bluuebunny/crossref_metadata_2025 huggingface dataset:
Seizure risk in multiple sclerosis patients treated with disease-modifying therapy: A systematic review and network meta-analysis
Authors: Dang Yew Li , Yong Vivien TY , Sharmin Sifat , Perucca Piero , Kalincik Tomas
Published: February 2023

Background:

Multiple sclerosis patients experience 3–6 times more seizures than the general population, but observations vary among studies. Seizure risk in disease-modifying therapy recipients remains unknown.

Objective:

The objective of this study was to compare seizure risk in multiple sclerosis patients receiving disease-modifying therapy versus placebo.

Methods:

MEDLINE(OVID), Embase, CINAHL, and ClinicalTrials.gov were searched from database inception until August 2021. Phase 2–3 randomized, placebo-controlled trials reporting efficacy and safety data for disease-modifying therapies were included. Network meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using Bayesian random effects model for individual and pooled (by drug target) therapies. Main outcome was loge seizure risk ratios [95% credible intervals]. Sensitivity analysis included meta-analysis of non-zero-event studies.

Results:

A total of 1993 citations and 331 full-texts were screened. Fifty-six included studies (29,388 patients—disease-modifying therapy = 18,909; placebo = 10,479) reported 60 seizures (therapy = 41; placebo = 19). No individual therapy was associated with altered seizure risk ratio. Exceptions were daclizumab (−17.90 [−65.31; −0.65]) and rituximab (−24.86 [−82.71; −1.37]) trending toward lower risk ratio; cladribine (25.78 [0.94; 4.65]) and pegylated interferon-beta-1a (25.40 [0.78; 85.47]) trended toward higher risk ratio. Observations had wide credible intervals. Sensitivity analysis of 16 non-zero-event studies revealed no difference in risk ratio for pooled therapies (l0.32 [−0.94; 0.29])

Conclusion:

No evidence of association was found between disease-modifying therapy and seizure risk—this informs seizure management in multiple sclerosis patients.
How to navigate a pandemic: Competing discourses in The Australian Women's Weekly magazine
Authors: James Sara , Sawyer Anne-Maree
Published: February 2023

As the Covid-19 pandemic caused schools, workplaces, and childcare centres to close, pressures in the home increased. Much of the additional unpaid work required under these conditions was done by women. Most women's magazines at this time urged women to stay positive and develop wellbeing routines to help them flourish. This approach reinforces normative neoliberal subjectivity with its roots in therapeutic culture and the happiness industry. While the focus on self-care may seem empowering, it puts more pressure on women in times of upheaval. Based on a thematic analysis of pandemic-related content in Australia's most popular women's magazine, The Australian Women's Weekly, we identified three key themes: ‘finding the silver lining’, ‘making lifestyle choices’, and ‘recognising hardships and social divides’. While self-responsibilising discourses were prominent, some articles acknowledged the broader structural issues impacting women, revealing a tension between competing discourses.
Perspectives of social workers and supervisors about the supervision of protective services
Authors: Yu Mei-Kuei , Liao Min-Yu
Published: February 2023

Although numerous studies have quantitatively examined the different aspects of supervision, such as satisfaction in clinical and student supervision, empirical evidence on current practices in the supervision of protective services is limited. The present study explored barriers that protective social workers and their supervisors (line managers) face with respect to supervisory support. Moreover, the perceived challenges related to supervision were identified. The participants were recruited from public and private protective service organizations across Taiwan. In-depth interviews were conducted by the authors on 10 social workers and 10 supervisors.

Findings

Through the analysis of the transcripts, four themes were identified: emotional responses, knowledge components, modeling of values and creation of a culture of equality, and tensions related to supervisory accountability. Exploring protective social workers and supervisors’ perspectives on supervision is essential for understanding the complex needs of these employees.

Applications

The present findings fill the research gap on the supervision of protective services and constitute a foundation for future studies on this subject. The findings contribute to the literature on the supervision of protective services, which is beginning to address issues concerning supervisees’ emotional responses, supervisory knowledge, supervisor–supervisee relationships, and supervisory accountability. Potential limitations of the study were also discussed.
Plasma Galectin-3 and H-FABP correlate with poor physical performance in patients with congestive heart failure
Authors: Ahmad Firdos , Karim Asima , Khan Javaidullah , Qaisar Rizwan
Published: February 2023

Heart failure (HF) is often associated with compromised physical capacity in patients. However, it is unclear if established HF markers correlate with the physical performance of patients with congestive HF (CHF). We assessed the left ventricular end-systolic dimension (LVESD) and ejection fraction (LVEF) and, physical performance parameters, including short physical performance battery (SPPB), gait speed (GS), and handgrip strength (HGS) in 80 patients with CHF along with 59 healthy controls. Furthermore, levels of plasma HF markers galectin-3 and heart-specific fatty acid binding protein (H-FABP) were measured in relation to the severity of HF and physical performance. Irrespective of etiology, significantly greater LVESD and lower LVEF were observed in HF patients versus controls. As expected, the levels of HF markers galectin-3 and H-FABP were upregulated in the CHF patients which were accompanied by significantly elevated levels of plasma zonulin and inflammatory marker C-reactive protein (CRP). The SPPB scores, GS, and HGS were significantly lower in the ischemic and non-ischemic HF patients than controls. The level of galectin-3 was inversely correlated with SPPB scores ( r2 = 0.089, P = 0.01) and HGS ( r2 = 0.078, P = 0.01). Similarly, H-FABP levels were also inversely correlated with SPPB scores ( r2 = 0.06, P = 0.03) and HGS ( r2 = 0.109, P = 0.004) in the patients with CHF. Taken together, CHF adversely affects physical performance, and galectin-3 and H-FABP may serve as biomarkers of physical disability in patients with CHF. The robust correlations of galectin-3 and H-FABP with the physical performance parameters and CRP in CHF patients suggest that the poor physical performance may partly be caused due to systemic inflammation.
Long-Term Survival and Quality of Life After Fenestrated Endovascular Repair for Complex Abdominal Aortic Aneurysms
Authors: Schreuder Wietske M. A. , Dijkstra Martijn L. , von Meijenfeldt Gerdine C. I. , Tielliu Ignace F. J. , Zeebregts Clark J. , Saleem Ben R. , van der Laan Maarten J.
Published: February 2023

