bluuebunny/crossref_metadata_2025 huggingface dataset:
Thymoquinone and Costunolide Induce Apoptosis of Both Proliferative and Doxorubicin-Induced-Senescent Colon and Breast Cancer Cells
Authors: El-Far Ali H , Godugu Kavitha , Noreldin Ahmed E. , Saddiq Amna A. , Almaghrabi Omar A. , Al Jaouni Soad K. , Mousa Shaker A.
Published: September 2021

Doxorubicin (Dox) induces senescence in numerous cancer cell types, but these senescent cancer cells relapse again if they are not eliminated. On this principle, we investigated the apoptotic effect of thymoquinone (TQ), the active ingredient of Nigella sativa seeds and costunolide (COS), the active ingredient of Costus speciosus, on the senescent colon (Sen-HCT116) and senescent breast (Sen-MCF7) cancer cell lines in reference to their corresponding proliferative cells to rapidly eliminate the senescent cancer cells. The senescence markers of Sen-HCT116 and Sen-MCF7 were determined by a significant decrease in bromodeoxyuridine (BrdU) incorporation and significant increases in SA-β-gal, p53, and p21 levels. Then proliferative, Sen-HCT116, and Sen-MCF7 cells were subjected to either TQ (50 µM) or COS (30 µM), the Bcl2-associated X protein (Bax), B-cell lymphoma 2 (Bcl2), caspase 3 mRNA expression and its activity were established. Results revealed that TQ significantly increased the Bax/Bcl2 ratio in HCT116 + Dox5 + TQ, MCF7 + TQ, and MCF7 + Dox5 + TQ compared with their corresponding controls. COS significantly increased the Bax/Bcl2 ratio in HCT116 + Dox5 + TQ and MCF7 + Dox5 + TQ compared with their related controls. Also, TQ and COS were significantly increased caspase 3 activity and cell proliferation of Sen-HCT116 and Sen-MCF7. The data revealed a higher sensitivity of senescent cells to TQ or COS than their corresponding proliferative cells.
Renal cystic disease in tuberous sclerosis complex
Authors: Kumar Prashant , Zadjali Fahad , Yao Ying , Bissler John J
Published: September 2021

Tuberous sclerosis complex (TSC) is associated with TSC1 or TSC2 gene mutations resulting in hyperactivation of the mTORC1 pathway. This mTORC1 activation is associated with abnormal tissue development and proliferation such that in the kidney there are both solid tumors and cystic lesions. This review summarizes recent advances in tuberous sclerosis complex nephrology and focuses on the genetics and cell biology of tuberous sclerosis complex renal disease, highlighting a role of extracellular vesicles and the innate immune system in disease pathogenesis.
Ascending Aortoiliac Bypass for One-Stage Repair of Adult Aortic Coarctation With Concomitant Cardiac Lesions
Authors: Peng Zhan , Qiu Juntao , Wang De , Yang Xiubin , Yu Cuntao , Zhang Liang
Published: September 2021

Background

To evaluate the efficacy and safety of ascending aortoiliac bypass surgery for one-stage repair of adult coarctation of the aorta (CoA) and concomitant cardiac disease.

Methods

From March 2012 to October 2018, 51 consecutive CoA patients were treated with ascending aorta to bilateral iliac artery bypass concomitant with and cardiac surgerical procedures performed for a variety of reasons. A Y-shaped graft was used for the bypass procedure. We evaluated early outcomes, including postoperative death, systolic blood pressure and differences between upper and lower limb blood pressure.

Results

The average age was 41 years and 64.7% of patients were men. Simultaneous cardiac procedures included aortic valve replacement, ventricular septal defect repair, Bentall procedures and Wheat procedures. No deaths occurred in the early postoperative period. Three patients had delayed healing at the site of the abdominal lower quadrant incisions. The average systolic pressure in the upper limb and the average difference between the upper- and lower-limb blood pressure decreased significantly after surgery (162.7 ± 13.4 mmHg vs 128.4 ± 6.7 mmHg, P = .000; 69.6 ± 15.6 mmHg vs 8.7 ± 7.6 mmHg, P = .000, respectively); The systolic blood pressure in the lower limb increased after bypass surgery (93.1 ± 6.2 mmHg vs 119.6 ± 7.7 mmHg, P = .000). The follow-up rate was 100%, with an average follow-up time of 61 months. Six patients (11.8%) had graft stenosis or occlusion. Three patients (5.9%) underwent endovascular embolectomy.

Conclusions

In our small series, ascending aortoiliac bypass for one-stage repair of CoA with concomitant cardiac lesions appears safe and efficacious in effectively reduceing differences between upper and lower limb systolic blood pressure. Further study with larger sample size and longer follow-up is needed.
Incorporating Glucose Variability into Glucose Forecasting Accuracy Assessment Using the New Glucose Variability Impact Index and the Prediction Consistency Index: An LSTM Case Example
Authors: Mosquera-Lopez Clara , Jacobs Peter G.
Published: September 2021

Background:

In this work, we developed glucose forecasting algorithms trained and evaluated on a large dataset of free-living people with type 1 diabetes (T1D) using closed-loop (CL) and sensor-augmented pump (SAP) therapies; and we demonstrate how glucose variability impacts accuracy. We introduce the glucose variability impact index (GVII) and the glucose prediction consistency index (GPCI) to assess the accuracy of prediction algorithms.

