bluuebunny/crossref_metadata_2025 huggingface dataset:
Good life in old age: Qualitative interviews about ageing with older adults with mild intellectual disability, prior to an educational intervention
Authors: Holmgren Marianne , Ahlström Gerd
Published: November 2023

Background

Knowledge about ageing from the perspective of people with intellectual disability is extremely scarce, which means a lack of evidence-based interventions for healthy ageing adjusted to their needs.

Aim

To investigate how people with intellectual disability experience ageing, prior to an educational intervention.

Methods

Twenty-six persons with mild intellectual disability, age 42-74 (mean 61.3) were interviewed and the text was analyzed qualitatively.

Results

The main findings are reflected in the themes Live for today – tomorrow you are old and Need of support to enable a meaningful ageing. The participants avoided thinking about ageing, which they associated with retirement, loneliness and social isolation, increased need for help in everyday life, worsening health and death. Meaningful ageing meant continuance of leisure activities and working as long as possible.

Conclusions

Interventions to prepare people with mild intellectual disability for healthy ageing must take into account these people’s loneliness.
Long-term stroke risk in Moyamoya disease
Authors: Birkeland Peter , Hansen Victoria , Tharmabalan Vinosha , Lauritsen Jens , Nielsen Troels , Truelsen Thomas , Rosenbaum Sverre , von Weitzel-Mudersbach Paul
Published: November 2023

Background:

Moyamoya disease (MMD) is considered a progressive disease with an ongoing risk of recurrent stroke. However, there is a lack of long-term observational data to quantify the extent of the stroke risk.

Methods:

This study aimed to provide insight into the long-term stroke risk in MMD and explore possible risk factors for stroke. Records from all patients diagnosed with MMD in 13 clinical departments from 6 different Danish hospitals between 1994 and 2017 were retrospectively reviewed until 2021.

Results:

The cohort comprised 50 patients (33 females and 17 males). Patients were followed up for a median of 9.4 years, with more than 10 years of follow-up for 24 patients. Ten patients had 11 new stroke events—6 ischemic strokes and 5 brain hemorrhages. Events occurred at a median of 7 years and up to 25 years after diagnosis. The overall Kaplan-Meier 5-year stroke risk was 10%. Patients with bypass performed had significantly fewer events than conservatively treated patients (HR 0.25, 95% confidence interval (CI) 0.07–0.91, p < 0.05). All but one event occurred in females, a difference that reached statistical significance.

Conclusions:

The study provides data on the extent of the risk of recurrent stroke in MMD. Bypass surgery patients had fewer stroke events than those treated conservatively. There was a trend toward a higher stroke risk in females.

Data access statement:

The data supporting this study’s findings are available from the corresponding author upon reasonable request.
A comparative evaluation of Elo ratings- and machine learning-based methods for tennis match result prediction
Authors: Bunker Rory , Yeung Calvin , Susnjak Teo , Espie Chester , Fujii Keisuke
Published: November 2023

Elo ratings-based methods, including the recently proposed Weighted Elo method, have been found to perform well when forecasting tennis match results, however, whether they can outperform machine learning (ML) has not been established. In this study, a comparative evaluation of the two types of methods is conducted using the Sports Result Prediction CRISP-DM experimental framework. The first full year of mens ATP tennis data (2006), in a dataset containing matches from 2005 to 2020, was set to be the initial training set and 1 year of data was incrementally added to this set to predict 14 test years, from 2007 to 2020. Features were ranked based on their average rank across five feature selection techniques. It was found that, of the five ML models, Alternating Decision Trees (ADTrees) and Logistic Regression achieved higher accuracies than Elo ratings and similar accuracies to predictions derived from betting odds. Furthermore, ADTrees show potential in this domain, with solid performance achieved with an interpretable decision tree that allows for variation in the average betting odds difference threshold.
Allergic rhinitis
Authors: Giri Dr Sandarva
Published: November 2023

Allergic rhinitis (AR) is a major public health issue worldwide and one of the top-10 reasons for primary care attendance. AR affects between 10 and 25% of people worldwide, including 10–15% of children and 26% of adults in the United Kingdom. Sneezing, nasal itching, rhinorrhoea, nasal congestion, ocular symptoms (irritation and lacrimation), non-productive cough, Eustachian tube dysfunction and chronic sinusitis are all symptoms of AR. AR can be characterised as seasonal (hay fever), perennial, intermittent, persistent, or occupational, depending on the allergens and the pattern and frequency of symptoms. Asthma and conjunctivitis are significantly associated with AR. A clinical history and physical examination are the most important processes in diagnosis. Skin tests can be used to confirm the diagnosis of AR. Patients with AR may experience changes in their everyday activities, emotions, and sleep habits, to the detriment of quality of life. Early detection and treatment can ameliorate the unpleasant effects of AR. Management includes medication, avoidance of exposure to environmental allergens and when appropriate, measures to help with associated asthma and sinusitis. Psychological interventions can also help in the management of AR.
The Role of Hubris in Explaining Tourism Policy Failure: Some Observations and New Research Directions
Authors: Thomas Rhodri
Published: November 2023