Objectives

Fenestrated endovascular repair (FEVAR) has become a widely used treatment option for complex abdominal aortic aneurysms (AAA) but long-term survival and quality of life (QoL) outcomes are scarce. This single center cohort study aims to evaluate both long-term survival and QoL after FEVAR.

Methods

All juxtarenal and suprarenal AAA patients treated with FEVAR in a single-center between 2002 and 2016 were included. QoL scores, measured by the RAND 36-Item Short Form Survey (SF-36), were compared with baseline data of the SF-36 provided by RAND.

Results

A total of 172 patients were included at a median follow-up of 5.9 years (IQR 3.0-8.8). Follow-up at 5 and 10 years post-FEVAR yielded survival rates of 59.9% and 18%, respectively. Younger patient age at surgery had a positive influence on 10-year survival and most patients died due to cardiovascular pathology. Emotional well-being was better in the research group as compared to baseline RAND SF-36 1.0 data (79.2 ± 12.4 vs 70.4 ± 22.0; P < 0.001). Physical functioning (50 (IQR 30–85) vs 70.6 ± 27.4; P = 0.007) and health change (51.6 ± 17.0 vs 59.1 ± 23.1; P = 0.020) were worse in the research group as compared to reference values.

Conclusions

Long-term survival was 60% at 5-years follow-up, which is lower than reported in recent literature. An adjusted positive influence of younger age at surgery was found on long-term survival. This could have consequences for future treatment indication in complex AAA surgery but further large-scale validation is necessary.
A novel histological occlusion classification for coiled aneurysms based on multiphoton microscopy
Authors: Zoltan Szatmary , Jonathan Cortese , Jeremy Mounier , Marie-Laure Perrin , Kevin Janot , Claude Couquet , Le Flahec Aurélien , Claire Leger-Bretou , Charbel Mounayer , Aymeric Rouchaud , Bardet Sylvia M
Published: February 2023

Objective

Intracranial aneurysm (IA) coiling remains the most commonly used endovascular approach for ruptured and unruptured IA, and recanalization is a common drawback that impairs treatment success. Angiographic occlusion and aneurysm healing are not synonymous, and histological evaluation of embolized aneurysms remains a challenge. We propose here an experimental study of coil embolization in animal models by multiphoton microscopy (MPM) in comparison with conventional histological staining. The purpose of his work is to analyze coil healing process using histological sections of aneurysms.

Methods

Based on a rabbit elastase model, 27 aneurysms were fixed, embedded in resin, and cut in thin histological sections 1 month after coils implantation and after angiographic control. Hematoxylin and eosin (H&S) staining were realized. Non-stained adjacent slices were imaged for multiphoton excited autofluorescence (AF) and second-harmonic generation (SHG) to construct three-dimensional (3D) projections of sequentially and axially acquired images.

Results

The contrast provided by the combination of these two imaging modalities can be used to distinguish five levels of aneurysm healing, based on a combination of thrombus evolution and increased extracellular matrix (ECM) deposit.

Conclusion

RDPC:\Users\SHAHUL\RDP6|We have established a novel histological scale from a rabbit elastase aneurysm model after coiling with a classification of five different stages thanks to nonlinear microscopy. This classification is an actualized tool in order to obtain a more precise evaluation of occlusion device efficacy in the scope of new innovative microscopy for research.
Patient attitudes, experiences, and satisfaction with healthcare and office visit utilization among Medicare beneficiaries with type 2 diabetes
Authors: He Qing , Hawkins Georgianne Tiu , Park Chanhyun , Han Sola , LaManna Jacqueline B. , Ng Boon Peng
Published: February 2023

Objectives

To examine patient attitudes, experiences, and satisfaction with healthcare associated with office visit utilization among Medicare beneficiaries with type 2 diabetes.

Methods

We analyzed the 2019 Medicare Current Beneficiary Survey Public Use File of beneficiaries aged ≥65 years with type 2 diabetes ( n = 1092). The ordinal dependent variable was defined as 0, 1 to 5, and ≥6 office visits. An ordinal partial proportional odds model was conducted to examine associations of beneficiaries’ attitudes, experiences, and satisfaction with healthcare and office visit utilization.