Methods:

A long-short-term-memory (LSTM) neural network was designed to predict glucose up to 60 minutes in the future using continuous glucose measurements and insulin data collected from 175 people with T1D (41,318 days) and evaluated on 75 people (11,333 days) from the Tidepool Big Data Donation Dataset. LSTM was compared with two naïve forecasting algorithms as well as Ridge linear regression and a random forest using root-mean-square error (RMSE). Parkes error grid quantified clinical accuracy. Regression analysis was used to derive the GVII and GPCI.

Results:

The LSTM had highest accuracy and best GVII and GPCI. RMSE for CL was 19.8 ± 3.2 and 33.2 ± 5.4 mg/dL for 30- and 60-minute prediction horizons, respectively. RMSE for SAP was 19.6 ± 3.8 and 33.1 ± 7.3 mg/dL for 30- and 60-minute prediction horizons, respectively; 99.6% and 97.6% of predictions were within zones A+B of the Parkes error grid at 30- and 60-minute prediction horizons, respectively. Glucose variability was strongly correlated with RMSE (R≥0.64, P < 0.001); GVII and GPCI demonstrated a means to compare algorithms across datasets with different glucose variability.

Conclusions:

The LSTM model was accurate on a large real-world free-living dataset. Glucose variability should be considered when assessing prediction accuracy using indices such as GVII and GPCI.
A Mixed-Methods Approach for Evaluating the Relationship between Sustainable Urban Renewal Projects and Environmental Perception and Action in Chengdu
Authors: Schmitt Edwin Anton , Shao Yuqian , Wang Yuehan , Zhao Baoyang , Gao Yushi
Published: September 2021

This article draws from a mixed-methods approach to explore the relationship between sustainable urban renewal projects and the way Chinese urban residents perceive and act upon the environment. We examine sustainable urban renewal projects in the city of Chengdu, called Ecological Housing Estate projects. By collaborating with nongovernmental organizations and local officials, we used a two-step process, including collecting freelists and semi-structured interviews, to design a survey instrument used to interview 245 households in three Ecological Housing Estates and four Regular Housing Estates in Chengdu. Our findings demonstrate how recycling practices are reinforced by the Ecological Housing Estate projects but also explain why the rainwater collection aspect of the projects are not well matched with existing household water conservation practices. We argue that integrating mixed-methods research into the design of a sustainable urban renewal project will help mitigate the potential that projects will develop similar kinds of urban sustainable fixes.
College Transition Program for Student-Athletes (CTPSA): A Psychoeducational Group for Boys of Color
Authors: Challenger Clewiston D. , Duquette Kevin
Published: September 2021

This article suggests a group intervention for student-athlete boys of color who intend to play sports in college. This group is a component of a larger proposed school-wide program, the College Transition Program for Student-Athletes (CTPSA). The CTPSA’s suggested group intervention offers school counselors a college readiness option to support the college application process, college adjustment, and transition for boys of color who are student-athletes. We discuss the group’s purpose, design, format, curriculum, and expected outcomes and present implications for school counselors and other counseling professionals.
The Impact of Moral-Injury Cognitions on Psychological Outcomes in Refugees: An Experimental Investigation
Authors: Hoffman Joel , Nickerson Angela
Published: September 2021

Moral-injury cognitions (beliefs regarding moral violations) represent a potential mechanism that may underlie the association between potentially morally injurious events (PMIEs) and psychological symptoms in refugees. We implemented a novel experimental paradigm (i.e., the simulation of a PMIE using mental imagery) to investigate the impact of moral-injury cognitions on psychological outcomes in 71 Arabic-speaking refugees. A latent class analysis of preexisting moral-injury beliefs yielded three classes characterized by (a) high moral-injury beliefs about violations by others (49.3%), (b) high moral-injury beliefs about violations by others and by oneself (25.5%), and (c) low moral-injury beliefs (25.5%). Investigation of group differences revealed that the moral-injury classes reported greater negative emotional responses following the simulated PMIE. Furthermore, the association between moral-injury classes and psychological outcomes was moderated by situation-specific blame appraisals of the simulated PMIE. These findings have important implications for psychological interventions for refugees.
A 5-Year Follow-up of Patients Treated for Full-Thickness Rotator Cuff Tears: A Prospective Cohort Study
Authors: Gagnier Joel , Bedi Asheesh , Carpenter James , Robbins Christopher , Miller Bruce
Published: September 2021

Background:

The evidence in support of operative versus nonoperative management of rotator cuff tears (RCTs) is limited, based primarily on observational studies of lower scientific merit.

Purpose:

To (1) compare the efficacy of operative versus nonoperative management of full-thickness RCTs across time and (2) detect variables that predict success within each group.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

We included patients with symptomatic full-thickness RCTs who were enrolled in an institutional shoulder registry. Patient enrollment began in 2009 and continued until early 2018. The following outcome measures were collected at baseline, then 6 months, 1 year, and annually up to 5 years postoperatively: Western Ontario Rotator Cuff Index (WORC), American Shoulder and Elbow Surgeons (ASES) score, Veterans RAND 12-Item Health Survey (VR-12) mental and physical component subscales (MCS and PCS, respectively), 100-point Single Assessment Numeric Evaluation (SANE) rating, and 100-point visual analog scale (VAS) for pain and for patient satisfaction. We performed regression models for all outcome variables across all 5 years of follow-up and included the following predictor variables: treatment type (operative vs nonoperative), sex, age, symptom duration, smoking status, diabetes status, injury side, and obesity status.