The COVID-19 pandemic brought into sharp focus the important role public policy, including tourism policy, plays in improving economic and social welfare. This paper advocates consideration of the potential value of hubristic leadership theories when seeking to explain tourism policy failure (though it might also be used to contribute to examinations of policy innovation). In doing so, it seeks to complement existing literature by introducing ‘lower-level’ frameworks to show how more localized crises may occur. The flavour of a growing body of theoretical work in this field is provided alongside a truncated illustrative case study of policy failure in a British regional tourism policy context.
Cannabis Use in Adolescent and Young Adult Athletes: A Clinical Review
Authors: Benoy Ryan , Ramirez Cesar , Hitchcock Mary , Reardon Claudia
Published: November 2023

Context:

Cannabis use among the general population has increased over time, in part due to decriminalization of use and greater social acceptance of cannabis use. These changes have contributed to increased availability of cannabis products, thus raising the likelihood that a subset of adolescent and young adult athletes will use cannabis. Therefore, it is imperative that clinicians and other providers working with young athletes have a thorough understanding of the impact cannabis can have on the athletic performance and overall health of a young athlete.

Evidence Acquisition:

PubMed (Medline), CINAHL, PsycINFO, and SportDiscus databases were used to perform a literature search of articles published between January 1, 2010 and December 31, 2022. Additional articles were reviewed based on references obtained from initial articles.

Study Design:

Clinical review.

Level of Evidence:

Level 4.

Results:

Survey studies suggest that up to 1 in 4 athletes have used cannabis at least once in the last year. Age, sex, race, sexual orientation, level of competition, and country of residence of an athlete all contribute to differing rates of cannabis use among athletes. The scientific literature does not support using cannabis for athletic performance, and multiple studies have demonstrated notable impairments in objective athletic performance measures. Cannabis use can also negatively impact an athlete’s overall health via cardiovascular, gastrointestinal, and mental health symptoms and disorders.

Conclusion:

Cannabis use among adolescent and young adult athletes is common, and rates of use are influenced by many different factors. Current evidence suggests that cannabis use can worsen sport performance, negatively impact an athlete’s general health, and contribute to negative mental health outcomes.
Assessing the Maximal Mechanical Capacities Through the Load-Velocity Relationship in Elite Versus Junior Male Volleyball Players
Authors: Baena-Raya Andrés , Díez-Fernández David M. , García-de-Alcaraz Antonio , Soriano-Maldonado Alberto , Pérez-Castilla Alejandro , Rodríguez-Pérez Manuel A.
Published: November 2023

Background:

Physical testing is crucial for athlete monitoring, talent identification, optimizing training, and tailoring programs to enhance game-performance in elite competitions.

Hypothesis:

Load-velocity (L-V) relationship variables discriminate between elite and junior volleyball players, correlate with volleyball-specific performance, and are generalizable across lower- and upper-body exercises.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 3.

Methods:

A total of 9 elite and 11 junior volleyball players were assessed for the L-V relationship (load-axis intercept [ L0], velocity-axis intercept [ v0], and area under the L-V relationship line [ Aline]) during the countermovement jump (CMJ) and bench press throw (BPT) exercises. Block and spike jump height, as well as standing and jumping spike speed were assessed 24 hours later.

Results:

Elite players presented greater magnitude in the L-V variables ( P ≤ 0.03; effect size [ES] ≥ 1.06) and higher volleyball-specific performance ( P ≤ 0.03; ES ≥ 1.09) than juniors (except for CMJ v0 and Aline). The L-V relationship variables were significantly associated with the block and spike jump height and jumping spike speed only in elite players ( r ≥ 0.703 and P ≤ 0.04 in 11 out of 18 correlations). No significant associations were observed between CMJ and BPT for any L-V relationship variable ( r ≤ 581; P ≥ 0.08, except for Aline in junior players).

Conclusion:

The L-V relationship is a practical procedure to assess volleyball players’ maximal mechanical capacities, which are associated with volleyball-specific performance in elite players. However, these data should not be used interchangeably between playing standards or exercises.

Clinical Relevance:

This information might help strength and conditioning coaches to prescribe more effective training programs that focus on developing the specific physical capacities necessary for players to potentially advance to elite status.
Health staff’s job motivation post COVID-19 pandemic: A case study in Vietnam
Authors: Thanh Nguyen Duc , Anh Pham Quynh , Huyen Chang Pham Thi , Dung Hoang Van , Xiem Chu Huyen , Chau Le Bao
Published: November 2023

Objectives:

Vietnam has witnessed a severe shortage of qualified staff in the public health sector after the COVID-19 pandemic. Our cross-sectional study aimed to identify job motivation and associated factors among experienced frontline health staff working in public health in order to have preventive measures in the event of future pandemics.

Methods:

A cross-sectional study, from March 2022 to November 2022 at a Vietnamese public hospital, on the job motivation and the predicted factors of 381 healthcare workers who participated in the frontlines of the COVID-19 pandemic from 2020 to 2021. The survey tool, developed by Mbindyo Patrick (2009), includes three components: (i) job satisfaction, (ii) organizational commitment, and (iii) conscientiousness. The survey tool was revalidated in our study with structural equation model for the construction of job motivation model and confirmatory factor analysis for certifying the elementary three components (factors) of the tool. And the tool’s reliability was evaluated by Cronbach’s Alpha. Bivariate analysis and multiple logistic regression were used to identify the predicted factors with the job motivation cutoff of 4.0.