Results

Among the beneficiaries, approximately 17.7%, 22.8%, and 59.5% reported having 0, 1 to 5, and ≥6 office visits, respectively. Being male (OR = 0.67, p = 0.004), Hispanic (OR = 0.53, p = 0.006), divorced/separated (OR = 0.62, p = 0.038) and living in a non-metro area (OR = 0.53, p < 0.001) were associated with a lower likelihood of attending more office visits. Trying to keep sickness to themselves (OR = 0.66, p = 0.002) and dissatisfaction with the ease and convenience of getting to providers from home (OR = 0.45, p = 0.010) were associated with a lower likelihood of having more office visits.

Discussion

The proportion of beneficiaries foregoing office visits is concerning. Attitudes concerning healthcare and transportation challenges can be barriers to office visits. Efforts to ensure timely and appropriate access to care should be prioritized for Medicare beneficiaries with diabetes.
Reliability and validity of the K-force grip dynamometer in healthy subjects: do we need to assess it three times?
Authors: Magni Nico , Olds Margie , McLaine Sally
Published: February 2023

Introduction

Digital dynamometers to assess grip strength are becoming more common in research and clinical settings. The aim of the study was to assess validity and reliability of the K-force dynamometer compared to the Jamar dynamometer. We also aimed to assess differences over the course of three measurements.

Methods

Twenty-seven healthy participants were included. Three trials with the K-force and Jamar dynamometers were completed. Testing order was randomised. Intraclass correlation coefficients (ICCs) with absolute agreement assessed reliability and validity. Standard error of the measurement (SEM) and minimal detectable change (MDC95) were calculated. Concurrent validity was assessed using Pearson’s correlations and ICCs. Differences between the three repetitions were assessed using one-way repeated measures ANOVAs.

Results

Both the K-force and the Jamar presented excellent intra-rater reliability with ICCs ranging from 0.96 to 0.97. The SEM ranged from 1.7 to 2 kg and the MDC from 4.7 to 5.7 kg for both dynamometers. The concurrent validity of the K-force was high ( r ≥ 0.89). However, the K-force underestimated the grip strength by 4.5–8.5 kg. There was no change in grip strength with either dynamometer over the course of three trials.

Conclusions:

The K-force is reliable, but it underestimates grip strength by 4.5–8.5 kg compared to the Jamar dynamometer. K-force can be used to monitor progress over time but cannot be used to compare results against normative data. The use of a single measurement when assessing grip strength is sufficient when assessing healthy subjects.
Programming for older children in School Age Care: Adult and child engagement with developmental pedagogies
Authors: Hurst Bruce
Published: February 2023

How to work with older children has been ongoing question in Australian School Age Care (SAC) for over 30 years. Children aged 10–12 years are often spoken of as a problematic Other whose pose a risk to the younger children who attend SAC in higher proportions. This article aims to address the gap in research about what practices might work with this age group. It draws on a qualitative study conducted with SAC practitioners and older children who attend SAC. In semi-structured interviews, practitioners were asked about what strategies they employed with older children. These strategies are then viewed in relation to the perspectives of older children who were consulted via participatory methods and ethnography about what good SAC might look like. The research explores two approaches that draw on developmental knowledges, the use of separate spaces and resources, and a role called apprentice educator. Whilst older children appear to value strategies like age-segregated spaces and resources, they are less likely to take up adult-like, apprentice educator roles curated for them by practitioners. Older children’s responses to these strategies can be understood as powerful acts around developmental discourses that construct and reconstruct the category of older child in SAC.
Dimensions of repair work
Authors: Barca Stefania
Published: February 2023

Reflecting on the necessary, though risky path of overcoming dualistic thinking about repair and care work, I develop analytical distinctions between different kinds of repair work, reflecting gendered, racial, and spatial divisions of labour, as well as distinct forms of ecological consciousness and agency.
North Flinders Reef (Coral Sea, Australia) Porites sp. corals as a candidate Global boundary Stratotype Section and Point for the Anthropocene series
Authors: Zinke Jens , Cantin Neal E , DeLong Kristine L , Palmer Kylie , Boom Arnoud , Hajdas Irka , Duprey Nicolas , Martínez-García Alfredo , Rose Neil L , Roberts Sarah L , Yang Handong , Roberts Lucy R , Cundy Andrew B , Gaca Pawel , Milton James Andy , Frank Grace , Cox Adam , Sampson Sue , Tyrrell Genevieve , Agg Molly , Turner Simon D
Published: February 2023

Corals are unique in the suite of proposed Anthropocene Global Boundary Stratotype Section and Point (GSSP) archives, as living organisms that produce aragonite exoskeletons preserved in the geological record that contain highly accurate and precise (<±1 year) internal chronologies. The GSSP candidate site North Flinders Reef in the Coral Sea (Australia) is an offshore oceanic reef, and therefore less vulnerable to local human influences than those closer to the coast. Here, we present geochemical records from two Porites sp. corals sampled at an annual to pluri-annual (i.e. 3–5 years) resolution that shows clear global and regional human impacts. Atmospheric nuclear bomb testing by-products (14C,239+240Pu) show a clear increase in the Flinders Reef corals coincident with well-dated nuclear testing operations. By contrast, the radionuclides 241Am and 137Cs are present at low or undetectable levels, as are spheroidal carbonaceous fly-ash particles. Coral δ13C shows centennial variability likely influenced by growth effects in the 18th century and with a progression to lower values starting in 1880 CE and accelerating post-1970 CE. The latter may be related to the Suess effect resulting from 13C-depleted fossil fuel burning. Coral δ15N decreased between 1710 and 1954 CE with a reversal post-1954 CE. Coral temperature proxies indicate prominent centennial variability with equally warm conditions in the 18th and end of 20th century. However, the exact mechanisms responsible for the mid-20th century changes in these parameters need to be scrutinised in further detail.

