bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevention of sclerosis around cannulated screw after treatment of femoral neck fractures with bioceramic nails: a finite element analysis
Authors: Liu Yang , Xing Yugang , Shao Huifeng , Wu Xiaogang , Ma Yongsheng , Yang Wenming , Lin Qitai , Li Pengcui , He Yong , Duan Wangping , Wei Xiaochun
Published: July 2023

Purpose

Conventional cannulated screws (CS) are the main treatment method for femoral neck fractures (FNF). However, the rate of femoral head necrosis remains high after FNF treatment. The study aimed to compare the biomechanical features of different internal fixation materials for the treatment of Pauwel type III FNF to explore new strategies for clinical management.

Methods

A new material was prepared by applying casting, freeze drying and sintering process. The independently developed calcium magnesium silicate ceramic powder and hydrogel solution were evenly mixed to obtain a high-viscosity bio-ink, and a bioceramic nail (BN) with high mechanical strength and high fracture toughness was successfully prepared. Four internal fixations were developed to establish the Pauwel type III FNF and healed fracture finite element models: A, three CSs; B, three BNs; C, two BNs and one CS; D, one BN and two CSs. Von Mises stress and displacement of the implants and femur were observed.

Results

The measured Mg content in ceramic powder was 2.08 wt%. The spectral data confirmed that the ceramic powder has high crystallinity, which coincides with the wollastonite-2 M (PDF# 27–0088). The maximum von Mises stresses for the four models were concentrated in the lower part of the fracture surface, at 318.42 Mpa, 103.52 MPa, 121.16 MPa, and 144.06 MPa in models A, B, C, and D, respectively. Moreover, the maximum Von-mises stresses of the implants of the four models were concentrated near the fracture end at 243.65 MPa (A) and 58.02 MPa (B), 102.18 MPa (C), and 144.06 MPa (D). The maximum displacements of the four models were 5.36 mm (A), 3.41 mm (B), 3.60 mm (C), and 3.71 mm (D). The displacements of the three models with BNs were similar and smaller than that of the triple CS fracture model. In the fracture healing models with and without three CSs, the greatest stress concentration was scattered among the lowest screw tail, femoral calcar region, and lateral femur shaft. The displacement and stress distributions in both models are generally consistent. The stress distribution and displacement of the three healed femoral models with BNs were essentially identical to the healing models with three CSs. The maximum von Mises stresses were 65.94 MPa (B), 64.61 MPa (C), and 66.99 MPa (D) while the maximum displacements of the three healed femoral models were 2.49 mm (B), 2.56 mm (C), and 2.49 mm (D), respectively.

Conclusions

Bioceramic nails offer greater advantages than conventional canulated screws after femoral neck fractures. However, the combination of bioceramic nails and CSs is more clinically realistic; replacing all internal fixations with bioceramic nails after the healing of femoral neck fractures can solve the problem of sclerosis formation around CSs and improve bone reconstruction by their bioactivity.
Anatomical morphometry for Cricothyrotomy puncture and incision
Authors: Suzuki Kaiji , Yambe Naohito , Hojo Kentaro , Komatsu Yasunori , Serikawa Masamitsu , Usami Akinobu
Published: July 2023

Purpose

Emergency surgical airway securing techniques include cricothyrotomy, puncture, and incision. While the instruments used for these methods vary in size, no index of laryngeal morphology exists to guide instrument selection. Therefore, we measured the morphology of the cricothyroid ligament in Japanese individuals and assessed its correlations with height.

Methods

This retrospective study used 61 anatomical practice specimens. The cricothyroid ligament of the laryngeal area was dissected, and a frontal image was recorded. Next, images of the midsagittal sections of the larynx and trachea were recorded. The width and height of the cricothyroid ligament were measured from the frontal images, and the depth of the larynx and the angle to the lower edge of the cricothyroid plate were measured from the mid-sagittal cross-sectional images. The height was estimated from the tibial lengths of the specimens and statistically analyzed for correlations. 　

Results

The width and depth were significantly greater in males. Overall, there was a slight correlation between the results of each laryngeal measurement and estimated height for all items.

