bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between place of birth and timely breastfeeding initiation among Cambodian women: a population-based study
Authors: Harriott Raleigh M. , Haile Zelalem T. , Chertok Ilana R. Azulay , Haider Mohammad Rifat
Published: July 2022

Background

Enhancing timely breastfeeding initiation within the first hour postpartum is a goal the WHO’s Early Essential Newborn Care (EENC) and Baby-friendly Hospital Initiative (BFHI) aim to achieve globally. However, many health professionals and facilities have yet to adopt these guidelines in Cambodia, impeding timely initiation progress and maternal-infant health goals.

Methods

This secondary data analysis used the 2014 Cambodia Demographic and Health Survey (CDHS) data of 2,729 women who gave birth in the two years preceding the survey to examine the association between place of birth and timely breastfeeding initiation. Descriptive statistics, chi-square test and multivariable logistic regression were performed. Pairwise interaction terms between place of birth and each covariate were included in the regression model to examine the presence of multiplicative effect modification.

Results

The prevalence of timely breastfeeding initiation was 62.9 percent. Most women gave birth in public health facilities (72.8%) followed by private health facilities (15.9%) and at home (11.2%). The proportions of timely breastfeeding initiation differ by place of birth (p < 0.001). In the multivariable model, there was a significant interaction between place of birth and household wealth index and between place of birth and residence on timely initiation. Among women who reside in poor households, the odds of timely initiation were lower among women who gave birth at home compared to those who gave birth in public health facilities, adjusted odds ratio (95% confidence interval) 0.43 (0.21, 0.88). For urban settings, the odds of timely breastfeeding initiation were lower among women who gave birth in private health facilities compared to those who gave birth in public health facilities 0.52 (0.36, 0.75). For rural settings, the odds of timely breastfeeding initiation were lower among women who gave birth at home compared to those who gave birth in public health facilities 0.55 (0.31, 0.97).

Conclusions

Wealth index and residence moderated the association between place of birth and timely breastfeeding initiation in Cambodia. To improve breastfeeding outcomes and eliminate practices impeding timely initiation, breastfeeding advocacy programs need greater integration and follow-up in Cambodia’s health systems, including among home birth attendants and private health facilities.
Leveraging academic initiatives to advance implementation practice: a scoping review of capacity building interventions
Authors: Juckett Lisa A. , Bunger Alicia C. , McNett Molly M. , Robinson Monica L. , Tucker Sharon J.
Published: July 2022

Background

Academic institutions building capacity for implementation scholarship are also well positioned to build capacity in real world health and human service settings. How practitioners and policy makers are included and trained in implementation capacity-building initiatives, and their impact on building implementation practice capacity is unclear. This scoping review identified and examined features of interventions that build implementation practice capacity across researchers and practitioners or practitioners-in-training.

Methods

Five bibliographic databases were searched. Eligible studies (a) described an implementation capacity building intervention with a connection to an academic institution, (b) targeted researchers and practitioners (including practitioners-in-training, students, or educators), and (c) reported intervention or participant outcomes. Articles that only described capacity building interventions without reporting outcomes were excluded. Consistent with Arksey and O’Malley’s framework, key study characteristics were extracted (target participants, core components, and outcomes) and analyzed using open coding and numerical analysis.

Results

Of 1349 studies identified, 64 met eligibility for full-text review, and 14 were included in the final analysis. Half of the studies described implementation capacity building interventions that targeted health or behavioral health researchers, practitioners, and practitioners-in-training together, and half targeted practitioners or practitioners-in-training only. The most common components included structured didactic activities offered in person or online, mentorship and expert consultation to support implementation, and practical application activities (e.g., field placements, case studies). Knowledge sharing activities and technical assistance were less common. All studies reported favorable outcomes related to knowledge attainment, increased ability to implement evidence, productivity, and satisfaction.

Conclusions

Building implementation capacity among practitioners is critical for integrating insights from implementation science into the field and preventing the “secondary” implementation research-to-practice gap. This scoping review identified several promising implementation practice capacity building interventions that tend to build practitioner capacity via expert led activities which may be relevant for academic institutions seeking to build implementation practice capacity. To avoid widening the implementation research-to-practice gap, implementation capacity building interventions are needed that target policy makers, expand beyond multiple practice settings, and leverage university/community partnerships or on-site academic medical centers. Future studies will also be needed to test the impact on service quality and public health outcomes.
Randomized controlled phase 2 trial of hydroxychloroquine in childhood interstitial lung disease
Authors: Griese Matthias , Kappler Matthias , Stehling Florian , Schulze Johannes , Baden Winfried , Koerner-Rettberg Cordula , Carlens Julia , Prenzel Freerk , Nährlich Lutz , Thalmeier Andreas , Sebah Daniela , Kronfeld Kai , Rock Hans , Ruckes Christian ,   the HCQ-study group, Olivier Margarete , Zielen Stefan , Bagheri-Potthof Azadeh , Thome Ulrich , Gebhardt Julia , Mehl Anna , Lau Susanne Gabriele , Philipp Utz , Kopp Matthias , Stichtenoth Guido , Sommerburg Olaf , Stahl Mirjam , Kitz Richard , Rietschel Christoph , Stock Philippe , Ahrens Frank , Hebestreit Helge , Segerer Florian , Brinkmann Folke , Anne Schlegtendal , Eismann Claudia , Neuner Dörthe , Witt Sabine , Hengst Meike , Feilcke Maria , Babl Jürgen , Stauffer Gabriele , Nickolay Tanja , Gorbulev Stanislav , Anthony Gisela , Stöhr Linda , Vieweg Laura , Strenge-Hesse Anke , Wetzke Martin , Seidl Elias , Schwerk Nicolaus
Published: July 2022