Results:

The tool for job motivation constructs showed all specifications were good fit indices and the Cronbach’s Alpha was 0.85. The job motivation of health staff decreased dramatically in all dimensions post COVID-19 pandemic, with a mean score of 3.26. Job satisfaction and organizational commitment were the most negatively impacted areas, with scores of 3.02 and 3.00, respectively. The predicted factors of low job motivation were young age (less than 30 years old), low monthly income (less than $400), high qualification, and non-managerial positions with odds ratio of 2.27, 2.5, 2.09, and 3.61, respectively.

Conclusion:

Following the COVID-19 outbreak in Vietnam, healthcare workers who had been in the frontlines of the COVID-19 pandemic, had experienced a significant decline in their job motivation, despite their continued employment at public hospitals.
Social stigma during COVID-19: A systematic review
Authors: SeyedAlinaghi SeyedAhmad , Afsahi Amir Masoud , Shahidi Ramin , Afzalian Arian , Mirzapour Pegah , Eslami Mohammad , Ahmadi Sepide , Matini Parisa , Yarmohammadi Soudabeh , Saeed Tamehri Zadeh Seyed , Asili Pooria , Paranjkhoo Parinaz , Ramezani Maryam , Nooralioghli Parikhani Sahar , Sanaati Foziye , Amiri Fard Iman , Emamgholizade Baboli Elham , Mansouri Somaye , Pashaei Ava , Mehraeen Esmaeil , Hackett Daniel
Published: November 2023

Objectives:

Stigmatization was reported throughout the COVID pandemic for COVID-19 patients and close contacts. The aim of this systematic review was to comprehensively examine the prevalence and impact of stigmatization during COVID-19 pandemic.

Methods:

English articles were searched using online databases that included PubMed, Scopus, Embase, and Web of Science up to 24 August 2022. A two-step screening and selection process was followed utilizing an inclusion and exclusion criteria and then data was extracted from eligible articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed, and the risk of bias was assessed using the Newcastle-Ottawa Scale.

Results:

Seventy-six studies were eligible for inclusion. Twenty-two studies reported the prevalence of social stigma due to COVID-19 infection with social isolation being the most commonly reported stigma. There were 20 studies that reported the majority of participants experienced stigma due to COVID-19 infection, which was as high as 100% of participants in two studies. Participants in 16 studies reported blaming from others as the second most common type of stigma, with various other types reported such as psychological pressure, verbal violence, avoidance, and labeling. The most common effect of the stigma was anxiety followed by depression, and then reduction of socialization.

Conclusion:

Findings from the present review have identified that COVID-19-related stigma studies have generally focused on its prevalence, type, and outcome. Greater awareness of this topic may assist with improving public education during pandemics such as COVID-19 as well as access to support services for individuals impacted by stigmatization.
A Case Series of Median Arcuate Ligament Syndrome With Varied Presentations
Authors: Abu-Hilal Al-hakam H. , Adawi Yousef , Abu-ghosh Mohammad , Abu-hilal Lila H. , Al Shawwa Khaled N. , AbuKeshek Tawfiq , Maree Mohammed
Published: November 2023

Median arcuate ligament syndrome (MALS) is characterized by the constriction of the celiac trunk caused by fibrous connections originating from the median arcuate ligament (MAL) and diaphragmatic crura. It presents with symptoms often leading to misdiagnosis. In this study, we present three cases of MALS, with distinct manifestations. These cases were diagnosed through comprehensive investigations and managed successfully using laparoscopic decompression. The diagnosis of MALS poses challenges due to its variable presentations and overlap with other conditions. Diagnostic imaging techniques such as Doppler ultrasound, computed tomography (CT) scans and angiography play a role in confirming the diagnosis. Laparoscopic decompression has proven to be a treatment option that relieves symptoms and restores blood flow. This series highlights the importance of considering MALS as a cause for abdominal pain cases. Early detection and the use of diagnostic techniques can result in favorable outcomes.
Needle Decompression Causing Pericardial and Pulmonary Artery Injuries in Patients With Blunt Trauma: Two Case Reports and Literature Review
Authors: Abdelrahman Husham , Atique Sajid , Kloub Ahmad G. , Hakim Suhail Y. , Laughton James , Abdulrahman Yassir S. , El-Menyar Ayman , Al-Thani Hassan
Published: November 2023

Tension pneumothorax (TPX) is a severe chest complication of blunt or penetrating trauma. Immediate decompression is the lifesaving action in patients with TPX. Needle decompression (ND) is frequently used for this purpose, particularly in limited resources setting such as the prehospital arena. Despite the safe profile, the blind nature of the procedure can result in a serious range of complications, including injury to the vital intrathoracic structures such as the lungs, great vessels, and heart. Here, we reported 2 cases of blunt chest trauma resulting in TPX demanding immediate ND; however, nonintentional pericardial and pulmonary artery injuries occurred. The first case was a 42-year-old man with a needle-related pulmonary artery injury that required surgery. The second case was a 19-year-old man in whom a needle-related pneumopericardium occurred and was treated conservatively. In both cases, trained personnel performed the ND. Although ND in the field is a lifesaving intervention, it may further complicate the patient condition. Therefore, it should be performed in adherence to the universal guidelines.
Performance of carbon nanotubes (CNTs) on the development of radiating hybrid nanofluid flow through an stretching cylinder
Authors: Dey Subhalaxmi , Ontela Surender , Pattnaik Pradyumna Kumar , Mishra Satyaranjan
Published: November 2023