Results:

A total of 595 patients were included. Longitudinal mixed-effects regression revealed that patients who received operative treatment did better across time on all outcomes. Women (n = 242; 40.7%) did not fare as well as did men on the ASES, WORC, or VR-12 PCS. Older patients tended to improve less on the VR-12 PCS and more on the VR12-MCS. Patients with longer symptom duration at baseline had better scores across time on the ASES, WORC, VAS for pain, and SANE. Current or recent smokers and patients with diabetes tended to have lower scores on all measures across time. For changes in scores from baseline, patients in the operative group improved to a larger degree out to 3 years compared with those in the nonoperative group.

Conclusion:

Patients with RCTs tended to improve regardless of whether they received operative or nonoperative treatment, but patients who underwent operative treatment improved faster. There appear to be several predictors of improved and worsened outcomes for patients with RCTs undergoing operative or nonoperative treatment.
The Effects of COVID-19 Lockdown on Health and Psychosocial Functioning in Older Adults Aged 70 and Over
Authors: Docherty Sarah , Haskell-Ramsay Crystal F. , McInnes Lynn , Wetherell Mark A.
Published: September 2021

The COVID-19 pandemic led to a state-imposed lockdown in the UK; there are many psychosocial consequences of pandemics, with older adults potentially at an increased risk. The current study assessed psychosocial functioning in a sample of older adults in the UK with baseline data collected pre-lockdown and follow-up 12 weeks later during lockdown. Thus, allowing investigation of the effect of COVID-19 and associated lockdown on psychosocial well-being. Thirty-five older adults (Mean age = 76.06, sex = 12 males) participated in this repeated measures study. A final follow-up was then conducted post-lockdown to capture any factors that were viewed as helpful to well-being during lockdown. From pre- to during lockdown, perceived stress, well-being, depressive symptoms, mood disturbance and memory were all significantly worsened. There were significant improvements in self-reported physical health symptoms, social interaction, time spent engaging in physical activity and certain aspects of relationship quality. Follow-up showed that well-being, depression and mood were still negatively affected post-lockdown. Given the sample were all ‘healthy’ at baseline in comparison to established norms, there may be greater impairment in more vulnerable populations. Support for older populations is needed to mitigate the negative effects shown, particularly in light of the endurance of some of these effects post-lockdown.
Determinants of Treatment Adherence Among Patients Living With Noncommunicable Diseases: A Mixed-Method Study in a Rural Area of West Bengal
Authors: Banerjee Ankush , Paul Bobby , Dobe Madhumita , Bandyopadhyay Lina , Bhattacharyya Madhumita , Sahu Monalisha
Published: September 2021

The multisectoral impact of the COVID-19 pandemic can impair treatment adherence of patients with noncommunicable diseases (NCDs). This mixed-method study, conducted from November 2020 to January 2021, assessed the quantum of their treatment adherence and its determinants in rural West Bengal. Quantitative data were collected from 213 NCD patients while qualitative exploration for barriers of treatment adherence was conducted as 6 in-depth Interviews. Treatment adherence was assessed by “Medication Compliance Questionnaire” and “Adherence to Healthy Lifestyle and Follow-up Advice” Questionnaire. A total of 39.4% were nonadherent to medications while 67.1% had nonadherence to healthy lifestyle and follow-up advice. Significant predictors associated with nonadherence were increasing age, female gender, lower socioeconomic status, decreasing patient empowerment, and decreasing trust in the medical profession. Economic crisis, fear of contagion, and nonavailability of investigation facilities were some new emerging barriers in addition to preexisting barriers of treatment adherence. Therefore, measures for improving patient empowerment and patient–provider relationship by motivation and counseling, taking proper care of vulnerable patients affected by the pandemic, and correcting deficiencies at the health-system level should be given utmost priority.
Improving public housing policies that target low-income households: The value of adding proximity to discretion
Authors: Gonzalez Lauro , Lima-Silva Fernanda , Pozzebon Marlei
Published: September 2021

Research on street-level bureaucrats has examined the various ways in which these professionals have implemented public policies in areas such as healthcare, education, and security, often emphasizing the role played by discretion in the implementation process. Despite its importance, the concept of street-level bureaucracy has scarcely been approached by housing studies. This study focuses on the role of street-level workers in the delivery of public housing to the lower-income population. We affirm the value of complementing street-level discretion with the concept of proximity, a premise borrowed from the microfinance literature, to increase the understanding of the interactions and relationships established between street-level workers and policy recipients during the implementation process. Such complementarity may contribute to a more accurate understanding of the housing policy implementation dynamics on the street-level and the possible adjustments to meet local needs. To explore this issue, we used a theoretical lens inspired by Goffman’s frame analysis that points to the importance of relational mechanisms that characterize the interactions between street-level workers and beneficiaries. These lenses were applied to a collective case study of Minha Casa Minha Vida-Entidades, a Brazilian subprogram in which street-level workers linked to social housing movements assume a leading role in the planning and execution of interventions. The results indicate that the combination of proximity and discretion has a positive influence on the implementation of housing policies. Our analysis shows the existence of nonprofit-oriented arrangements that may present different features and nuances at the implementation (micro) level and contribute to the (macro) debate on housing policies.
Facile growth of high transmittance ZnO micro-rod clusters on indium tin oxide by a wet-chemical synthesis method
Authors: Morkoç Karadeniz S
Published: September 2021