Conclusion

The morphology of cricothyrotomy revealed that the width and depth of the laryngeal area varied according to sex. Moreover, the results also showed a correlation with the estimated height. Thus, it is important to predict the morphology of the laryngeal area and cricothyroid ligament by considering factors such as patient sex, weight, and height.
Spatial distribution and multilevel analysis of the ideal number of children among Ethiopian women
Authors: Mengist Addisalem , Lakew Workie Demeke , Dessie Zelalem G. , Tesfaw Lijalem Melie
Published: July 2023

Background

Ideal number of children (INC) is the number of children that a woman or man would have if they could go back to the time when they did not have any children and could choose accurately the number of children to have in their total life. Despite numerous studies on the prevalence and associated factors of the ideal number of children, there is a lack of studies that incorporated spatial and multilevel analysis. Thus, this study was aimed at the spatial and multilevel analysis of an ideal number of children and associated factors.

Methods

The study design was a cross-sectional study in which the data was obtained from Ethiopian Demographic and Health Survey (EDHS) in 2016. About 13,961 women ages 15–49 who fulfill the inclusion criterion were considered. A negative binomial regression model that incorporates spatial and multilevel analysis was employed.

Results

About 33 and 12.8% of the women had four and six ideal numbers of children respectively. The highest INC per woman was recorded in Oromia region 5055 (36.1%) and the lowest in Harare 35(0.2%). The INC per woman is high in rural 10,726 (76.6%) areas as compared to urban areas 3277(23.4%). The ideal number of children was spatially clustered (Global Moran’s I = 0.1439, p < .00043). Significant hotspot clusters were found in the Somali region such as in Afder, Shabelle, Korahe, and Doolo zone.

Conclusion

The spatial analysis revealed a significant clustering of the ideal number of children in the Ethiopia zone. Specifically, higher INC was observed in the Somali region, specifically in the Afder, Shabelle, Korahe, and Doolo zones. Among the various factors considered, women’s age, region, place of residence, women’s education level, contraception use, religion, marital status, family size, and age at first birth year were identified as significant predictors of the ideal number of children. These findings indicate that these factors play a crucial role in shaping reproductive preferences and decisions among women in the study population. Based on these findings, responsible bodies should prioritize targeted interventions and policies in high-risk regions to address women’s specific reproductive needs.
Screening antibiofilm activity of invasive plants growing at the Slope Merapi Mountain, Central Java, against Candida albicans
Authors: Desrini Sufi , Girardot Marion , Imbert Christine , Mustofa Mustofa , Nuryastuti Titik
Published: July 2023

Background

Candida albicans causes high-mortality candidiasis. Antifungal drug resistance demands the development of virulence factor-targeting drugs, particularly antibiofilm. This study screened the effects of five invasive plants growing in Indonesia (Mimosa pudica, Lantana camara, Acacia mangium, Ageratina riparia, and Mikania micrantha) against C. albicans biofilms. Antifungal activity, antiphospholipase activity, biofilm morphology of C. albicans, and cytotoxic capacity were also evaluated.

Methods

Maceration was used to extract the plants, and the most active extract inhibiting the biofilms was fractionated using liquid–liquid fractionation. Antibiofilm activity was determined by a colorimetric assay, MTT. Antifungal activity was tested using the broth microdilution method. A phospholipase assay was performed using the egg-yolk agar method. Influence on the C. albicans morphology was assessed using scanning electron microscopy (SEM). The cytotoxic effect was carried out against Vero and HeLa cell lines.

Results

M. pudica extracts showed the most potent antifungal efficacy with minimum inhibitory concentration (MIC) of 15.62 µg/mL and 7.81 µg/mL for aerial parts and roots, respectively. At high concentrations (500 µg/mL and 250 µg/mL), ethanol extract of M. pudica aerial parts strongly inhibited the phospholipase activity. Ethyl-acetate fraction of M. pudica aerial parts demonstrated the most potent antibiofilm activity against 24 h old biofilm of C. albicans with an inhibitory concentration (53.89%) of 62.5 µg/mL showed no cytotoxicity in both Vero and HeLa cells. This fraction affected the morphology of C. albicans and contained promising compounds for inhibiting the 24 h old biofilm of C. albicans.