Background

No results of controlled trials are available for any of the few treatments offered to children with interstitial lung diseases (chILD). We evaluated hydroxychloroquine (HCQ) in a phase 2, prospective, multicentre, 1:1-randomized, double-blind, placebo-controlled, parallel-group/crossover trial. HCQ (START arm) or placebo were given for 4 weeks. Then all subjects received HCQ for another 4 weeks. In the STOP arm subjects already taking HCQ were randomized to 12 weeks of HCQ or placebo (= withdrawal of HCQ). Then all subjects stopped treatment and were observed for another 12 weeks.

Results

26 subjects were included in the START arm, 9 in the STOP arm, of these four subjects participated in both arms. The primary endpoint, presence or absence of a response to treatment, assessed as oxygenation (calculated from a change in transcutaneous O2-saturation of ≥ 5%, respiratory rate ≥ 20% or level of respiratory support), did not differ between placebo and HCQ groups. Secondary endpoints including change of O2-saturation ≥ 3%, health related quality of life, pulmonary function and 6-min-walk-test distance, were not different between groups. Finally combining all placebo and all HCQ treatment periods did not identify significant treatment effects. Overall effect sizes were small. HCQ was well tolerated, adverse events were not different between placebo and HCQ.

Conclusions

Acknowledging important shortcomings of the study, including a small study population, the treatment duration, lack of outcomes like lung function testing below age of 6 years, the small effect size of HCQ treatment observed requires careful reassessments of prescriptions in everyday practice (EudraCT-Nr.: 2013-003714-40, www.clinicaltrialsregister.eu, registered 02.07.2013).

Registration The study was registered on 2 July 2013 (Eudra-CT Number: 2013-003714-40), whereas the approval by BfArM was received 24.11.2014, followed by the approval by the lead EC of the University Hospital Munich on 20.01.2015. At clinicaltrials.gov the trial was additionally registered on November 8, 2015 (NCT02615938).
Renal phenotypes correlate with genotypes in unrelated individuals with tuberous sclerosis complex in China
Authors: Luo Cong , Zhang Ye , Zhang Yu-shi , Zhang Ming-Xin , Ning Jun , Chen Min-Feng , Li Yuan , Qi Lin , Zu Xiong-Bing , Li Yang-Le , Cai Yi
Published: July 2022

Purpose

To explore the relationship between the genotype and renal phenotype in a Chinese cohort and guide clinical decision-making for treating tuberous sclerosis complex (TSC).

Materials and methods

We reviewed 173 patients with definite TSC at three centers in China from September 2014 to September 2020. All the patients underwentTSC1andTSC2genetic testing as well as renal phenotypic evaluation. All analyses were performed using the SPSS software, version 19.0, with a cut-offPvalue of 0.05 considered statistically significant.

Results

We identified variants in 93% (161/173) cases, including 16%TSC1and 77%TSC2variants. Analysis of the relationship between the genotype and renal phenotype, revealed that those withTSC2variants were more likely to develop severe renal AML (> 4) (P = 0.044). In terms of treatment,TSC2variants were more likely to undergo nephrectomy/partial nephrectomy (P = 0.036) and receive mTOR medication such as everolimus (P < 0.001). However, there was no significant difference between the two groups in terms of their response to the everolimus treatment.

Conclusion

Patients withTSC2variants exhibit more severe renal phenotypes, especially those associated with renal angiomyolipomas (AML), and they often require nephrectomy/partial nephrectomy or mTOR medication. Detection of the genotype is helpful in TSC management.
Clusters of clinical and immunologic features in patients with bullous systemic lupus erythematosus: experience from a single-center cohort study in China
Authors: Qiao Lin , Zhang Bingjie , Zheng Wenjie , Li Mengtao , Zhao Yan , Zeng Xiaofeng , Zhang Fengchun , Wang Li , Li Li
Published: July 2022

Background

Bullous systemic lupus erythematosus (BSLE) is a rare subtype of systemic lupus erythematosus (SLE) that is clinically characterized by subepidermal tense vesicles or bullae. We aimed to investigate the clinical and laboratory features of patients with BSLE.

Methods

We retrospectively reviewed all patients who fulfilled the diagnostic criteria for BSLE in our institution from 2015 to 2021. Cutaneous lesions, systemic manifestations, treatment options, and outcomes were evaluated. For each case of BSLE, four controls were randomly selected from patients with single SLE. Major clinical and laboratory characteristics were compared between the two groups.

Results

Among 4221 patients with SLE, 12 developed BSLE. Vesiculobullous lesions were the first sign in five of the BSLE patients (5/12, 41.7%) and appeared after SLE diagnosis in the remaining seven patients (7/12, 58.3%), with a median duration from SLE onset of 36 months (4–115 months). The most common BSLE-affected sites were the head and neck (10/12, 83.3%), extremities (9/12, 75.0%), trunk (7/12, 58.3%), and mucosae (6/12, 50.0%). All patients with BSLE had extra-cutaneous involvement. The SLE disease activity index score exceeded 5 in 10/12 (83.3%) patients, which indicated high disease activity. Patients in the BSLE group had significantly higher incidences of proteinuria (83.3% vs. 47.9%, P = 0.027), hematuria (75% vs. 31.3%, P = 0.006), hemolytic anemia (33.3% vs. 0%, P = 0.000), and leukopenia (66.7% vs. 25.0%, P = 0.006) than those in the control group. The use of systemic corticosteroids, immunosuppressants, dapsone, and skin care was effective in controlling disease.