A simple wet-chemical synthesis method was developed to fabricate Zinc oxide micro-rod clusters. The synthesis process involved the rapid dilution of a zinc-bearing alkaline solution at 150°C in a convection oven on indium tin oxide (ITO) substrates. The synthesis was carried out by immersing an unseeded ITO substrate in a mixture of zinc nitrate hexahydrate (Zn(NO3)2·6H2O) and hexamethylenetetramine ((CH2)6N4) aqueous solution. The obtained sample was annealed at 400°C for 2 h. The structural, morphological and optical properties of the synthesized ZnO microstructures were investigated by X-ray diffraction, scanning electron microscopy and ultraviolet-visible spectroscopy, respectively. The ZnO rod clusters are hexagonal phase of the wurtzite structure. The crystal grain sizes of the films were found to be 72.6, 84.3 and 66.3 nm for the (100), (002) and (101) crystal planes, respectively. The optical bandgap of the ZnO was determined to be 3.147 eV.
Characterization and Evaluation of Transgenic Rice Pyramided with the Pi Genes Pib, Pi25 and Pi54
Authors: Peng Meifang , Lin Xiaomin , Xiang Xiaoli , Ren Huibo , Fan Xiaoli , Chen Kegui
Published: September 2021

Background

Emergence of new pathogen strains of Magnaporthe oryzae is a major reason for recurrent failure of the resistance mediated by a single resistance gene (Pi) in rice. Stacking various Pi genes in the genome through marker-assisted selection is thus an effective strategy in rice breeding for achieving durable resistance against the pathogen. However, the effect of pyramiding of multiple Pi genes using transgenesis still remains largely unknown.

Results

Three Pi genes Pib, Pi25 and Pi54 were transferred together into two rice varieties, the indica variety Kasalath and the japonica variety Zhenghan 10. Transgenic plants of both Kasalath and Zhenghan 10 expressing the Pi transgenes showed imparted pathogen resistance. All the transgenic lines of both cultivars also exhibited shorter growth periods with flowering 2–4 days early, and shorter plant heights with smaller panicle. Thus, pyramiding of the Pi genes resulted in reduced grain yields in both rice cultivars. However, tiller numbers and grain weight were generally similar between the pyramided lines and corresponding parents. A global analysis of gene expression by RNA-Seq suggested that both enhancement and, to a lesser extent, inhibition of gene transcription occurred in the pyramided plants. A total of 264 and 544 differentially expressed genes (DEGs) were identified in Kasalath and Zhenghan 10, respectively. Analysis of the DEGs suggested that presence of the Pi transgenes did not alter gene expression only related to disease resistance, but also impacted many gene transcriptions in the pathways for plant growth and development, in which several were common for both Kasalath and Zhenghan 10.

Conclusion

Pyramiding of the Pi genes Pib, Pi25 and Pi54 via transgenesis is a potentially promising approach for improving rice resistance to the pathogen Magnaporthe oryzae. However, pleiotropic effects of the Pi genes could potentially result in yield loss. These findings support the idea that immunity is often associated with yield penalties. Rational combination of the Pi genes based on the genetic background may be important to balance yield and disease resistance.
Redox proteomic study of Bacillus cereus thiol proteome during fermentative anaerobic growth
Authors: Hamitouche Fella , Gaillard Jean-Charles , Schmitt Philippe , Armengaud Jean , Duport Catherine , Dedieu Luc
Published: September 2021

Background

Bacillus cereus is a notorious foodborne pathogen, which can grow under anoxic conditions. Anoxic growth is supported by endogenous redox metabolism, for which the thiol redox proteome serves as an interface. Here, we studied the cysteine (Cys) proteome dynamics of B. cereus ATCC 14579 cells grown under fermentative anoxic conditions. We used a quantitative thiol trapping method combined with proteomics profiling.

Results

In total, we identified 153 reactive Cys residues in 117 proteins participating in various cellular processes and metabolic pathways, including translation, carbohydrate metabolism, and stress response. Of these reactive Cys, 72 were detected as reduced Cys. The B. cereus Cys proteome evolved during growth both in terms of the number of reduced Cys and the Cys-containing proteins identified, reflecting its growth-phase-dependence. Interestingly, the reduced status of the B. cereus thiol proteome increased during growth, concomitantly to the decrease of extracellular oxidoreduction potential.

Conclusions

Taken together, our data show that the B. cereus Cys proteome during unstressed fermentative anaerobic growth is a dynamic entity and provide an important foundation for future redox proteomic studies in B. cereus and other organisms.
Silencing of StRIK in potato suggests a role in periderm related to RNA processing and stress
Authors: Boher Pau , Soler Marçal , Fernández-Piñán Sandra , Torrent Xènia , Müller Sebastian Y. , Kelly Krystyna A. , Serra Olga , Figueras Mercè
Published: September 2021

Background

The periderm is a protective barrier crucial for land plant survival, but little is known about genetic factors involved in its development and regulation. Using a transcriptomic approach in the cork oak (Q. suber) periderm, we previously identified an RS2-INTERACTING KH PROTEIN (RIK) homologue of unknown function containing a K homology (KH)-domain RNA-binding protein, as a regulatory candidate gene in the periderm.