Conclusions

Invasive M. pudica plant inhibited the growth of planktonic C. albicans cells and its ethyl acetate fraction decreased the metabolic activity of C. albicans biofilms. This result demonstrates the potential of invasive M. pudica plant to reduce biofilm-associated candida infection.
Pharmacy professionals’ perceptions of educational supervision in primary care through the lens of Proctor’s model
Authors: Styles Michelle , Schafheutle Ellen , Willis Sarah , Shaw Matthew
Published: July 2023

Background

Educational supervision plays a vital role in postgraduate medical education and more recently in pharmacy and advanced clinical practitioner training in England. Proctor’s three-function model of clinical supervision (consisting of formative, restorative, and normative functions) is assumed to apply to educational supervision, but this has not been tested empirically. The aim of this study was to establish perceptions of the purpose of educational supervision from the perspective of primary care pharmacy professionals enrolled on a national training pathway in England.

Methods

Using a mixed methods design, data were collected using a validated 25-item online survey and respondents were invited to add comments explaining their responses. The survey was sent to all 902 learners enrolled on a postgraduate training pathway for pharmacy professionals working in primary care. Principal components analysis (PCA) was used to interpret patterns in the survey data, and framework analysis of qualitative free text comments was used to identify themes and aid interpretation of quantitative findings.

Results

One hundred eighty-seven pharmacy professionals responded (response rate 20.7%). PCA extracted three factors explaining 71.5% of the total variance. Factor 1 corresponded with survey items linked to the formative function of Proctor’s model, while factor 2 corresponded with survey items linked to the restorative function. No items corresponded with the normative function. Framework analysis of qualitative free-text comments identified two themes: learning support, which corresponded with factor 1; and personal support, which corresponded with factor 2.

Conclusions

This study identified that pharmacy professionals perceived educational supervision to perform two functions, formative (educational) and restorative (pastoral), but did not perceive it to perform a normative (surveillance) function. Educational supervision has the potential to support allied health professionals advancing their roles and we suggest the need for more research to develop models of effective educational supervision which can inform practice.
AMPK activation improves recovery from pneumonia-induced lung injury via reduction of er-stress and apoptosis in alveolar epithelial cells
Authors: Becker Eugene , Husain Maroof , Bone Nathaniel , Smith Samuel , Morris Peter , Zmijewski Jaroslaw W.
Published: July 2023

Background

Bacterial pneumonia and related lung injury are among the most frequent causes of mortality in intensive care units, but also inflict serious and prolonged respiratory complications among survivors. Given that endoplasmic reticulum (ER) stress is a hallmark of sepsis-related alveolar epithelial cell (AEC) dysfunction, we tested if AMP-activated protein kinase (AMPK) affects recovery from ER stress and apoptosis of AECs during post-bacterial infection.

Methods

In a murine model of lung injury by P. aeruginosa non-lethal infection, therapeutic interventions included AMPK activator metformin or GSK-3β inhibitor Tideglusib for 96 h. Recovery from AEC injury was evidenced by accumulation of soluble T-1α (AEC Type 1 marker) in BAL fluids along with fluorescence analysis of ER-stress (CHOP) and apoptosis (TUNEL) in lung sections. AMPK phosphorylation status and mediators of ER stress were determined via Immunoblot analysis from lung homogenates. Macrophage-dependent clearance of apoptotic cells was determined using flow cytometry assay.

Results

P. aeruginosa-induced lung injury resulted in accumulation of neutrophils and cellular debris in the alveolar space along with persistent (96 h) ER-stress and apoptosis of AECs. While lung infection triggered AMPK inactivation (de-phosphorylation of Thr172-AMPK), metformin and Tideglusib promptly restored the AMPK activation status. In post infected mice, AMPK activation reduced indices of lung injury, ER stress and related apoptosis of AECs, as early as 24 h post administration of AMPK activators. In addition, we demonstrate that the extent of apoptotic cell accumulation is also dependent on AMPK-mediated clearance of apoptotic cells by macrophages.