Conclusions

Vesiculobullous lesions may be the first manifestation and indicate a high disease activity in patients with BSLE. Early diagnosis using clinical, histopathological, and immunological evaluations can lead to appropriate treatment of this progressive disease and improve prognosis.
Does inter-border conflict influence the views of task sharing among community health volunteers in Nigeria? A qualitative study
Authors: Lar Luret , Stewart Martyn , Isiyaku Sunday , Dean Laura , Ozano Kim , Mpyet Caleb , Theobald Sally
Published: July 2022

Background

Volunteer community health workers are increasingly being engaged in Nigeria, through the World Health Organization’s task sharing strategy. This strategy aims to address gaps in human resources for health, including inequitable distribution of health workers. Recent conflicts in rural and fragile border communities in northcentral Nigeria create challenges for volunteer community health workers to meet their community's increasing health needs. This study aimed to explore the perception of volunteers involved in task sharing to understand factors affecting performance and delivery in such contexts.

Methods

This was a qualitative study conducted in fragile border communities in north central Nigeria. Eighteen audio recorded, semi-structured interviews with volunteers and supervisors were performed. Their perceptions on how task sharing and allocation of tasks affect performance and delivery were elucidated. The transactional social framework was applied during the thematic analysis process to generate an explanatory account of the research data, which was analysed using NVivo software.

Results

Promotive and preventive tasks were shared among the predominantly agrarian respondents. There was a structured task allocation process that linked the community with the health system and mainly cordial relationships were in place. However, there were barriers related to ethnoreligious crises and current conflict, timing of task allocations, gender inequities in volunteerism, shortage of commodities, inadequate incentives, dwindling community support and negative attitudes of some volunteers.

Conclusion

The perception of task sharing was mainly positive, despite the challenges, especially the current conflict. In this fragile context, reconsideration of non-seasonal task allocations within improved community-driven selection and security systems should be encouraged. Supportive supervision and providing adequate and timely renumeration will also be beneficial in this fragile setting.
Knockdown of myorg leads to brain calcification in zebrafish
Authors: Zhao Miao , Lin Xiao-Hong , Zeng Yi-Heng , Su Hui-Zhen , Wang Chong , Yang Kang , Chen Yi-Kun , Lin Bi-Wei , Yao Xiang-Ping , Chen Wan-Jin
Published: July 2022

Primary familial brain calcification (PFBC) is a neurogenetic disorder characterized by bilateral calcified deposits in the brain. We previously identified that MYORG as the first pathogenic gene for autosomal recessive PFBC, and established a Myorg-KO mouse model. However, Myorg-KO mice developed brain calcifications until nine months of age, which limits their utility as a facile PFBC model system. Hence, whether there is another typical animal model for mimicking PFBC phenotypes in an early stage still remained unknown. In this study, we profiled the mRNA expression pattern of myorg in zebrafish, and used a morpholino-mediated blocking strategy to knockdown myorg mRNA at splicing and translation initiation levels. We observed multiple calcifications throughout the brain by calcein staining at 2–4 days post-fertilization in myorg-deficient zebrafish, and rescued the calcification phenotype by replenishing myorg cDNA. Overall, we built a novel model for PFBC via knockdown of myorg by antisense oligonucleotides in zebrafish, which could shorten the observation period and replenish the Myorg-KO mouse model phenotype in mechanistic and therapeutic studies.
A large-scale polygenic risk score analysis identified candidate proteins associated with anxiety, depression and neuroticism
Authors: Cheng Bolun , Yang Xuena , Cheng Shiqiang , Li Chun’e , Zhang Huijie , Liu Li , Meng Peilin , Jia Yumeng , Wen Yan , Zhang Feng
Published: July 2022

Psychiatric disorders and neuroticism are closely associated with central nervous system, whose proper functioning depends on efficient protein renewal. This study aims to systematically analyze the association between anxiety / depression / neuroticism and each of the 439 proteins. 47,536 pQTLs of 439 proteins in brain, plasma and cerebrospinal fluid (CSF) were collected from recent genome-wide association study. Polygenic risk scores (PRS) of the 439 proteins were then calculated using the UK Biobank cohort, including 120,729 subjects of neuroticism, 255,354 subjects of anxiety and 316,513 subjects of depression. Pearson correlation analyses were performed to evaluate the correlation between each protein and each of the mental traits by using calculated PRSs as the instrumental variables of protein. In general population, six correlations were identified in plasma and CSF such as plasma protease C1 inhibitor (C1-INH) with neuroticism score (r = − 0.011, P = 2.56 × 10− 9) in plasma, C1-INH with neuroticism score (r = -0.010, P = 3.09 × 10− 8) in CSF, and ERBB1 with self-reported depression (r = − 0.012, P = 4.65 × 10− 5) in CSF. C1-INH and ERBB1 may induce neuroticism and depression by affecting brain function and synaptic development. Gender subgroup analyses found that BST1 was correlated with neuroticism score in male CSF (r = − 0.011, P = 1.80 × 10− 5), while CNTN2 was correlated with depression score in female brain (r = − 0.013, P = 6.43 × 10− 4). BST1 and CNTN2 may be involved in nervous system metabolism and brain health. Six common candidate proteins were associated with all three traits (P < 0.05) and were confirmed in relevant proteomic studies, such as C1-INH in plasma, CNTN2 and MSP in the brain. Our results provide novel clues for revealing the roles of proteins in the development of anxiety, depression and neuroticism.
Genetic subtypes and phenotypic characteristics of 110 patients with Prader-Willi syndrome
Authors: Zhang Lu , Liu Xiaoliang , Zhao Yunjing , Wang Qingyi , Zhang Yuanyuan , Gao Haiming , Zhang Bijun , Cui Wanting , Zhao Yanyan
Published: July 2022