In various industries, one of the important aspects is the cooling processes for which the material exhibits its perfect shape and size. Intending to the aforementioned property the current investigation leads to carry out the features of the materialistic property of thermal radiation and the dissipative heat by incorporating these in the water-based hybrid nanofluid. The fluid past a stretching cylinder embedded with a permeable medium and the impact of the magnetic field, and thermal radiation are depicted in momentum and energy profiles. In addition to that, the role of the Hamilton-Crosser conductivity model for the behavior of various shapes of the carbon nanotube (CNT) nanoparticles with their volume concentration is also vital. The transformation of the dimensional form of the governing equations into the non-dimensional form is obtained with the use of proper transformation rules. Further, the proposed designed model is handled by employing the traditional shooting-based Runge-Kutta fourth-order technique. The significant properties of different components are deployed graphically and the validation with earlier study shows a good correlation. Moreover, the important characteristics of the outcomes are; the surface cooling, driven by increased thermal buoyancy, promotes fluid velocity while simultaneously influencing the curvature parameter and profile to slow down the accumulation of nanoparticles.
Resilience as Mediator Between Two Restriction Stages of COVID-19 and Mental Distress
Authors: Zrihan-Weitzman Aviva , Merhav Inbal , Farchi Moshe , Peled-Avram Maya
Published: November 2023

The COVID-19 pandemic prompted worldwide policies ranging from social distancing to total lockdown. This study aims to assess mental distress and resilience as stress mediators during these two periods. The cross-sectional research followed 636 adults in March–April 2020, from social-distancing restrictions through the transition to general lockdown. Participants completed the Depression Anxiety and Stress Scale-21 (DASS-21) and the Adult Resilience Measure (ARM-R). Higher DASS scores were associated with female gender, younger age, being single and childless, no graduate degree, being employed during the pandemic and lower socioeconomic status. After controlling for age, DASS scores were significantly higher during total lockdown vs. social distancing. Full mediation of the ARM-R measure was revealed in the association between DASS score and restriction stage (social distancing vs. lockdown). Tightening restrictive policies is associated with higher distress in the general population, with specific groups at risk. Intervention programs are necessary to increase resilience from an eco-contextual perspective.
Agonal Rhythm: Not Always a Herald of Death! A Rare Presentation of Ebstein’s Anomaly
Authors: Imamuddin Syed , Srinivas Ravi , Parvathareddy Krishna Mala Konda Reddy , Nagula Praveen , Badami Sanjana
Published: November 2023

An agonal rhythm is a variant of idioventricular rhythm often preceding asystole. It reflects significant myocardial or metabolic derangement and has a grave prognosis. Ebstein’s anomaly accounts for 0.3–0.7% of all cases of congenital heart diseases. The electrocardiogram in Ebstein’s is seldom normal across the spectrum and plays a major role in establishing diagnosis. This case report describes an electrocardiogram with extreme low voltage and bizarre complexes mimicking agonal rhythm in a patient having Ebstein’s anomaly, presenting with severe biventricular failure.
Building a landscape ecology pathway forward to restore ecosystem in highly urbanized areas
Authors: Liu Zhenhuan , Wei Lai , Wang An , Liu Ziyu , Yang Fan , Zhou Yi
Published: November 2023

Ecosystem restoration is a huge task for ecosystem management in the context of rapid urbanization processes from regional governance to global ecosystem restoration in the new era. Significant ecological restoration efforts are underway to improve the ecological quality in highly urbanized areas. However, the path forward is far from clear for those who wish to apply these approaches to manage the urban ecosystem. In this study, we present five core dimensions to guide a landscape-scale management approach to restore ecosystems, with the objective of integrating restoration targets, spatial identification, planning and projects, monitoring and evaluation across the whole ecological restoration. We illustrate some key steps of our approach to landscape-scale ecosystem management through case tudies from Shenzhen City in China. We propose that a landscape ecology pathway is best implemented at regional scale for ecosystem restoration.
Agility training to integratively promote neuromuscular, cardiorespiratory and cognitive function in healthy older adults: a one-year randomized-controlled trial
Authors: Lichtenstein Eric , Held Steffen , Rappelt Ludwig , Zacher Jonas , Eibl Angi , Ludyga Sebastian , Faude Oliver , Donath Lars
Published: November 2023

Background

Exercise training recommendations for seniors include the targeted training of strength, balance, endurance and flexibility domains. Agility training (AT) is conceptualized as a multi-component and time-efficient training framework for older adults to improve physical, functional and cognitive health domains that are relevant for maintaining activities of daily living. The aim of this one-year trial was to comparatively evaluate the effects of agility training on physical and cognitive function.