Results

To gain insight into the function of RIK in the periderm, potato (S. tuberosum) tuber periderm was used as a model: the full-length coding sequence of RIK, hereafter referred to as StRIK, was isolated, the transcript profile analyzed and gene silencing in potato performed to analyze the silencing effects on periderm anatomy and transcriptome. The StRIK transcript accumulated in all vegetative tissues studied, including periderm and other suberized tissues such as root and also in wounded tissues. Downregulation of StRIK in potato by RNA interference (StRIK-RNAi) did not show any obvious effects on tuber periderm anatomy but, unlike Wild type, transgenic plants flowered. Global transcript profiling of the StRIK-RNAi periderm did show altered expression of genes associated with RNA metabolism, stress and signaling, mirroring the biological processes found enriched within the in silico co-expression network of the Arabidopsis orthologue.

Conclusions

The ubiquitous expression of StRIK transcript, the flower associated phenotype and the differential expression of StRIK-RNAi periderm point out to a general regulatory role of StRIK in diverse plant developmental processes. The transcriptome analysis suggests that StRIK might play roles in RNA maturation and stress response in the periderm.
Overexpression of four MiTFL1 genes from mango delays the flowering time in transgenic Arabidopsis
Authors: Wang Yi-Han , He Xin-Hua , Yu Hai-Xia , Mo Xiao , Fan Yan , Fan Zhi-Yi , Xie Xiao-Jie , Liu Yuan , Luo Cong
Published: September 2021

Background

TERMINAL FLOWER 1 (TFL1) belongs to the phosphatidylethanolamine-binding protein (PEBP) family, which is involved in inflorescence meristem development and represses flowering in several plant species. In the present study, four TFL1 genes were cloned from the mango (Mangifera indica L.) variety ‘SiJiMi’ and named MiTFL1-1, MiTFL1-2, MiTFL1-3 and MiTFL1-4.

Results

Sequence analysis showed that the encoded MiTFL1 proteins contained a conserved PEBP domain and belonged to the TFL1 group. Expression analysis showed that the MiTFL1 genes were expressed in not only vegetative organs but also reproductive organs and that the expression levels were related to floral development. Overexpression of the four MiTFL1 genes delayed flowering in transgenic Arabidopsis. Additionally, MiTFL1-1 and MiTFL1-3 changed the flower morphology in some transgenic plants. Yeast two-hybrid (Y2H) analysis showed that several stress-related proteins interacted with MiTFL1 proteins.

Conclusions

The four MiTFL1 genes exhibited a similar expression pattern, and overexpression in Arabidopsis resulted in delayed flowering. Additionally, MiTFL1-1 and MiTFL1-3 overexpression affected floral organ development. Furthermore, the MiTFL1 proteins could interact with bHLH and 14-3-3 proteins. These results indicate that the MiTFL1 genes may play an important role in the flowering process in mango.
Socializing the evidence for diabetes control to develop “mindlines”: a qualitative pilot study
Authors: Epling John W. , Rockwell Michelle S. , Miller Allison D. , Carver M. Colette
Published: September 2021

Background

Evidence on specific interventions to improve diabetes control in primary care is available, but this evidence is not always well-implemented. The concept of “mindlines” has been proposed to explain how clinicians integrate evidence using specifics of their practices and patients to produce knowledge-in-practice-in-context. The goal of this pilot study was to operationalize this concept by creating a venue for clinician-staff interaction concerning evidence. The research team attempted to hold “mindlines”-producing conversations in primary care practices about evidence to improve diabetes control.

Methods

Each of four primary care practices in a single health system held practice-wide conversations about a simple diabetes intervention model over a provided lunch. The conversations were relatively informal and encouraged participation from all. The research team recorded the conversations and took field notes. The team analyzed the data using a framework adapted from the “mindlines” research and noted additional emergent themes.

Results

While most of the conversation concerned barriers to implementation of the simple diabetes intervention model, there were examples of practices adopting and adapting the evidence to suit their own needs and context. Performance metrics regarding diabetes control for the four practices improved after the intervention.

Conclusion

It appears that the type of conversations that “mindlines” research describes can be generated with facilitation around evidence, but further research is required to better understand the limitations and impact of this intervention.
Patient education booklet to support evidence-based low back pain care in primary care – a cluster randomized controlled trial
Authors: Simula Anna S. , Jenkins Hazel J. , Hancock Mark J. , Malmivaara Antti , Booth Neill , Karppinen Jaro
Published: September 2021

Background

Inappropriate imaging and low-value care for low back pain (LBP) are common. A new patient-education booklet was created to overcome identified barriers to the delivery of recommended care, including the use of inappropriate imaging. Our aim was to assess the effectiveness of this booklet as part of primary care for LBP patients in comparison to usual care.