Background

Prader-Willi syndrome (PWS) is a complex disorder caused by impaired paternally expressed genes on chromosome 15q11-q13. Variable findings have been reported about the phenotypic differences among PWS genetic subtypes.

Methods

A total of 110 PWS patients were diagnosed from 8,572 pediatric patients included from July 2013 to December 2021 by MLPA and MS-MLPA assays. Atypical deletions were defined by genomic CNV-sequencing. Maternal uniparental disomy (UPD) was subgrouped by microsatellite genotyping. Clinical data were collected for phenotype-genotype associations. Twenty-one patients received growth hormone (GH) treatment, and the anthropometric and laboratory parameters were evaluated and compared.

Results

Genetically, the 110 patients with PWS included 29 type I deletion, 56 type II deletion, 6 atypical deletion, 11 heterodisomy UPD, and 8 isodisomy UPD. The UPD group had significantly higher maternal age (31.4 ± 3.4 vs 27.8 ± 3.8 years), more anxiety (64.29% vs 26.09%) and autistic traits (57.14% vs 26.09%), and less hypopigmentation (42.11% vs 68.24%) and skin picking (42.86% vs 71.01%) than the deletion group. The type I deletion group was diagnosed at earlier age (3.7 ± 3.3 vs 6.2 ± 3.2 years) and more common in speech delay (95.45% vs 63.83%) than the type II. The isodisomy UPD group showed a higher tendency of anxiety (83.33% vs 50%) than the heterodisomy. GH treatment for 1 year significantly improved the SDS of height (− 0.43 ± 0.68 vs − 1.32 ± 1.19) and IGF-I (− 0.45 ± 0.48 vs − 1.97 ± 1.12). No significant changes were found in thyroid function or glucose/lipid metabolism.

Conclusion

We explored the physical, psychological and behavioral phenotype-genotype associations as well as the GH treatment effect on PWS from a large cohort of Chinese pediatric patients. Our data might promote pediatricians' recognition and early diagnosis of PWS.
Explore the attitudes of children and adolescent parents towards the vaccination of COVID-19 in China
Authors: Wang Lin , Wen Wen , Chen Chen , Tang Jiake , Wang Chunyi , Zhou Mengyun , Cheng Yongran , Zhang Xingwei , Wang Mingwei , Feng Zhanhui , Wang Weiqian
Published: July 2022

Background

With the increasing incidence of asymptomatic carriers or milder symptoms, children and adolescents are likely to become a silent source of infection. In view of the efficacy and safety of vaccines in the treatment of novel Coronavirus pneumonia, population-wide vaccination will be an inevitable trend to control the spread of COVID-19. However, there is no survey on the attitudes of Chinese parents of children and adolescents towards their children’s COVID-19 vaccination.

Methods

We used online questionnaires to find out the attitudes of Chinese parents toward their children’s immunization against COVID-19. Logistic regression was used to explore the influencing factors.

Results

A total of 2019 parents participated in the survey. Overall, 74.38% parents said they would actively get vaccinated, 8.90% refused to get vaccinated, 4.60% said they would delay vaccination and 12.12% were still undecided.

Conclusions

In general, Chinese parents have a high desire to be vaccinated against COVID-19, and most parents have a positive attitude towards their children’s vaccination. However, many people still hesitate or even refuse to be vaccinated. Education background, attitudes towards children’s vaccination, children’s age, recent illness and other factors have a certain impact on Chinese parents of children and adolescents towards their children’s COVID-19 vaccination.
Different AHO phenotype in a Chinese family with a novel GNAS missense variant: a case report
Authors: Zhou Qing , Liang Bin , Fu Qing-Xian , Liu Hui , Zou Chao-Chun
Published: July 2022

Background

Albright’s hereditary osteodystrophy (AHO) is an inherited disorder which is caused by an inactivating variant in the GNAS gene. AHO appears associated to either pseudohypoparathyroidism 1a (PHP1a) when GNAS gene is maternally inherited or to pseudo-pseudohypoparathyroidism (PPHP) when it is paternally inherited. We describe the clinical and biochemical characteristics of two patients, a boy and his mother with a novel heterozygous missense variant of GNAS gene.

Case presentation

The boy presented with typical AHO phenotype (early-onset obesity, round face, short neck, shortened fifth metacarpal bone, developmental retardation, but without short stature and subcutaneous calcifications), multiple hormone resistance including PTH, TSH and ACTH, and mild calcification in the right basal ganglia. The mother only presented with brachydactyly and short stature, without hormone resistance and other signs of AHO. Whole-exome sequencing identified in the son and his mother a novel heterozygous missense variant (p. Val375Leu) in exon 13 of GNAS gene. The diagnosis of PHP-1a for the son and PPHP for the mother were confirmed.