Plain Language summary:

This work proposes a candidate natural archive for the official marker of the Anthropocene that geologists will use to mark this important interval in time. Our candidate is a live coral from North Flinders Reef in the Coral Sea (Australia), located 150 km east of the Great Barrier Reef, a location that is remote from direct local human influences. Corals are a unique archive of tropical ocean change because they incorporate the geochemical signature from seawater into their limestone skeleton during their long life-spans. Here we investigated a number of geochemical markers in yearly growth layers of the corals to define several markers for the Anthropocene based on changes in temperature, water chemistry, chemicals from pollution and fertilisers, radioactive products from nuclear bomb testing, and by-products from burning fossil fuels. We have detected clear human influences in several of these markers.
Proactive transparency in governance: A comparative study of digitalisation of the Right to Information Act in central and state governments in India
Authors: Mandowara Khushi , Thomas Vineeth
Published: February 2023

In the age of information, communication and technology, the digitalisation of governance is quintessential for implementing a culture of transparency and accountability in administration. India is a quasi-federal state and administration happens at the centre and state levels. In this context, this article makes a comparative study of the digitalisation of the Right to Information (RTI) Act in India at the centre and state levels of administration and governance. The article looks at the legislation on the right to information, the factors that motivated the digitalisation of the RTI Act, the importance of the RTI Act under Sustainable Development Goals and the political reasons behind the inadequate operationalisation of the RTI Act. The article concludes with a summary of the arguments and key policy recommendations.
Why Do Leaders Escalate Their Commitment to a Failed Course of Action? A Moderated-Mediation Personality Traits Model
Authors: Shertzer Yonatan , Brender-Ilan Yael
Published: February 2023

Escalation of Commitment (EoC) relates to decision-makers’ tendency to commit resources to a failing course of action. The current study attempts to expand the understanding of personality traits as factors that potentially engender EoC by offering an EoC-prone personality profile. Our moderated-mediation model illustrates how extraversion affects EoC through the mediations of sensation-seeking, and how hubris moderates the effect of sensation-seeking on EoC. The results are based on data gleaned from an online questionnaire completed by 314 respondents from various managerial levels employed among wide-ranging Israeli industries. Data was obtained via network respondent-driven sampling from a 500 managers’ sample. The model was tested using Hayes’s Process procedure. Sensation-seeking was found to fully mediate the relationship between extraversion and EoC, while hubris was found to moderate the relationship between sensation-seeking and EoC. Managerial implications and future research directions are suggested.
Effect of Changes in Iliocapsularis Cross-sectional Area on Hip Arthroscopy Outcomes: Clinical and Magnetic Resonance Imaging Follow-up
Authors: Gao Guanying , Wang Cheng , Liu Rongge , Wang Jianquan , Ao Yingfang , Xu Yan
Published: February 2023

Background:

The function of the iliocapsularis (IC) muscle is still unclear. Previous studies have reported that the cross-sectional area of the IC may be useful in identifying borderline developmental dysplasia of the hip (BDDH).

Purpose:

To evaluate the pre- to postoperative changes in IC cross-sectional area in patients with femoroacetabular impingement (FAI) and to determine if there are any associations with clinical outcomes after hip arthroscopy.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The authors retrospectively evaluated patients who underwent arthroscopic surgery for FAI at a single institution between January 2019 and December 2020. Patients were divided into 3 groups according to lateral center-edge angle: BDDH group (20°-25°), control group (25°-40°), and pincer group (>40°). Supine anteroposterior hip radiographs, 45° Dunn view radiographs, computed tomography scans, and magnetic resonance imaging (MRI) scans were obtained for all patients preoperatively and postoperatively. The cross-sectional areas of the IC and the rectus femoris (RF) were measured on an axial MRI slice at the level of the femoral head center. Preoperative and final follow-up scores on the visual analog scale for pain and the modified Harris Hip Score (mHHS) were compared between groups with the independent-samples t test.

Results:

A total of 141 patients (mean age, 38.5 years; 64 male, 77 female) were included. The preoperative IC-to-RF ratio of the BDDH group was significantly higher than that of the pincer group ( P < .05). In the BDDH group, there was significant pre- to postoperative decrease in IC cross-sectional area and the IC-to-RF ratio ( P < .05 for both) as well as a significant correlation between the preoperative IC cross-sectional area and the postoperative mHHS ( r = 0.434; P = .027).

Conclusion:

Patients with BDDH had a significantly higher preoperative IC-to-RF ratio than patients with pincer morphology. A higher preoperative IC cross-sectional area was associated with better postoperative patient-reported outcomes after arthroscopy for the treatment of FAI combined with BDDH.
Resilience and Influencing Factors Among Youths Undergoing Substance Abuse Treatment in Thailand: A Cross-Sectional Study
Authors: Dallas Jinjutha Chaisena , Jullamate Pornchai , Vatanasin Duangjai , Moungkum Saifone , Nadarajan Sivasankari , Krungkraipetch Nisakorn
Published: February 2023

Introduction

Resilience aids rapid recovery from substance abuse, prevents the likelihood of relapse, and improves the quality of life of the youths with substance abuse.

Objective

This study aimed to assess the resilience level and related factors predicting resilience among youths undergoing substance abuse treatment in Thailand.