Methods

A cluster-randomized trial was performed. The intervention involved providing practitioners with the new patient-education booklet and a 30-min training session on its use. The booklet was provided during the clinical consult to all consenting LBP patients in the intervention group. Primary outcomes were the proportion of patients presenting with LBP who underwent imaging examinations during the first three months of follow-up and PROMIS PF-20 (Patient-Reported Outcomes Measurement Information System, 20-item physical functioning short form) change between baseline and three-month follow-up. Secondary outcomes, including sick leave and imaging examinations at 12 months, were investigated. Logistic regression using GEE-estimation was used for dichotomous outcomes, Poisson regression using GEE-estimation for count outcomes, and linear mixed models for continuous outcomes.

Results

Using the patient education booklet appeared to substantially reduce the proportion of LBP patients who underwent an imaging examination at three months, but the result was not statistically significant (OR 0.57, 95% confidence interval (Cl) 0.27 to 1.22). At 12 months, the effect was slightly larger and statistically significant (OR 0.50, 95%Cl 0.30 to 0.83, p = 0.008). No difference was observed in the PROMIS PF-20 T-score change between baseline and 3 months or 12 months (p = 0.365 and p = 0.923, respectively). The number of sick leave days in the intervention group was less than that in the control group at 3 months (RR 0.47, 95%Cl 0.26 to 0.83, p = 0.010) and at 12 months (RR 0.36, 95%Cl 0.18 to 0.72, p = 0.004).

Conclusions

The booklet appeared to be effective in reducing the proportion of LBP patients who underwent imaging examinations over 12 months. The intervention had no discernible effect on the PROMIS PF20 T-score change. The number of sick leave days was substantially lower in the intervention group.

Trial registration

ISRCTN, ISRCTN14389368, Registered 4 April 2019—Retrospectively registered.
Long-term telemetric intracranial pressure monitoring for diagnosis and therapy optimisation of idiopathic intracranial hypertension
Authors: Velazquez Sanchez Victor F. , Al Dayri Giath , Tschan Christoph A.
Published: September 2021

Background

Idiopathic intracranial hypertension (IIH) is a disease which is difficult to diagnose and moreover difficult to treat. We developed a strategy for long-term telemonitoring of intracranial pressure (ICP), by incorporation of the NEUROVENT®-P-tel System, with the goal of improved diagnosis and consequent therapy of this disease. We highlight the results obtained through this approach.

Methods

Twenty patients with suspected IIH who were treated in our hospital from August 2014 to October 2020 (16 females, 4 males, median age 36,6 years), were assigned to one of two ICP monitoring settings, “Home-Telemonitoring” (n = 12) and “Home-Monitoring” (n = 8). The ICP data were analysed and used conjointly with the accompanying clinical picture for establishment of IIH diagnosis, and telemonitoring was resumed for therapy optimisation of confirmed cases.

Results

The diagnosis of IIH was confirmed in 18 of the 20 patients. Various surgical/interventional treatments were applied to the confirmed cases, including ventriculoperitoneal (VP) shunting (n = 15), stenting of the transvers venous sinus (n = 1), endoscopic third ventriculostomy (ETV) (n = 1), and ETV in combination with endoscopic laser-based coagulation of the choroid Plexus (n = 1). Optimal adjustment of the implanted shunt valves was achieved with an average valve opening pressure of 6,3 ± 2,17 cm H2O for differential valves, and of 29,8 ± 3,94 cm H2O for gravitational valves. The Home-Telemonitoring setting reduced consequent outpatient visits, compared to the Home-Monitoring setting, with an average of 3,1 visits and 4,3 visits, respectively. No complications were associated with the surgical implantation of the P-tel catheter.

Conclusion

This study offers insight into the use of long-term ICP monitoring for management of IIH patients in combination with dual-valve VP shunts. The use of NEUROVENT® P-tel system and potentially other similar fully implantable ICP-monitoring devices, albeit invasive, may be justified in this complex disease. The data suggest recommending an initial adjustment of dual-valve VP-shunts of 30 and 6 cm H2O, for gravitational and differential valves, respectively. Further research is warranted to explore potential integration of this concept in IIH management guidelines.
Treating posttraumatic stress disorder in substance use disorder patients with co-occurring posttraumatic stress disorder: study protocol for a randomized controlled trial to compare the effectiveness of different types and timings of treatment
Authors: Lortye Sera A. , Will Joanne P. , Marquenie Loes A. , Goudriaan Anna E. , Arntz Arnoud , de Waal Marleen M.
Published: September 2021

Background

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) have high comorbidity. Although prior research indicated that PTSD can effectively be treated with Prolonged Exposure (PE) in these patients, reported effects are small and treatment dropout rates high. Eye Movement Desensitization and Reprocessing (EMDR) and Imagery Rescripting (ImRs) are other promising treatment options for PTSD, that have not yet been examined in this patient group. Furthermore, it is unclear whether PTSD treatment is most effective when offered simultaneous to or after SUD treatment.

Methods

In this article, the Treatment Of PTSD and Addiction (TOPA) study is described: a Dutch randomized controlled trial (RCT) that studies the effectiveness of PTSD treatment as an add-on to regular SUD treatment in patients with SUD and co-occurring PTSD. Effects of PE, EMDR, ImRs, and a 3-month SUD treatment only condition will be compared, as well as simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment. The primary outcome measure is PTSD symptoms. Secondary outcomes are: treatment completion, psychological distress, substance use, interpersonal problems, emotion dysregulation, and trauma-related emotions guilt, shame, and anger.