Conclusion

This study further expands the spectrum of known GNAS pathogenic variants, and also demonstrates the heterogeneous phenotype of AHO due to a novel GNAS pathogenic variant.
Unravelling genetic variants of a swedish family with high risk of prostate cancer
Authors: Barilla Serena , Lindblom Annika , Helgadottir Hafdis T.
Published: July 2022

Background

Prostate cancer is the most prevalent cancer in men worldwide. It is a polygenic disease with a substantial proportion of heritability. Identification of novel candidate biomarkers is crucial for clinical cancer prevention and the development of therapeutic strategies. Here, we describe the analysis of rare and common genetic variants that can predispose to the development of prostate cancer.

Methods

Whole-genome sequencing was performed on germline DNA of five Swedish siblings which were diagnosed with prostate cancer. The high-risk variants were identified setting the minor allele frequency < 0.01, CADD > 10 and if tested in PRACTICAL, OR > 1.5, while the low-risk variants were identified minor allele frequency > 0.01, CADD > 10 and if tested in PRACTICAL, OR > 1.1.

Results

We identified 38 candidate high-risk gene variants and 332 candidate low-risk gene variants, where 2 and 14 variants were in coding regions, respectively, that were shared by the brothers with prostate cancer.

Conclusions

This study expanded the knowledge of potential risk factor candidates involved in hereditary and familial prostate cancer. Our findings can be beneficial when applying targeted screening in families with a high risk of developing the disease.
Rationale and methods of the Antioxidant and NMDA receptor blocker Weans Anoxic brain damage of KorEa OHCA patients (AWAKE) trial
Authors: Choi Jin-Ho , Chun Byeong Jo , Yeom Seok Ran , Chung Sung Phil , Lee Young Hwan , Kim Yun-Hee , Lee Ji Sung , Lee Jin Hwan , Lee Hwan Goo , Jin Jing Yu , An Chun San , Gwag Byoung Joo
Published: July 2022

Background

Ischemic brain injury is a major hurdle that limits the survival of resuscitated out-of-hospital cardiac arrest (OHCA).

Methods

The aim of this study is to assess the feasibility and potential for reduction of ischemic brain injury in adult OHCA patients treated with high- or low-dose Neu2000K, a selective blocker of N-methyl-d-aspartate (NMDA) type 2B receptor and also a free radical scavenger, or given placebo. This study is a phase II, multicenter, randomized, double-blinded, prospective, intention-to-treat, placebo-controlled, three-armed, safety and efficacy clinical trial. This trial is a sponsor-initiated trial supported by GNT Pharma. Successfully resuscitated OHCA patients aged 19 to 80 years would be included. The primary outcome is blood neuron-specific enolase (NSE) level on the 3rd day. The secondary outcomes are safety, efficacy defined by study drug administration within 4 h in > 90% of participants, daily NSE up to 5th day, blood S100beta, brain MRI apparent diffusion coefficient imaging, cerebral performance category (CPC), and Modified Rankin Scale (mRS) at 5th, 14th, and 90th days. Assuming NSE of 42 ± 80 and 80 ± 80 μg/L in the treatment (high- and low-dose Neu2000K) and control arms with 80% power, a type 1 error rate of 5%, and a 28% of withdrawal prior to the endpoint, the required sample size is 150 patients.

Discussion

The AWAKE trial explores a new multi-target neuroprotectant for the treatment of resuscitated OHCA patients.

Trial registration

ClinicalTrials.gov NCT03651557. Registered on August 29, 2018.
Supporting families to achieve a healthy weight development for their child with overweight/obesity using the STARKIDS intervention: study protocol for a cluster-randomized controlled trial
Authors: Ziser Katrin , Junne Florian , Herschbach Anne , Martus Peter , Jacoby Johann , Stuber Felicitas , Rahmani Azad Zahra , Mack Isabelle , Weiland Alisa , Krauß Inga , Greule Constanze , Sudeck Gorden , Kastner Lydia , Zurstiege Guido , Hoell Andreas , Bethge Wolfgang , Sammet Torben , Schliesing Olaf , Zipfel Stephan , Ehehalt Stefan , Giel Katrin E.
Published: July 2022

Background

Childhood and adolescent overweight and obesity are among the most serious health challenges today. Structured weight reduction programs can be helpful to reduce severe health consequences but evidence is partly scarce. The STARKIDS program aims to improve on some of these limitations and is designed to be a structured, stepwise, digitally supported intervention program for the whole family. It is divided into two intervention steps spanning over 1.5 years and aims at promoting a healthy weight development of children/adolescents with overweight/obesity and an increase in quality of life.

Methods

The STARKIDS intervention is evaluated in a cluster-randomized study design by comparing it with a control group receiving a one-time structured counselling in the pediatric practice. The study aims to include 1000 families with children/adolescents with overweight/obesity from 100 pediatric practices. The main outcomes are reduction in body mass index percentiles and improvements in children’s/adolescent’s quality of life, secondary outcomes refer to the contents of the intervention such as diet, physical activity, stress, and media habits. All outcomes are measured on three measurement time points: (T0) at baseline/inclusion in the study, (T1) baseline + 12 months which is the end of step 1 of the STARKIDS intervention, and (T2) baseline + 18 months which is the end of step 2 of the STARKIDS intervention.

Discussion

The stepwise, e-health-supported STARKIDS program is a low-threshold intervention program for families with children/adolescents with overweight/obesity. With the proof of concept, STARKIDS provides the potential to be implemented as a standard care tool for the prevention and intervention of childhood/adolescence obesity in the German health system.