Methods

A descriptive cross-sectional design with a simple random sampling technique was used. A total of 430 young substance abusers undergoing treatment were recruited from ten treatment centers in Eastern Thailand from April to June 2021. Data were collected using nine questionnaires: demographic form, resilience questionnaire, Rosenberg self-esteem questionnaire, psychological flexibility for substance abuser questionnaire, cognitive fusion questionnaire, substance abuse self-stigma scale, family connectedness scale, friendship intimacy questionnaire, and personal resource questionnaire. Descriptive statistics and stepwise multiple regression were used to analyze data.

Results

The results showed a high level of resilience (89.30%) among the youths undergoing substance abuse treatment. The stepwise multiple regression analysis revealed that the significant factors associated with resilience include self-esteem (β = 0.260, p < .001), psychological flexibility (β = 0.222, p < .001), social support (β = 0.209, p < .000), and family connectedness (β = −0.194, p < .001). All the variables collectively explained 26.9% of the variance for resilience among the youths with substance abuse ( R2 = .269, p < .001).

Conclusion

Determining resilience and its related factors among the youths undergoing substance abuse treatment is significant as it guides the formulation of the substance abuse treatment programs, improves mental health and quality of life, and prevents relapse.
Medication Adherence and Contributing Factors Among Type 2 Diabetes Patients at Adama Hospital Medical College in Eastern Ethiopia
Authors: Yosef Tewodros , Nureye Dejen , Tekalign Eyob , Assefa Elias , Shifera Nigusie
Published: February 2023

Introduction

Good glycemic control and preventing early complications are the ultimate targets of diabetes management, which depends on patients’ adherence to regimens. Even though highly potent and effective medications have been developed and manufactured with astonishing advancement over the past few decades, excellent glycemic control has remained elusive.

Objective

This study aimed to assess the magnitude and factors associated with medication adherence among type 2 diabetes (T2D) patients on follow-up at Adama Hospital Medical College (AHMC) in East Ethiopia.

Methods

A hospital-based cross-sectional study was conducted among 245 T2D patients on follow-up at AHMC from March 1 to March 30, 2020. Medication adherence reporting scale-5 (MARS-5) was utilized to collect information regarding patients’ medication adherence. The data were entered and analyzed using SPSS (Statistical Package for Social Sciences) version 21. The level of significance was declared at a p-value of  < .05.

Results

Of the 245 respondents, the proportion of respondents who adhere to diabetes medication was 29.4%, 95% CI [confidence interval] (23.7%–35.1%). After adjusting for khat chewing and adherence to blood glucose testing as confounding factors, being married (AOR [adjusted odds ratio]  =  3.43, 95%CI [1.27–4.86]), government employee (AOR  =  3.75, 95%CI [2.12–7.37]), no alcohol drinking (AOR  =  2.25, 95%CI [1.32–3.45]), absence of comorbidity (AOR  =  1.49, 95%CI [1.16–4.32]), and having diabetes health education at health institution (AOR  =  3.43, 95%CI [1.27–4.86]) were the factors associated with good medication adherence.

Conclusion

The proportion of T2D patients who adhere to medication in the study area was remarkably low. The study also found that being married, government employee, no alcohol drinking, absence of comorbidity, and having diabetes health education at a health institution were the factors associated with good medication adherence. Therefore, imparting health education on the importance of diabetes medication adherence by health professionals at each follow-up visit should be considered. Besides, awareness creation programs regarding diabetes medication adherence should be considered using mass media (radio and television).
Deep phenotypic analysis of psychiatric features in genetically defined cohorts: application to XYY syndrome
Authors: Raznahan Armin , Rau Srishti , Schaffer Luke , Liu Siyuan , Fish Ari M. , Mankiw Catherine , Xenophontos Anastasia , Clasen Liv S. , Joseph Lisa , Thurm Audrey , Blumenthal Jonathan D. , Bassett Dani S. , Torres Erin N.
Published: February 2023

Background

Recurrent gene dosage disorders impart substantial risk for psychopathology. Yet, understanding that risk is hampered by complex presentations that challenge classical diagnostic systems. Here, we present a suite of generalizable analytic approaches for parsing this clinical complexity, which we illustrate through application to XYY syndrome.

Method

We gathered high-dimensional measures of psychopathology in 64 XYY individuals and 60 XY controls, plus additional interviewer-based diagnostic data in the XYY group. We provide the first comprehensive diagnostic description of psychiatric morbidity in XYY syndrome and show how diagnostic morbidity relates to functioning, subthreshold symptoms, and ascertainment bias. We then map behavioral vulnerabilities and resilience across 67 behavioral dimensions before borrowing techniques from network science to resolve the mesoscale architecture of these dimensions and links to observable functional outcomes.

Results

Carriage of an extra Y-chromosome increases risk for diverse psychiatric diagnoses, with clinically impactful subthreshold symptomatology. Highest rates are seen for neurodevelopmental and affective disorders. A lower bound of < 25% of carriers are free of any diagnosis. Dimensional analysis of 67 scales details the profile of psychopathology in XYY, which survives control for ascertainment bias, specifies attentional and social domains as the most impacted, and refutes stigmatizing historical associations between XYY and violence. Network modeling compresses all measured symptom scales into 8 modules with dissociable links to cognitive ability, adaptive function, and caregiver strain. Hub modules offer efficient proxies for the full symptom network.

