients’ hospitalization processes, and the achieved results demonstrate the applicability and usefulness of the proposed methodology for CPs mining. Compared to existing benchmarks, our model shows significant improvement and robustness.

Conclusion

Our TTM provides a more competitive way to mine potential CPs considering the temporal features of the EMR data, providing a very prospective tool to support clinical diagnostic decisions.
Only the anxious ones? Identifying characteristics of symptom checker app users: a cross-sectional survey
Authors: Wetzel Anna-Jasmin , Klemmt Malte , Müller Regina , Rieger Monika A. , Joos Stefanie , Koch Roland
Published: January 2024

Background

Symptom checker applications (SCAs) may help laypeople classify their symptoms and receive recommendations on medically appropriate actions. Further research is necessary to estimate the influence of user characteristics, attitudes and (e)health-related competencies.

Objective

The objective of this study is to identify meaningful predictors for SCA use considering user characteristics.

Methods

An explorative cross-sectional survey was conducted to investigate German citizens’ demographics, eHealth literacy, hypochondria, self-efficacy, and affinity for technology using German language–validated questionnaires. A total of 869 participants were eligible for inclusion in the study. Asn = 67 SCA users were assessed and matched 1:1 with non-users, a sample ofn = 134 participants were assessed in the main analysis. A four-step analysis was conducted involving explorative predictor selection, model comparisons, and parameter estimates for selected predictors, including sensitivity and post hoc analyses.

Results

Hypochondria and self-efficacy were identified as meaningful predictors of SCA use. Hypochondria showed a consistent and significant effect across all analyses OR: 1.24–1.26 (95% CI: 1.1–1.4). Self-efficacy OR: 0.64–0.93 (95% CI: 0.3–1.4) showed inconsistent and nonsignificant results, leaving its role in SCA use unclear. Over half of the SCA users in our sample met the classification for hypochondria (cut-off on the WI of 5).

Conclusions

Hypochondria has emerged as a significant predictor of SCA use with a consistently stable effect, yet according to the literature, individuals with this trait may be less likely to benefit from SCA despite their greater likelihood of using it. These users could be further unsettled by risk-averse triage and unlikely but serious diagnosis suggestions.

Trial Registration

The study was registered in the German Clinical Trials Register (DRKS) DRKS00022465, DERR1-https://doi.org/10.2196/34026.