Trial registration

German Clinical Trials Register (DRKS) DRKS00022813 (acknowledged primary register of the World Health Organization). Registered on 27 November 2020 (Universal Trial Number U1111-1254-9536).
Evaluation of the effect of perioperative administration of S(+)-ketamine hydrochloride injection for postoperative acute pain in children: study protocol for a prospective, multicenter, randomized, open-label, parallel-group, pragmatic clinical trial
Authors: Wang Hong , Duan Chongyang , Zhang Jianmin , Qu Shuangquan , Sun Ying , Zhou Lizhi , Yang Lujia , Lan Chen , Mi Weidong , Chen Pingyan
Published: July 2022

Background

Inadequate postoperative pain management increases the risk of adverse events after the surgery and aggressive perioperative pain prevention has both short-term and long-term benefits. S(+)-ketamine is an N-methyl-D-aspartic acid (NMDA) receptor antagonist with a strong analgesic effect and can significantly relieve postoperative acute pain and reduce opioid consumption. However, for children, it still needs to be confirmed by large sample clinical studies.

Methods

This is a pragmatic, randomized controlled trial which will evaluate the effect of perioperative administration of S(+)-ketamine hydrochloride injection for postoperative acute pain in children in a pragmatic clinical setting. A total of 3000 children (≤17 years old) undergoing surgery will be included in this protocol. Subjects will be randomized 2:1 to either receive S(+)-ketamine hydrochloride injection or conventional therapy without S(+)-ketamine during the entire perioperative period. The primary endpoints are the area under the receiver operating characteristic (ROC) curve of Face Legs Activity Cry and Consolability (FLACC, 0–7 years old) scale score or Numerical Rating Scale (NRS, 8–17 years old) score within 48 h after surgery, and the consumption of opioids within 48 h after surgery. The secondary endpoints include the time of first use of rescue analgesics after surgery, rescue analgesia rate within 48 h after surgery, anesthesia recovery time, incidence of emergency delirium (for 0-7 years old), changes of anxiety and depression scale scores at 48 h after surgery (for 8-17 years old), incidence of intraoperative adverse events (AEs), and incidence of postoperative AEs and pharmacoeconomic indicators. AEs and serious AEs were recorded to evaluate safety.

Discussion

This trial will be the first pragmatic clinical trial to prospectively assess the effect of perioperative administration of S(+)-ketamine hydrochloride injection for postoperative acute pain in children, which is of great significance to the continuous optimization of clinical anesthesia and analgesia programs for children.

Trial registration

This trial was registered in the U.S. National Institutes of Health ClinicalTrials.gov database (http://clinicaltrials.gov; Registration number: NCT04834427). Registered on 8 April 2021.
Effect of adding a positive memories’ module in a trauma-focused cognitive-behavioural treatment for female survivors of intimate partner violence: trial protocol
Authors: Crespo M. , Miguel-Alvaro A. , Hornillos C. , Sánchez-Ferrer S. , Antón A. A.
Published: July 2022

Background

Trauma-focused cognitive-behavioural treatments have been proven to be effective for reducing symptoms in female survivors of intimate partner violence (IPV), although they still present some difficulties (e.g. significant drop-out rates, low adherence). Based on existing evidence about the difficulty of accessing memories of positive experiences among these women, we considered integrating positive memory evocation in trauma-focused treatments. The present study aims to test the effect of adding a positive memory module to trauma-focused CBT for female survivors of IPV.

Methods

The study is a single-blind, randomized controlled trial (RCT) comparing two trauma-focused CBT (with and without a positive memory module) for female survivors of IPV and a wait-list condition (superiority trial), including pretreatment and posttreatment measures, and follow-ups at 3, 6 and 12 months. Assessors of treatment outcome will be blinded to the trial arm. We aim to recruit 135 participants who will be randomized to one of the experimental conditions. The primary outcome is PTSD symptom severity. Secondary outcome measures include IPV, attitudes towards IPV, posttraumatic cognitions, centrality of trauma, self-concept, positive and negative affect, depression, anxiety, emotional dysregulation or health-related quality of life, as well as satisfaction with treatment. Moreover, adherence to and satisfaction with treatment will be considered.

Discussion

This study first analyses the effect of including positive memory evocation into a trauma-focused treatment for female survivors of IPV. This strategy aims to improve the effect of the treatments and enhance the healing of the trauma by developing a more integrated and emotionally modulated autobiographical narrative that contributes to the recovery and well-being of the victims.

Trial registration

ISRCTN73702156. Registered on 10 March 2022.
The validation of a serious game for teaching ultrasound skills
Authors: Olgers T. J. , van Os J. M. , Bouma H. R. , ter Maaten J. C.
Published: July 2022

Background

Point-of-care ultrasound (POCUS) is an important bedside diagnostic tool and is being taught in several specialties. However, mastering the required psychomotor skills takes time and learning curves are different between students. Especially learning to make the right probe movements with the corresponding changes of the ultrasound image on screen, and integrating it into a 3D mental model takes time. This precious bedside-time of trainers and physicians may be reduced using other learning methods for mastering the psychomotor skills, for example the use of serious games. Such a game is under development but it needs to be validated before widespread use can be advised. In this article we describe the development and the first three steps in the validation of a serious game for ultrasound skills.