Conclusions

This study parses the complex behavioral phenotype of XYY syndrome by applying new and generalizable analytic approaches for analysis of deep-phenotypic psychiatric data in neurogenetic disorders.
Whole-genome sequence of Macaca fascicularis: liver tissue
Authors: Seo Eun-Hye , Kim Jeong-Hwan , Kim Da-Hee , Oh Jung-Hwa , Kim Seon-Young
Published: February 2023

Objectives

Thrombocytopenia is a condition that causes a low amount of blood platelets. Platelets are blood cells that play an essential role in blood coagulation. Therefore, thrombocytopenia can put the patient at risk for mild to severe bleeding. Thrombocytopenia is caused by a decrease in platelet production in the bone marrow or by a drug or immune system problem when production is normal. In particular, in some ASO-induced thrombocytopenia, the mechanism is not clear. Therefore, whole genome sequencing (WGS) was performed to discover genetic differences that affect thrombocytopenia and individual susceptibility to drugs between normal and reduced platelet monkeys despite administering the same ASO.

Data description

Three antisense oligonucleotide (ASO) substances were injected into the subcutaneous tissue of monkeys for 12 weeks in two experiments. The monkeys were classified into three groups: monkeys with thrombocytopenia, monkeys without thrombocytopenia, and control monkeys not treated with ASO substances. Whole genome sequencing data was generated using liver tissues of monkeys. These data will be useful for identifying genetic differences that affect thrombocytopenia and drug sensitivity.
Post discharge management of heart failure patients: clinical findings at the first medical visit in a single-center study
Authors: Sall F. , Adoubi A. , Boka C. , Koffi N. , Ouattara P. , Dakoi A. , Anzouan-Kacou J. B.
Published: February 2023

Background

The Post Discharge Management of patients with heart failure impact significantly their incomes. This study aims to analyze the clinical findings and management at the first medical visit of these patients in our context.

Material and methods

This is a retrospective cross-sectional descriptive study on consecutive files of patients hospitalized for heart failure from January to December 2018 in our Department. We analyse data from the first post discharge medical visit including medical visit time, clinical conditions and management.

Results

Three hundred and eight patients (mean age: 53.4 ± 17.0 years, 60% males) were hospitalized on median duration of 4 days [1–22 days]. One hundred and fifty-three patients (49,67%) were presented at the first medical visit after 66.53 days[0.06–369] on average, 10 (3.24%) patients died before this first medical visit and 145 (47.07%) had been lost to follow-up. The re-hospitalization and treatment non-compliance rates were 9.4% and 3.6%, respectively. Male gender (p = 0.048), renal failure (p = 0.010), and Vitamin K antagonist (VKA) /direct oral anticoagulant (DOAC) (p = 0.049) were the main lost to follow-up factors in univariate analysis without statistic signification in multivariate analysis. Hyponatremia (OR = 2.339; CI 95% = 0.908–6.027; p = 0.020) and atrial fibrillation (OR = 2.673; CI 95% = 1.321–5.408; p = 0.012) were the major mortality factors.

Conclusion

The management of patients with heart failure after discharge from hospital seems to be insufficient and inadequate. A specialized unit is required to optimize this management.
Associations between transitions of intrinsic capacity and frailty status, and 3-year disability
Authors: Jia Shuli , Zhao Wanyu , Ge Meiling , Xia Xin , Hu Fengjuan , Hao Qiukui , Zhang Yan , Yang Mei , Yue Jirong , Dong Birong
Published: February 2023

Background

The trajectory of frailty and intrinsic capacity (IC) often overlap in older adults. Longitudinal analyses of transitions of frailty and IC, and their associations with incident functional decline are limited. The present study aimed to identify transitions of frailty status and IC, and explore associations between transitions of frailty and IC, and future disability among community-dwelling older adults.

Methods

In the West China and Aging Trend Study, 808 participants aged ≥ 60 years completed baseline and three years follow-up (frailty, IC and disability assessments). Physical frailty was measured based on Fried phenotype. IC was evaluated by five domains (cognition, locomotion, sensory, psychological, and vitality). Disability was defined as a need for assistance in any items in activity of daily living (ADL) or the instrumental activity of daily living (IADL). Logistic regressions were performed to examine their relationships.

Results

Four transitions of IC status (kept well: 27.4%, improved: 8.4%, worsened: 35.4%, and kept poor: 28.8%), and two transitions of frailty status (kept not-frail/improved: 93.2%, kept frail/worsened: 6.8%) were identified. Impaired locomotion and vitality at baseline were significantly associated with kept frail or worsened frail. However, impaired sensory and vitality at baseline not frailty status was significantly associated with transitions of IC. Adjusted for covariates and transitions of frailty, kept poor IC was associated with ADL (OR = 2.26, 95%CI = 1.17,4.34) and IADL disability (OR = 3.74, 95%CI = 1.79, 7.82).

Conclusions

Transitions of IC, but not frailty were associated with higher risk of incident disability. Baseline locomotion and vitality impairment were associated with worsened or kept frail. Our findings support the WHO’s notion of monitoring and optimizing IC to delay deterioration of IC and preventing frailty and disability.