Methods

Seventy-nine healthy older adults (AT: 61.5% female, 70.8 ± 4.8 years, 27.7 ± 4.2 kg/m2; CG: 60.5% female, 69.6 ± 4.7 years, 27.5 ± 4.4 kg/m2) took part in this one-year randomized controlled intervention and were either assigned to the agility training group (AT) with two weekly 60 min AT sessions or to the control group (CG), receiving no treatment. Participants were assessed pre, intermediate and post intervention for strength and power, balance, gait speed under multi-task conditions, aerobic capacity as well as cognitive performance. Linear mixed effects models were used to analyze the effect of treatment over time.

Results

Fifty-four participants (AG: 25, CG: 29) were analyzed, most drop-outs attributed to COVID-19 (17/30 dropouts). Adherence was good (75%) of 90 offered sessions. Notable effects in favor of AT were found for gait parameters in single (d = 0.355, Δ = 4.3%), dual (d = 0.375, Δ = 6.1%) and triple (d = 0.376, Δ = 6.4%) task conditions, counter movement jump performance (strength and power) (d = 0.203, Δ = 6.9%), static one leg balance (d = 0.256, Δ = 12.33%) and n-back reaction time (cognitive performance) (d = 0.204, Δ = 3.8%). No effects were found for the remaining outcomes (d < 0.175).

Conclusion

AT might serve as an integrative training approach for older adults particularly improving gait and lower limb power parameters. It seems suitable to improve a broad range of seniors’ health domains and should replace isolated training of these domains. However, individual variation and progression of exercises should be considered when programming agility training providing adequate challenges throughout a long-term intervention for all participants.

Trial registration

DRKS, DRKS00017469. Registered 19 June 2019—Retrospectively registered.
Environmental impact of quarrying on air quality in Ebonyi state, Nigeria
Authors: Okafor Odera Chukwumaijem , Njoku Chima , Akwuebu Anselem Nwabuaku
Published: November 2023

Background

The insatiable demand for rock supplies has enticed numerous building and construction enterprises to participate in stone quarrying. However, this has had an environmental impact on air quality. This paper examines the environmental impact of quarrying on air quality in Ebonyi State, Nigeria. To achieve the main aim of the study, an objective was set to detect air pollutants at the quarry sites. A total of 220 air samples were measured from six points around the quarry locations and recorded in situ for analysis. The samples were measured three times a day (morning, afternoon, and evening) for three days. Gas monitors were used to monitor air pollutants. The generated data were subjected to completely random design (CRD) sampling techniques. The separation of means and tests was performed using Fisher’s Least Significant Difference (FLSD) at a significance probability level of 5%.

Results

Based on statistical analysis, the findings detected significantly higher concentration levels of particulate matter, nitrogen dioxide, hydrogen sulphide, carbon monoxide, sulphur dioxide, chlorine, volatile organic compounds, ammonia, and hydrogen cyanide in the quarry areas than the value detected in the control area. The findings also confirmed higher noise levels in the locations. It was also observed that the concentration levels of the parameters differed from point to point and at different times of the day. This really means the occurrence of a high rate of air pollution in the study locations.

Conclusions

Based on the above findings, it is highly recommended that, (i) if situation is not timely addressed, it will lead to a severe environmental disaster or hazard, as nobody selects the air he or she breathes; (ii) air pollution control equipment be installed in-situ at quarry sites where free air flow is available in order to reduce gaseous (pollutant) emissions, and (iii) the seasonal effects, meteorological parameters and time that were influenced by the activities of quarry should be put in check.
How does high-speed railway affect green technology innovation? A perspective of high-quality human capital
Authors: He Ziwen , Chen Ziyang , Feng Xiao
Published: November 2023

Green development is the main theme of modern development in China and even the world. Green development depends on green technology innovation (GTI). Therefore, for developing countries like China in the stage of economic transition, it is urgent to accelerate GTI to gain sustained advantages in the new round of international competition. As an important representative of contemporary rapid transportation, high-speed railway (HSR) can not only alleviate the rapidly growing transportation demand of the public, but also have potential benefits to the energy consumption structure and environmental quality. Whether and how HSR affects GTI has become the focus of this paper. Hence, by employing the panel data of 286 cities in China from 2007 to 2018 with the time-varying DID model, this paper verifies that HSR development can contribute to GTI. The main findings of this paper are as follows: (1) The operation of HSR can not only make the incremental development of GTI, but also improve the quality of GTI simultaneously. Moreover, the quality improvement effect of HSR is greater than the quantity increment effect. (2) Heterogeneity analysis shows that the positive effect of HSR on GTI is more significant for cities that have implemented LCCP. (3) This paper verifies the mediating effect of high-quality human capital. The opening of HSR further stimulates GTI by improving the level of high-quality human capital in cities and increasing the opportunities for knowledge exchange and diffusion. Based on the above findings, this paper proposes some policy recommendations to help developing countries achieve GTI with positive externalities.
Diagnosis of Crohn’s disease and ulcerative colitis using the microbiome
Authors: Kang Da-Yeon , Park Jong-Lyul , Yeo Min-Kyung , Kang Sang-Bum , Kim Jin-Man , Kim Ju Seok , Kim Seon-Young
Published: November 2023

Background

Inflammatory bowel disease (IBD) is a multifactorial chronic inflammatory disease resulting from dysregulation of the mucosal immune response and gut microbiota. Crohn's disease (CD) and ulcerative colitis (UC) are difficult to distinguish, and differential diagnosis is essential for establishing a long-term treatment plan for patients. Furthermore, the abundance of mucosal bacteria is associated with the severity of the disease. This study aimed to differentiate and diagnose these two diseases using the microbiome and identify specific biomarkers associated with disease activity.