Results

We have included 18 ultrasound experts and 24 ultrasound novices who played the serious game ‘Underwater” and provided feedback. They concluded that “underwater” is fun to play and that movement of the 3D-printed probe resembled real ultrasound probe movements. Participants highly valued the potential of the game for training eye–hand coordination and stability of probe handling, two very important skills in performing ultrasound in real practice. Although we compared several in-game parameters such as distance and speed, no difference was observed between novices and experts. This means that content- and face validity of the serious game is demonstrated but optimal parameters to measure differences between novices and experts still have to be determined.

Conclusions

Our study shows solid content- and face validity of the serious game “UnderWater” for training ultrasound skills, although construct validity could not be demonstrated yet. The game is appreciated as a promising serious game for training eye–hand coordination and learning ultrasound, which may reduce expensive bed-side teaching.
Physiological and locomotor demands during small-sided games are related to match demands and physical fitness? A study conducted on youth soccer players
Authors: Clemente Filipe Manuel , Silva Ana Filipa , Kawczyński Adam , Yıldız Mehmet , Chen Yung-Sheng , Birlik Sabri , Nobari Hadi , Akyildiz Zeki
Published: July 2022

Aim

The purpose of the study was: (i) to analyze the relationships of physiological and locomotor demands between small-sided games (3v3 and 5v5) and official matches (11v11); (ii) to analyze the relationships between small-sided games demands and the physical fitness of youth soccer players.

Methods

The observational study lasted three weeks. In the first week participants performed the 5v5 (50 × 31 and 40 × 25 m) repeatedly over four days. In the third week they repeatedly performed the 3v3 (39 × 24 and 32 × 19 m) over four consecutive days. Twenty youth soccer players (age: 16.8 ± 0.41) were tested twice for their final velocity at 30–15 Intermittent Fitness test (VIFT), peak speed attained at 30-m sprint test (peak speed), and anaerobic speed reserve (ASR). The heart rate responses and locomotor demands were monitored in the SSGs (3v3 and 5v5) and matches (11v11) occurring once a week. The Polar Team Pro was used as the instrument to monitor heart rate and locomotor demands. Three official matches were also monitored during the period.

Results

Results revealed no significant correlations (p > 0.05) between small-sided games and match physiological or locomotor demands. However, VIFT and ASR were significantly correlated with distance covered at 5v5 (r = 0.483; p = 0.031; and r = − 0.474; p = 0.035, respectively), average speed (r = 0.474; p = 0.035; and r = − 0.453; p = 0.045, respectively), while VIFT was also significantly correlated with distance covered at Z2 intensity (r = 0.510; p = 0.022).

Conclusions

The results suggest that the physiological and locomotor demands occurring in small-sided games are significantly different from those occurring in official matches. Thus, physiological and locomotor similarities between small-sided games and official matches are scarce. Considering the second purpose of this study, the results suggest that VIFT and ASR are important physical fitness parameters to modulate the amount of distance covered by the players in 5v5, the average pace, and also the distance covered at high intensities.
Occupational safety and health aspects of corporate social responsibility reporting in Japan: comparison between 2012 and 2020
Authors: Shimizu Takahiro , Nagata Tomohisa , Fujimoto Ayumi , Inoue Shunsuke , Nagata Masako , Mori Koji
Published: July 2022

Objective

To survey the content of occupational safety and health (OSH) disclosed in corporate social responsibility (CSR)-related reports and integrated reports in 2020 and to compare the changes between 2012 and 2020 according to industry and company size.

Results

Among all companies, 441 (20.3%) issued CSR-related reports and 590 (28.1%) issued integrated reports. The number (percentage) of companies that issued either CSR-related reports or integrated reports was 880 (40.5%). The percentages of both CSR-related reports and integrated reports increased with increased company size. The number (percentage) of companies reporting OSH in CSR-related reports was 391 (88.7%) and that in integrated reports was 493 (83.6%). The percentage of OSH reporting in CSR-related reports and integrated reports was high in secondary industries and low in tertiary industries.
Omental torsion mimicking acute appendicitis in a 7-year-old boy: a case report
Authors: Khalili Elham , Marashi Mahdis , Safarpanah Majid , Majidi Saeedeh , Hesarooeyeh Zahra Ghaeini
Published: July 2022

Background

Torsion of the greater omentum is an uncommon cause of acute abdominal pain. Omental torsion can be divided into primary and secondary. Owing to its nonspecific abdominal pain, preoperative diagnosis is difficult. Ultrasound sonography and abdominal computed tomography scans do not have a major role in preoperative diagnosis. The definite diagnosis is usually made during operation.

Case presentation

A 7-year-old Persian boy was referred with right lower quadrant pain associated with nausea and vomiting. Laboratory blood tests and urinalysis were requested that revealed normal values. Ultrasonography was performed, revealing inflammatory changes with mild free fluid collection in the interloop. The patient underwent an open appendectomy, confirming a normal appendix with omental torsion. Two days later, he was discharged home without postoperative complications.