Conclusions

Our study provides important insights into AMPK function in the preservation of AEC viability after bacterial infection, in particular due reduction of ER-stress and apoptosis, thereby promoting effective recovery from lung injury after pneumonia.
Impact of glycated hemoglobin on 2-year clinical outcomes in elderly patients with atrial fibrillation: sub-analysis of ANAFIE Registry, a large observational study
Authors: Terauchi Yasuo , Inoue Hiroshi , Yamashita Takeshi , Akao Masaharu , Atarashi Hirotsugu , Ikeda Takanori , Koretsune Yukihiro , Okumura Ken , Suzuki Shinya , Tsutsui Hiroyuki , Toyoda Kazunori , Hirayama Atsushi , Yasaka Masahiro , Yamaguchi Takenori , Teramukai Satoshi , Kimura Tetsuya , Morishima Yoshiyuki , Takita Atsushi , Shimizu Wataru
Published: July 2023

Background

This ANAFIE Registry sub-analysis investigated 2-year outcomes and oral anticoagulant (OAC) use stratified by glycated hemoglobin (HbA1c) levels among Japanese patients aged ≥ 75 years with non-valvular atrial fibrillation (NVAF) with and without clinical diagnosis of diabetes mellitus (DM).

Methods

The ANAFIE Registry was a large-scale multicenter, observational study conducted in Japan; this sub-analysis included patients with baseline HbA1c data at baseline. The main endpoints evaluated (stroke/systemic embolic events [SEE], major bleeding, intracranial hemorrhage, cardiovascular death, all-cause death, and net clinical outcome [a composite of stroke/SEE, major bleeding, and all-cause death]) were stratified by HbA1c levels (< 6.0%; 6.0% to < 7.0%; 7.0% to < 8.0%; and ≥ 8.0%).

Results

Of 17,526 patients with baseline HbA1c values, 8725 (49.8%) patients had HbA1c < 6.0%, 6700 (38.2%) had 6.0% to < 7.0%, 1548 (8.8%) had 7.0% to < 8.0%, and 553 (3.2%) had ≥ 8.0%. Compared with other subgroups, patients with HbA1c ≥ 8.0% were more likely to have lower renal function, higher CHA2DS2-VASc and HAS-BLED scores, higher prevalence of non-paroxysmal AF, and lower direct OAC (DOAC) administration, but higher warfarin administration. The HbA1c ≥ 8.0% subgroup had higher event rates for all-cause death (log-rank P = 0.003) and net clinical outcome (log-rank P = 0.007). Similar trends were observed for stroke/SEE. In multivariate analysis, risk of all-cause death (adjusted hazard ratio [aHR]: 1.46 [95% confidence interval 1.11–1.93]) and net clinical outcome (aHR 1.33 [1.05–1.68]) were significantly higher in the HbA1c ≥ 8.0% subgroup. No significant differences were observed in risks of major bleeding or other outcomes in this and other subgroups. No interaction was observed between HbA1c and OACs. Use/non-use of antidiabetic drugs was not associated with risk reduction; event risks did not differ with/without injectable antidiabetic drugs.

Conclusions

Among elderly Japanese patients with NVAF, only HbA1c ≥ 8.0% was associated with increased all-cause death and net clinical outcome risks; risks of the events did not increase in other HbA1c subgroups. Relative event risks between patients treated with DOACs and warfarin were not modified by HbA1c level.

Trial registration

UMIN000024006; date of registration: September 12, 2016.
Age-period-cohort analysis of lung cancer mortality inequalities in Southern Spain: missed opportunities for implementing equitable tobacco control policies
Authors: Córdoba-Doña Juan Antonio , Benítez-Rodríguez Encarnación , Escolar-Pujolar Antonio , Santos-Sánchez Vanessa
Published: July 2023

Background

Lung cancer mortality in European countries shows different epidemiological patterns according to sex and socioeconomic variables. Some countries show decreasing rates in both sexes, while others show a delayed profile, with increasing mortality in women, inconsistently influenced by socioeconomic status. Our aim was to evaluate the effect of age, period and birth cohort on lung cancer mortality inequalities in men and women in Andalusia, the southernmost region in Spain.