Results

Differences in the abundance and composition of the microbiome between IBD patients and healthy controls (HC) were observed. Compared to HC, the diversity of the gut microbiome in patients with IBD decreased; the diversity of the gut microbiome in patients with CD was significantly lower. Sixty-eight microbiota members (28 for CD and 40 for UC) associated with these diseases were identified. Additionally, as the disease progressed through different stages, the diversity of the bacteria decreased. The abundances of Alistipes shahii and Pseudodesulfovibrio aespoeensis were negatively correlated with the severity of CD, whereas the abundance of Polynucleobacter wianus was positively correlated. The severity of UC was negatively correlated with the abundance of A. shahii, Porphyromonas asaccharolytica and Akkermansia muciniphilla, while it was positively correlated with the abundance of Pantoea candidatus pantoea carbekii. A regularized logistic regression model was used for the differential diagnosis of the two diseases. The area under the curve (AUC) was used to examine the performance of the model. The model discriminated UC and CD at an AUC of 0.873 (train set), 0.778 (test set), and 0.633 (validation set) and an area under the precision-recall curve (PRAUC) of 0.888 (train set), 0.806 (test set), and 0.474 (validation set).

Conclusions

Based on fecal whole-metagenome shotgun (WMS) sequencing, CD and UC were diagnosed using a machine-learning predictive model. Microbiome biomarkers associated with disease activity (UC and CD) are also proposed.
Establishment of RT-RPA-Cas12a assay for rapid and sensitive detection of human rhinovirus B
Authors: Li Yongdong , Wang Xuefei , Xu Rong , Wang Ting , Zhang Dandan , Qian Weidong
Published: November 2023

Human rhinovirus B (HRV-B) is a major human viral pathogen that can be responsible for various kinds of infections. Due to the health risks associated with HRV-B, it is therefore crucial to explore a rapid, specific, and sensitive method for surveillance. Herein, we exploited a novel detection method for HRV-B by combining reverse-transcription recombinase polymerase amplification (RT-RPA) of nucleic acids isothermal amplification and the trans-cleavage activity of Cas12a. Our RT-RPA-Cas12a-based fluorescent assay can be completed within 35–45 min and obtain a lower detection threshold to 0.5 copies/µL of target RNA. Meanwhile, crRNA sequences without a specific protospacer adjacent motif can effectively activate the trans-cleavage activity of Cas12a. Moreover, our RT-RPA-Cas12a-based fluorescent method was examined using 30 clinical samples, and exhibited high accuracy with positive and negative predictive agreement of 90% and 100%, respectively. Taken together, a novel promising, rapid and effective RT-RPA-Cas12a-based detection method was explored and shows promising potential for on-site HRV-B infection in resource-limited settings.
Comparative retrospective review of perioperative analgesia using ultrasound-guided programmed intermittent erector spinae plane block for video-assisted thoracoscopic lobectomy
Authors: Zhu Xuefang , Ye Wei , Chen Jinhong , Xiao Jiwen , Zhao Weibing
Published: November 2023

Background

The retrospective cohort study was conducted to estimate the opioid-sparing anesthesia and limited side-effects with ultrasound (US)-guided ESPB using programmed intermittent bolus (PIB) or continuous infusion (CI) and standard opioid-based anesthesia in patients undergoing video-assisted thoracoscopic lobectomy (VATS).

Methods

Patients underwent VATS were stratified into either control group or one of the two ESPB groups in a 1:2:2 ratio depending on whether PIB was implemented or not. The primary endpoint was intra- and post-operative opioids consumption over the first 48 h following surgery.

Results

A total of 180 cases were included in the analysis. Cumulative perioperative opioid administration was found to be significantly different between PIB, CI and control group (both p < 0.001), and between PIB and CI group (p = 0.028). More specifically, the mean was 305.30 ± 51.35 mg, 339.68 ± 56.07 mg and 468.91 ± 79.84 mg in PIB, CI and control group. NRS scores at rest across all postoperative times were comparable in two ESPB groups, while significantly lower than control group, however, scores during exercising at postoperative 3, 6, 12 h were significantly lower in PIB group as compared to CI group. A wider anesthetized dermatomes with PIB was observed at 6, 24 and 48 h as opposed to the CI. The mean of levobupivacaine plasma concentration was significantly lower for PIB at postoperative 0.5, 12, 24 and 48 h after initiation than CI. However, local anesthetic toxicity was not observed in any of the two ESPB groups.