Clinical trial number

ChiCTR1800018895
Barriers and facilitators to oral PrEP uptake among high-risk men after HIV testing at workplaces in Uganda: a qualitative study
Authors: Nabunya Racheal , Karis Victoria M. S. , Nakanwagi Lydia Joslyline , Mukisa Pius , Muwanguzi Patience A.
Published: February 2023

Background

Men in Uganda contribute significantly to new HIV infections annually yet PrEP uptake among them is low and those initiated are likely to discontinue usage. We explored the barriers and facilitators to PrEP uptake among high-risk men employed in private security services with negative HIV results after testing at workplaces in Uganda.

Methods

An explorative qualitative study comprising in-depth participant interviews. Data were collected via telephone calls and manually analyzed by inductive content analysis.

Results

Fifty-six (56) men participated, 27(48.21%) had heard about PrEP, and 29(51.79%) were willing to initiate it. Four categories emerged for the facilitators of PrEP uptake including the perceived need for HIV prevention, awareness creation, availability, and sexual freedom. Six categories emerged for the barriers to PrEP uptake. These were: Inaccessibility of PrEP services, Misinformation, Knowledge deficit, Medication-related barriers, Potential for increased risky sexual behavior, and Perceptions about PrEP use.

Conclusion

The findings suggest the need for healthcare providers to offer information regarding PrEP and HIV prevention services and mass sensitization campaigns to facilitate uptake. Participants recommend mass roll-out of PrEP to lower-level facilities and accessible pick-up points for men such as workplaces. The men also suggested the use of longer-acting PrEP modalities such as an injectable option or an option that is utilized specifically by the female partner. Finally, the stigma surrounding PrEP use could be reduced by the separation of PrEP and ART services at health facilities, or special pick-up days to reduce waiting times.
De novo upper tract urothelial carcinoma after renal transplantation: a single-center experience in China
Authors: Li Shixin , Zhang Jian , Tian Ye , Zhu Yichen , Guo Yuwen , Wang Zhipeng , Yang Yang , Ding Guangpu , Lin Jun
Published: February 2023

Background

Long-term prognosis and risk factors of de novo upper tract urothelial carcinoma after renal transplantation were rarely studied. Thus, the aim of this study was to investigate the clinical features, risk factors, and long-term prognosis of de novo upper tract urothelial carcinoma after renal transplantation, especially the impact of aristolochic acid on tumor, using a large sample.

Methods

106 patients were enrolled in retrospective study. The endpoints included overall survival, cancer-specific survival, bladder or contralateral upper tract recurrence-free survival. Patients were grouped according to aristolochic acid exposure. Survival analysis was performed using Kaplan–Meier curve. Log-rank test was used to compare the difference. Multivariable cox regression was conducted to evaluate the prognostic significance.

Results

Median time from transplantation to development of upper tract urothelial carcinoma was 91.5 months. Cancer-specific survival rate at 1, 5, 10 years was 89.2%, 73.2%, 61.6%. Tumor staging (≥ T2), lymph node status (N +) were independent risk factors for cancer-specific death. Contralateral upper tract recurrence-free survival rate at 1, 3, 5 years was 80.4%, 68.5%, 50.9%. Aristolochic acid exposure was independent risk factor for contralateral upper tract recurrence. The patients exposed to aristolochic acid had more multifocal tumors and higher incidence of contralateral upper tract recurrence.

Conclusion

Both higher tumor staging and positive lymph node status were associated with a worse cancer-specific survival in patients with post-transplant de novo upper tract urothelial carcinoma, which highlighted the importance of early diagnosis. Aristolochic acid was associated with multifocality of tumors and higher incidence of contralateral upper tract recurrence. Thus, prophylactic contralateral resection was suggested for post-transplant upper tract urothelial carcinoma, especially for patients with aristolochic acid exposure.
Lived experiences and coping strategies of persons seeking infertility treatment in the Kumasi metropolis: a descriptive phenomenological study
Authors: Annan-Frey Louisa , Boateng Edward Appiah , Lomotey Alberta , Lartey Christopher , Dzomeku Veronica
Published: February 2023

Background

Women seeking fertility treatment face myriad challenges that they must adapt and adjust to daily. This aimed at exploring the experiences and coping strategies of such persons in the Kumasi.

Metropolis.

Methods

A qualitative approach was employed and a purposive sampling technique was used to select 19 participants. A semi-structured interview was used to collect data. The data collected were analyzed using Colaizzi's method of data analysis.

Results

Persons living with infertility had emotional experiences of anxiety, stress, and depression. Socially, participants experienced isolation, stigma, societal pressure, and marital problems due to their inability to conceive. The key coping strategies adopted were spiritual (faith-based) and social support. Though formal child adoption can be an option, no participant preferred it as a coping strategy. Some participants also reported using herbal medicine before going to the fertility centre upon realizing that the approach was not helping in achieving their desired outcome.

Conclusion

Infertility is a source of suffering for most women diagnosed with it, resulting in significant negative experiences in their matrimonial homes, families, friends, and the community at large. Most participants rely on spiritual and social support as their immediate and basic coping strategies. Future research could evaluate the treatment and coping strategies and also determine the outcomes of other forms of treatment for infertility.
A multi-target protective effect of Danggui-Shaoyao-San on the vascular endothelium of atherosclerotic mice
Authors: Sun Yuemeng , Gao Yushan , Zhou Lu , Lu Yixing , Zong Yulin , Zhu Haoyu , Tang Yang , Zheng Fengjie , Sun Yan , Li Yuhang
Published: February 2023

Background

Atherosclerosis (AS) is a chronic disease characterized by abnormal blood lipid metabolism, inflammation and vascular endothelial injury. Vascular endothelial injury is the initial stage during the occurrence of AS. However, the function and mechanism of anti-AS are not well characterized. Danggui-Shaoyao-San (DGSY) is a classic Traditional Chinese Medicine (TCM) prescription for the treatment of gynecological diseases, and has been widely used in the treatment of AS in recent years.