Discussion

This study is the first to compare effects of PE, EMDR, and ImRs in one study and to compare simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment as well. This RCT will provide more knowledge about the effectiveness of different treatment strategies for PTSD in patients with co-occurring SUD and will ultimately improve treatment outcomes for patients with this common co-morbidity worldwide.

Trial registration

Netherlands Trial Register (NTR), Identifier: NL7885. Registered 22 July 2019.
Association between sepsis incidence and regional socioeconomic deprivation and health care capacity in Germany – an ecological study
Authors: Rose Norman , Matthäus-Krämer Claudia , Schwarzkopf Daniel , Scherag André , Born Sebastian , Reinhart Konrad , Fleischmann-Struzek Carolin
Published: September 2021

Background

Sepsis is a substantial health care burden. Data on regional variation in sepsis incidence in Germany and any possible associations with regional socioeconomic deprivation and health care capacity is lacking.

Methods

Ecological study based on the nationwide hospital Diagnosis-related Groups (DRG) statistics data of 2016. We identified sepsis by ICD-10-codes and calculated crude and age-standardized incidence proportions in the 401 administrative German districts. Associations between socioeconomic and health care capacity indicators and crude and age-adjusted sepsis incidence were investigated by simple and multiple negative binomial (NB) regressions.

Results

In 2016, sepsis incidence was 178 per 100,000 inhabitants and varied 10-fold between districts. We found that the rate of students leaving school without certificate was significantly associated with crude and age-standardized explicit sepsis incidence in the simple and multiple NB regressions. While we observed no evidence for an association to the capacity of hospital beds and general practitioners, the distance to the nearest pharmacy was associated with crude- and age-standardized sepsis incidence. In the multiple regression analyses, an increase of the mean distance + 1000 m was associated with an expected increase by 21.6 [95% CI, 10.1, 33.0] (p < 0.001), and 11.1 [95% CI, 1.0, 21.2]/100,000 population (p = .026) after adjusting for age differences between districts.

Conclusions

Residence in districts with lower socioeconomic status (e.g., less education) and further distance to pharmacies are both associated with an increased sepsis incidence. This warrants further research with individual-level patient data to better model and understand such dependencies and to ultimately design public health interventions to address the burden of sepsis in Germany.
Investigating the effectiveness of re-opening policies before vaccination during a pandemic: SD modelling research based on COVID-19 in Wuhan
Authors: Qian Ying , Xie Wei , Zhao Jidi , Xue Ming , Liu Shiyong , Wang Lei , Li Wanglai , Dai Luojia , Cai Yuyang
Published: September 2021

Background

Lockdown policies were widely adopted during the coronavirus disease 2019 (COVID-19) pandemic to control the spread of the virus before vaccines became available. These policies had significant economic impacts and caused social disruptions. Early re-opening is preferable, but it introduces the risk of a resurgence of the epidemic. Although the World Health Organization has outlined criteria for re-opening, decisions on re-opening are mainly based on epidemiologic criteria. To date, the effectiveness of re-opening policies remains unclear.

Methods

A system dynamics COVID-19 model, SEIHR(Q), was constructed by integrating infection prevention and control measures implemented in Wuhan into the classic SEIR epidemiological model and was validated with real-world data. The input data were obtained from official websites and the published literature.

Results

The simulation results showed that track-and-trace measures had significant effects on the level of risk associated with re-opening. In the case of Wuhan, where comprehensive contact tracing was implemented, there would have been almost no risk associated with re-opening. With partial contact tracing, re-opening would have led to a minor second wave of the epidemic. However, if only limited contact tracing had been implemented, a more severe second outbreak of the epidemic would have occurred, overwhelming the available medical resources. If the ability to implement a track-trace-quarantine policy is fixed, the epidemiological criteria need to be further taken into account. The model simulation revealed different levels of risk associated with re-opening under different levels of track-and-trace ability and various epidemiological criteria. A matrix was developed to evaluate the effectiveness of the re-opening policies.

Conclusions

The SEIHR(Q) model designed in this study can quantify the impact of various re-opening policies on the spread of COVID-19. Integrating epidemiologic criteria, the contact tracing policy, and medical resources, the model simulation predicts whether the re-opening policy is likely to lead to a further outbreak of the epidemic and provides evidence-based support for decisions regarding safe re-opening during an ongoing epidemic.

Keyords

COVID-19; Risk of re-opening; Effectiveness of re-opening policies; IPC measures; SD modelling.
Physical distancing messages targeting youth on the social media accounts of Canadian public health entities and the use of behavioral change techniques
Authors: Dimanlig-Cruz Sheryll , Han Arum , Lancione Samantha , Dewidar Omar , Podinic Irina ,   OPH-SEPH Collaborative (OSC) Working Group, Haqani Baies , Haug Justin , Leonard Lynne , Medline Elaine , Patey Andrea , Presseau Justin , Thompson Emily , Kent Monique Potvin , Brouwers Melissa
Published: September 2021

Introduction

Physical distancing (PD) is an important public health strategy to reduce the transmission of COVID-19 and has been promoted by public health authorities through social media. Although youth have a tendency to engage in high-risk behaviors that could facilitate COVID-19 transmission, there is limited research on the characteristics of PD messaging targeting this population on social media platforms with which youth frequently engage. This study examined social media posts created by Canadian public health entities (PHEs) with PD messaging aimed at youth and young adults aged 16–29 years and reported behavioral change techniques (BCTs) used in these posts.