Conclusions

When US-guided ESPB using PIB was performed preoperatively, it contributed to the minimization of intra- and post-operative opioid consumption due to better analgesia with a wider anesthetic dermatome opposed to conventional CI, whereas, it was also associated with lower risk of local anesthetic toxicity because of lower plasma concentration of levobupivacaine.
The association between metabolic dysfunction-associated steatotic liver disease, cardiovascular and cerebrovascular diseases and the thickness of carotid plaque
Authors: Huang Yunqian , Wang Yuqun , Xiao Zhengguang , Yao Shengqi , Tang Yuhua , Zhou Linjun , Wang Qin , Xie Yanchun , Zhang Lixia , Zhou Yan , Lu Ying , Zhu Wenqian , Chen Man
Published: November 2023

Background

The relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and atherosclerosis has been controversial, which has become a hit of recent research. The study aimed to explore the association between MASLD, cardiovascular and cerebrovascular diseases (CCVD), and the thickness of carotid plaque which was assessed by ultrasound.

Methods

From September 2018 to June 2019, 3543 patients were enrolled. We asked participants to complete questionnaires to obtain information. All patients underwent liver ultrasound and bilateral carotid ultrasound to obtain carotid intima-media thickness (IMT) and maximum carotid plaque thickness (CPT). Hepatic steatosis was quantified during examination according to Hamaguchi’s ultrasonographic score, from 0 to 6 points. A score < 2 was defined as without fatty liver, and a score ≥ 2 was defined as fatty liver. Information about blood lipids was collected based on the medical records.

Results

We found common risk factors for CCVD events, MASLD, and atherosclerosis. There was a significant correlation between MASLD and carotid plaque, but not with CPT. No association was found between MASLD and CCVD events. CPT and IMT were thicker in CCVD patients than in non-CCVD patients. No significant difference was found between IMT and CPT in MASLD patients and non-MASLD patients. CCVD was independently and consistently associated with higher IMT, and free fatty acid (FFA).

Conclusions

According to our results, we recommend carotid ultrasound examination of the patients when FFA is increased, regardless of the presence of risk factors and MASLD. Due to the distribution of CPT of both CCVD and MASLD patients in the CPT 2-4 mm group, contrast-enhanced ultrasound is necessary to assess the vulnerability of the plaque when CPT ≥ 2 mm. Timely treatment of vulnerable plaques may reduce the incidence of future CCVD events.
The development and acceptability of an educational and training intervention for recruiters to neonatal trials: the TRAIN project
Authors: Smith V. , Delaney H. , Hunter A. , Torgerson D. , Treweek S. , Gamble C. , Mills N. , Stanbury K. , Dempsey E. , Daly M. , O’Shea J. , Weatherup K. , Deshpande S. , Ryan M. A. , Lowe J. , Black G. , Devane D.
Published: November 2023

Background

Suboptimal or slow recruitment affects 30–50% of trials. Education and training of trial recruiters has been identified as one strategy for potentially boosting recruitment to randomised controlled trials (hereafter referred to as trials). The Training tRial recruiters, An educational INtervention (TRAIN) project was established to develop and assess the acceptability of an education and training intervention for recruiters to neonatal trials. In this paper, we report the development and acceptability of TRAIN.

Methods

TRAIN involved three sequential phases, with each phase contributing information to the subsequent phase(s). These phases were 1) evidence synthesis (systematic review of the effectiveness of training interventions and a content analysis of the format, content, and delivery of identified interventions), 2) intervention development using a Partnership (co-design/co-creation) approach, and 3) intervention acceptability assessments with recruiters to neonatal trials.

Results

TRAIN, accompanied by a comprehensive intervention manual, has been designed for online or in-person delivery. TRAIN can be offered to recruiters before trial recruitment begins or as refresher sessions during a trial. The intervention consists of five core learning outcomes which are addressed across three core training units. These units are the trial protocol (Unit 1, 50 min, trial-specific), understanding randomisation (Unit 2, 5 min, trial-generic) and approaching and engaging with parents (Unit 3, 70 min, trial-generic). Eleven recruiters to neonatal trials registered to attend the acceptability assessment training workshops, although only four took part. All four positively valued the training Units and resources for increasing recruiter preparedness, knowledge, and confidence. More flexibility in how the training is facilitated, however, was noted (e.g., training divided across two workshops of shorter duration). Units 2 and 3 were considered beneficial to incorporate into Good Clinical Practice Training or as part of induction training for new staff joining neonatal units.

Conclusion

TRAIN offers a comprehensive co-produced training and education intervention for recruiters to neonatal trials. TRAIN was deemed acceptable, with minor modification, to neonatal trial recruiters. The small number of recruiters taking part in the acceptability assessment is a limitation. Scale-up of TRAIN with formal piloting and testing for effectiveness in a large cluster randomised trial is required.
Systematically analysis of decompensated cirrhotic patients with spontaneous bacterial peritonitis to identify diagnostic and prognostic indexes
Authors: Du Tao , Li Qing-ping , Jiang Gui-xiang , Tan Hui-yuan , Wu Jiao-hua , Qin Shan-yu , Yu Bing , Jiang Hai-xing , Luo Wei
Published: November 2023

Background

Spontaneous bacterial peritonitis (SBP) is a common complication in patients with cirrhosis. The diagnosis of SBP is still mostly based on ascites cultures and absolute ascites polymorphonuclear (PMN) cell count, which restricts the widely application in clinical settings. This study aimed to identify reliable and easy-to-use biomarkers for both diagnosis and prognosis of cirrhotic patients with SBP.