Methods

ApoE−/− atherosclerosis male mice were established by feeding with high-fat diet, and then randomly divided into three groups: Atherosclerosis group (AS), Danggui-Shaoyao-San group (DGSY), and Atorvastatin calcium group (X). The mice were administered with the drugs for 16 weeks. Pathological changes in aortic vessels were examined by staining with Oil red O, Masson and hematoxylin–eosin. In addition, blood lipids were analyzed. The level of IL-6 and IL-8 in aortic vessels were detected by ELISA and the expression of ICAM-1 and VCAM-1 in the aortic vascular endothelium were measured by Immunohistochemical. The mRNA expression of interα5β1/c-Abl/YAP in the aortic vessels were measured by Real-time quantitative PCR and location of expression was assessed by immunofluorescence.

Results

DGSY can significantly reduce the content of TC,TG and LDL-C and increase the level of HDL-C in the serum, reduce the plaque area and inhibit the concentration of IL-6 and IL-8, down-regulate the expression of IVAM-1,VCAM-1 and interα5β1/ c-Abl/YAP in the aortic vessels.

Conclusions

Collectively, DGSY can alleviate vascular endothelium damage and delay the occurrence of AS, and the underlying mechanism may be related to the multi-target protective of DGSY.
Angiotensin converting enzyme (ACE) inhibitors activity from purified compounds Fructus Phaleria macrocarpa (Scheff) Boerl
Authors: Eff Aprilita Rina Yanti , Huri Hasniza Zaman , Radji Maksum , Mun’im Abdul , Suyatna F. D. , Eden Yonatan
Published: February 2023

Background

Mahkota Dewa [Phaleria macrocarpa (Scheff) Boerl.] fruit in vitro and in- vivo can decrease and prevent elevation of the blood pressure, lower plasma glucose levels, possess an antioxidant effect, and recover liver and kidney damage in rats. This study aimed to determine the structure and inhibitory activity of angiotensin-converting enzyme inhibitors (ACE) from the Mahkota Dewa fruit.

Methods

The fruit powder was macerated using methanol and then partitioned by hexane, ethyl acetate, n-butanol, and water. The fractions were chromatographed on the column chromatography and incorporated with TLC and recrystallization to give pure compounds. The structures of isolated compounds were determined by UV-Visible, FT-IR, MS, proton (1H-NMR), carbon (13C-NMR), and 2D-NMR techniques encompassing HMQC and HMBC spectra. The compounds were evaluated for their ACE inhibitory activity, and the strongest compound was determined by the kinetics enzyme inhibition.

Results

Based on the spectral data, the isolated compounds were determined as 6,4-dihydroxy-4-methoxybenzophenone–2-O-β-D-glucopyranoside (1), 4,4′-dihydroxy-6-methoxybenzophenone-2-O-β-D-glucopyranoside (2) and mangiferin (3). IC50 values of the isolated compounds 1, 2 and 3 were 0.055, 0.07, and 0.025 mM, respectively.

Conclusion

The three compounds have ACE inhibitor and mangiferin demonstrated the best ACE inhibitory activity with competitive inhibition on ACE with the type of inhibition kinetics is competitive inhibition.
Predictis: an IoT and machine learning-based system to predict risk level of cardio-vascular diseases
Authors: Islam Muhammad Nazrul , Raiyan Kazi Rafid , Mitra Shutonu , Mannan M. M. Rushadul , Tasnim Tasfia , Putul Asima Oshin , Mandol Angshu Bikash
Published: February 2023

Background

Despite technological advancement in the field of healthcare, the worldwide burden of illness caused by cardio-vascular diseases (CVDs) is rising, owing mostly to a sharp increase in developing nations that are undergoing fast health transitions. People have been experimenting with techniques to extend their lives since ancient times. Despite this, technology is still a long way from attaining the aim of lowering mortality rates.

Methods

From methodological perspective, a design Science Research (DSR) approach is adopted in this research. As such, to investigate the current healthcare and interaction systems created for predicting cardiac disease for patients, we first analyzed the body of existing literature. After that, a conceptual framework of the system was designed using the gathered requirements. Based on the conceptual framework, the development of different components of the system was completed. Finally, the evaluation study procedure was developed taking into account the effectiveness, usability and efficiency of the developed system.

Results

To attain the objectives, we proposed a system consisting of a wearable device and mobile application, which allows the users to know their risk levels of having CVDs in the future. The Internet of Things (IoT) and Machine Learning (ML) techniques were adopted to develop the system that can classify its users into three risk levels (high, moderate and low risk of having CVD) with an F1 score of 80.4% and two risk levels (high and low risk of having CVD) with an F1 score of 91%. The stacking classifier incorporating best-performing ML algorithms was used for predicting the risk levels of the end-users utilizing the UCI Repository dataset.

Conclusion

The resultant system allows the users to check and monitor their possibility of having CVD in near future using real-time data. Also, the system was evaluated from the Human-Computer Interaction (HCI) point of view. Thus, the created system offers a promising resolution to the current biomedical sector.

Trial Registration

Not Applicable.