Methods

A content analysis of all social media posts of Canadian PHEs from Facebook, Twitter, Instagram and YouTube were conducted from April 1st to May 31st, 2020. Posts were classified as either implicitly or explicitly targeting youth and young adults. BCTs in social media posts were identified and classified based on Behavior Change Technique Taxonomy version 1 (BCTTv1). Frequency counts and proportions were used to describe the data.

Results

In total, 319 youth-targeted PD posts were identified. Over 43% of the posts originated from Ontario Regional public health units, and 36.4 and 32.6% of them were extracted from Twitter and Facebook, respectively. Only 5.3% of the total posts explicitly targeted youth. Explicit posts were most frequent from federal PHEs and posted on YouTube. Implicit posts elicited more interactions than explicit posts regardless of jurisdiction level or social media format. Three-quarters of the posts contained at least one BCT, with a greater portion of BCTs found within implicit posts (75%) than explicit posts (52.9%). The most common BCTs from explicit posts were instructions on how to perform a behavior(25.0%) andrestructuring the social environment(18.8%).

Conclusions

There is a need for more PD messaging that explicitly targets youth. BCTs should be used when designing posts to deliver public health messages and social media platforms should be selected depending on the target population.
Effects of remote digital monitoring on oral hygiene of orthodontic patients: a prospective study
Authors: Sangalli Linda , Savoldi Fabio , Dalessandri Domenico , Bonetti Stefano , Gu Min , Signoroni Alberto , Paganelli Corrado
Published: September 2021

Background

Remote digital monitoring during orthodontic treatment can help patients in improving their oral hygiene performance and reducing the number of appointments due to emergency reasons, especially in time of COVID-19 pandemic where non-urgent appointments might be discouraged.

Methods

Thirty patients scheduled to start an orthodontic treatment were divided into two groups of fifteen. Compared to controls, study group patients were provided with scan box and cheek retractor (Dental Monitoring®) and were instructed to take monthly intra-oral scans. Plaque Index (PI), Gingival Index (GI), and White Spot Lesions (WSL) were recorded for both groups at baseline (t0), every month for the first 3 months (t1, t2, t3), and at 6 months (t4). Carious Lesions Onset (CLO) and Emergency Appointments (EA) were also recorded during the observation period. Inter-group differences were assessed with Student's t test and Chi-square test, intra-group differences were assessed with Cochran’s Q-test (significance α = 0.05).

Results

Study group patients showed a significant improvement in plaque control at t3 (p = 0.010) and t4 (p = 0.039), compared to control group. No significant difference was observed in the number of WSL between the two groups. No cavities were detected in the study group, while five CLO were diagnosed in the control group (p = 0.049). A decreased number of EA was observed in the study group, but the difference was not significant.

Conclusions

Integration of a remote monitoring system during orthodontic treatment was effective in improving plaque control and reducing carious lesions onset. The present findings encourage orthodontists to consider this technology to help maintaining optimal oral health of patients, especially in times of health emergency crisis.
Examining the association between menstrual symptoms and health-related quality of life among working women in Japan using the EQ-5D
Authors: Shimamoto Kyoko , Hirano Mana , Wada-Hiraike Osamu , Goto Rei , Osuga Yutaka
Published: September 2021

Background

Menstrual symptoms have been identified as a substantial burden among women of reproductive age, affecting their health status and quality of life globally. A range of menstrual symptoms have been studied as they affect the health-related quality of life (HRQoL), showing variations across specific menstrual symptoms and study settings. A major concern is demonstrated due to menstrual symptoms in women’s professional and social life, and consequently societal and economic loss for women and the society at large. Yet evidence is scarce that estimates the index form HRQoL score related to menstrual symptoms that is needed for health economic evaluations.

Methods

This study aims to investigate the association between menstrual symptoms and the HRQoL among working women in Japan in an index form, using a self-reporting questionnaire (n = 6048). The EQ-5D-3L (EuroQoL 5-dimension 3-level) is used that is a widely used tool to measure health outcomes for health economic evaluations globally. Multivariate regression analysis is conducted to assess the association between the HRQoL score and specific nineteen physical and mental conditions related to menstruation (e.g., pain, heavy bleeding, concentration, negative affect).

Results

The index form HRQoL score for menstrual symptoms is estimated as 0.682 in the study population (where a score one suggests perfect health). The association of the HRQoL score varies substantially across the menstrual symptoms. Several of the physical conditions and disorders show a substantial negative association with the HRQoL score. Also, most of the mental and psychological issues are significantly and negatively related to the HRQoL score.

Conclusions

This study suggests that HRQoL is substantially and negatively affected by menstruation among working women in Japan. Distinct variations of negative influences across menstrual symptoms underscore the multi-dimensional nature of menstruation and consequently the need of collective interventions to address these difficulties. The evidence of HRQoL continues to be an important area for future research on women’s health and health economic evaluations to inform effective and efficient resource allocations for relevant health policies and financing strategies.