Methods

We conducted a retrospective study including 413 cirrhotic patients from March 2013 to July 2022 in the First Affiliated Hospital of Guangxi Medical University. Patients’ clinical characteristics and laboratory indices were collected and analyzed. Two machine learning methods (Xgboost and LASSO algorithms) and a logistic regression analysis were adopted to screen and validate the indices associated with the risk of SBP. A predictive model was constructed and validated using the estimated area under curve (AUC). The indices related to the survival of cirrhotic patients were also analyzed.

Results

A total of 413 cirrhotic patients were enrolled in the study, of whom 329 were decompensated and 84 were compensated. 52 patients complicated and patients with SBP had a poorer Child–Pugh score (P < 0.05). Patients with SBP had a greater proportion of malignancies than those without SBP(P < 0.05). The majority of laboratory test indicators differed significantly between patients with and without SBP (P < 0.05). Albumin, neutrophil-to-lymphocyte ratio (NLR), and ferritin-to-neutrophil ratio (FNR) were found to be independently associated with SBP in decompensated cirrhotic patients using LASSO algorithms, and logistic regression analysis. The model established by the three indices showed a high predictive value with an AUC of 0.808. Furthermore, increased neutrophils, ALP, and C-reactive protein-to-albumin ratio (CAR) were associated with the shorter survival time of patients with decompensated cirrhosis, and the combination of these indices showed a greater predictive value for cirrhotic patients.

Conclusions

The present study identified FNR as a novel index in the diagnosis of SBP in decompensated patients with cirrhosis. A model based on neutrophils, ALP and CAR showed high performance in predicting the prognosis of patients with decompensated cirrhosis.
Latent profile analysis and influencing factors of quality of life in pregnant women with gestational diabetes mellitus
Authors: Zhou Xin-yi , Wang Yan-feng , Yang Jie-mei , Yang Li-yuan , Zhao Wei-jia , Chen Yan-ling , Yang Qiao-hong
Published: November 2023

Purpose

Gestational diabetes mellitus (GDM) negatively affects the quality of life of pregnant women and is influenced by several factors. Research to date treats pregnant women with gestational diabetes as a homogeneous group based on their quality of life. We attempted to identify subgroups based on self-reported quality of life and explored variables associated with subgroups.

Methods

From September 1, 2020 to November 29, 2020, pregnant women with GDM from two hospitals in Guangdong Province were selected as subjects by convenience sampling method. Medical records provided sociodemographic data, duration of GDM, pregnancy status, and family history of diabetes. Participants completed validated questionnaires for quality of life, anxiety and depression. Latent profile analysis was used to identify profiles of quality of life in pregnant women with GDM, and then a mixed regression method was used to analyze the influencing factors of different profiles.

Results

A total of 279 valid questionnaires were collected. The results of the latent profile analysis showed that the quality of life of pregnant women with GDM could be divided into two profiles: C1 “high worry-high support” group (75.6%) and C2 “low worry-low support” group (24.4%). Daily exercise duration and depression degree are negative influencing factors, making it easier to enter the C1 group (p < 0.05). Disease duration and family history of diabetes are positive influencing factors, making it easier to enter the C2 group (p < 0.05).

Conclusion

The quality of life of pregnant women with GDM had obvious classification characteristics. Pregnant women with exercise habits and depression are more likely to enter the “high worry-high support” group, and health care providers should guide their exercise according to exercise guidelines during pregnancy and strengthen psychological intervention. Pregnant women with a family history of diabetes and a longer duration of the disease are more likely to fall into the “low worry-low support” group. Healthcare providers can strengthen health education for them and improve their disease self-management abilities.
Effectiveness of call system implementation for postpartum hemorrhage in a tertiary emergency medical center: a retrospective cohort study
Authors: Umeda Sayo , Abe Takeru , Obata Soichiro , Aoki Shigeru , Takeuchi Ichiro
Published: November 2023

Background

Postpartum hemorrhage is the leading cause of maternal death and severe maternal morbidity worldwide. Previous studies have reported the importance of multidisciplinary treatment approaches for postpartum hemorrhage; however, only a few studies have shown a clear improvement in maternal outcomes. Therefore, this study aimed to investigate the efficacy of a call system for postpartum hemorrhage in a tertiary emergency facility for rapid multidisciplinary treatment and its effect on maternal outcomes.

Methods

This single-center retrospective cohort study included patients transferred to our hospital due to postpartum hemorrhage between April 1, 2013, and March 31, 2019. The primary outcome was mortality, and the secondary outcomes were morbidity (duration of hospital stay, duration of intensive care unit stay, admission to the intensive care unit, respirator use, duration of ventilator support, acute kidney injury, transfusion-associated circulatory overload/transfusion-related acute lung injury, hysterectomy, composite adverse events, blood transfusion initiation time, blood transfusion volume, and treatment for postpartum hemorrhage). An in-hospital call system implementation commenced on April 1, 2016. The study outcomes were compared 3 years before and after implementing the call system.

Results

The blood transfusion initiation time and duration of hospital stay were significantly shortened after implementing the call system for postpartum hemorrhage. No maternal deaths were observed after implementing the system.

Conclusions

Implementing call systems specialized for postpartum hemorrhage in tertiary emergency facilities may improve maternal outcomes.