Conclusions

In patients with acute abdomen, particularly those with acute appendicitis symptoms, omental torsion should be considered in the differential diagnosis.
Organoids: a systematic review of ethical issues
Authors: de Jongh Dide , Massey Emma K. ,   the VANGUARD consortium, Berishvili Ekaterine , Fonseca Laura Mar , Lebreton Fanny , Bellofatto Kevin , Bignard Juliette , Seissler Jochen , Buerck Leila Wolf-van , Honarpisheh Mohsen , Zhang Yichen , Lei Yutian , Pehl Monika , Follenzi Antonia , Olgasi Christina , Cucci Alessia , Borsotti Chiara , Assanelli Simone , Piemonti Lorenzo , Citro Antonio , Pellegrini Silvia , Pignatelli Cataldo , Campo Francesco , Thaunat Olivier , Cronin Antonia J. , Mey Devi , Parisotto Chiara , Rossi Giovanna , Kugelmeier Patrick , Wolint Petra , Mühlemann Markus , Pal-Kutas Karolina , Cavallaro Marco , Götz Julia , Müller Jeanette , Bunnik Eline M.
Published: July 2022

Organoids are 3D structures grown from pluripotent stem cells derived from human tissue and serve as in vitro miniature models of human organs. Organoids are expected to revolutionize biomedical research and clinical care. However, organoids are not seen as morally neutral. For instance, tissue donors may perceive enduring personal connections with their organoids, setting higher bars for informed consent and patient participation. Also, several organoid sub-types, e.g., brain organoids and human–animal chimeric organoids, have raised controversy. This systematic review provides an overview of ethical discussions as conducted in the scientific literature on organoids. The review covers both research and clinical applications of organoid technology and discusses the topics informed consent, commercialization, personalized medicine, transplantation, brain organoids, chimeras, and gastruloids. It shows that further ethical research is needed especially on organoid transplantation, to help ensure the responsible development and clinical implementation of this technology in this field.
Adipose-derived stem cells attenuate acne-related inflammation via suppression of NLRP3 inflammasome
Authors: Li Xiaoxi , Luo Sai , Chen Xinyao , Li Shasha , Hao Lijun , Yang Dan
Published: July 2022

Background

Acne is a chronic facial disease caused by Propionibacterium acnes, which proliferates within sebum-blocked skin follicles and increases inflammatory cytokine production. Several therapeutic drugs and products have been proposed to treat acne, yet no single treatment that ensures long-term treatment efficacy for all patients is available. Here, we explored the use of facial autologous fat transplant of adipose-derived stem cells (ADSCs) to dramatically reduce acne lesions.

Methods

THP-1 cells were treated with active P. acnes for 24 h at different multiplicities of infection, and alterations in inflammatory factors were detected. To study the effect of THP-1 on inflammasome-related proteins, we first co-cultured ADSCs with THP-1 cells treated with P. acnes and evaluated the levels of these proteins in the supernatant. Further, an acne mouse model injected with ADSCs was used to assess inflammatory changes.

Results

Propionibacterium acnes-mediated stimulation of THP-1 cells had a direct correlation with the expression of active caspase-1 and interleukin (IL)-1β in an infection-dependent manner. ADSCs significantly reduced the production of IL-1β induced by P. acnes stimulation through the reactive oxygen species (ROS)/Nod-like receptor family pyrin domain-containing 3 (NLRP3)/caspase-1 pathway. The results showed that ADSCs inhibit the skin inflammation induced by P. acnes by blocking the NLRP3 inflammasome via reducing the secretion of IL-1β in vivo.

Conclusions

Our findings suggest that ADSCs can alter IL-1β secretion by restricting the production of mitochondria ROS, thereby inhibiting the NLRP3/caspase-1 pathway in P. acnes-induced inflammatory responses. This study indicates that anti‐acne therapy can potentially be developed by targeting the NLRP3 inflammasome.
Exosomes from mmu_circ_0001052-modified adipose-derived stem cells promote angiogenesis of DFU via miR-106a-5p and FGF4/p38MAPK pathway
Authors: Liang Zun-Hong , Pan Nan-Fang , Lin Shi-Shuai , Qiu Zhi-Yang , Liang Ping , Wang Jun , Zhang Zhi , Pan Yun-Chuan
Published: July 2022

Background

Diabetic foot ulcer (DFU) is a chronic infectious disease caused by diabetes mellitus (DM). Angiogenesis plays the decisive role in wound healing of DFU. Adipose-derived stem cells (ADSCs) can ameliorate angiogenesis in DFU by exosomes. This study aims to determine the mechanism of exosomes from mmu_circ_0001052-modified ADSCs in angiogenesis of DFU.

Methods

HUVECs were induced by high glucose and mice stimulated using STZ injection during high-fat feeding, which were treated with exosomes derived from mmu_circ_0001052-modified ADSCs. Real-time PCR determined the expression of gene and western blot determined protein levels. Proliferation, migration, apoptosis and angiogenesis of HUVECs were studied by MTT assay, transwell test, flow cytometry and tube formation experiment, respectively. Histological lesion of wound was determined by HE staining.

Results

The expression of circ_0001052 was upregulated in ADSCs and miR-106a-5p elevated in high glucose-induced HUVECs. Exosomal mmu_circ_0001052 significantly accelerated wound healing in mice with DFU. Also, exosomal mmu_circ_0001052 evoked the reduction of miR-106a-5p and the elevation of FGF4 in high glucose-induced HUVECs and wound tissue of DFU mice. Exosomal mmu_circ_0001052 was determined to sponge miR-106a-5p that targeted FGF4 in DFU. In high glucose-induced HUVECs, exosomal mmu_circ_0001052 inhibited apoptosis and miR-106a-5p expression, and meanwhile promoted proliferation, migration, angiogenesis and expressions of FGF4, VEGF and p-p38/p38, which were reversed by miR-106a-5p elevation.

Conclusion

Mmu_circ_0001052 in ADSCs-derived exosomes promote angiogenesis of DFU via miR-106a-5p and FGF4/p38MAPK pathway.

Graphical Abstract