Methods

We used the Longitudinal Database of the Andalusian Population, which collects demographic and mortality data from the 2001 census cohort of more than 7.35 million Andalusians, followed up between 2002 and 2016. Mortality rates were calculated for men and women by educational level, and small-area deprivation. Poisson models were used to assess trends in socioeconomic inequalities in men and women. Finally, age-period-cohort (APC) models were used separately for each educational level and gender.

Results

There were 39,408 lung cancer deaths in men and 5,511 in women, yielding crude mortality rates of 78.1 and 11.4 × 105person-years, respectively. In men higher mortality was found in less educated groups and inequalities increased during the study period: i.e. the rate ratio for primary studies compared to university studies increased from 1.30 (CI95:1.18–1.44) to 1.57 (CI95:1.43–1.73). For women, educational inequalities in favour of the less educated tended to decrease moderately. In APC analysis, a decreasing period effect in men and an increasing one in women were observed. Cohort effect differed significantly by educational level. In men, the lower the educational level, the earlier the peak effect was reached, with a 25-year difference between the least-educated and college-educated. Conversely, college-educated women reached the peak effect with a 12-year earlier cohort than the least-educated women. The decline of mortality followed the same pattern both in men and women, with the best-educated groups experiencing declining rates with earlier birth cohorts.

Conclusions

Our study reveals that APC analysis by education helps to uncover changes in trends occurring in different socioeconomic and gender groups, which, combined with data on smoking prevalence, provide important clues for action. Despite its limitations, this approach to the study of lung cancer inequalities allows for the assessment of gaps in historical and current tobacco policies and the identification of population groups that need to be prioritised for public health interventions.
A case of acquired thrombotic thrombocytopenic purpura induced by acute severe hepatitis E: successfully treated by plasma exchange and rituximab
Authors: Ou Yingwei , Xu Yifan , Tan Zhaowang , Pang Lingxiao , Li Shengqin , Li Qian , Cai Wenwei , Nan Yong , Tu Jianfeng
Published: July 2023

With its low morbidity and high mortality rates, thrombotic thrombocytopenic purpura (TTP) has imposed a critical physical and economic burden on both society and individuals. Thrombocytopenia commonly occurs in severe liver failure, and a variety of hepatitis viruses are known to induce immune thrombocytopenic purpura. However, TTP is extremely rare in hepatitis E virus infection. We hereby report a case of a 53-year-old male who present with TTP caused by severe hepatitis E, and the patients achieved successful recovery after treatment. Therefore, we propose considering AMAMTS13 testing as an essential and beneficial approach for accurately diagnosing and treating patients with severe hepatitis or infection with notable platelet decline.
Does patient and public involvement impact public health decision-making? A 10 year retrospective analysis of public consultation in Brazil
Authors: De Freitas Lopes Ana Carolina , Novaes Hillegonda Maria Dutilh , De Soárez Patrícia Coelho
Published: July 2023

Background

 The aim of this work is to characterize the processes associated with patient and public involvement (PPI) in the form of public consultations (PC) during the first 10 years of operation of the National Committee for Health Technology Incorporation in the Unified Health System (Conitec) of Brazil, and to identify factors associated with changes in Conitec’s recommendations following these PC.

Methods

 This cross-sectional study analysed all processes related to the adoption of technologies that took place in Brazil between 2012 and 2021 based on technical reports and self-reported information collected from PC participants. A multiple logistic regression model identified factors associated with changes in Conitec’s recommendations following PC.

Results

 A total of 479 technical reports were published, of which 83% (n = 400) were submitted to PC. Demands were made mainly by applicants from the government (n = 262; 55%), regarding the adoption of medicines (n = 366; 76%), in which context neoplasms and infectious diseases were the most frequent indications (n = 66; 14% for each). A total of 264 (55%) processes resulted in a final recommendation in favour of introducing the technology. Over the period of 10 years, 196 483 contributions were received in response to PC. The largest volume of contributions was made by patients and their families or representatives (n = 99 082; 50%), females (122 895; 67%), white individuals (129 165; 71%) and individuals between the ages of 25 and 59 years (145 364; 80%). Alteration of the preliminary recommendation occurred in 13% (n = 53) of the PC, with a higher proportion of recommendations being altered from 2017 onwards. Increased participation by patients had a significant impact on the alteration of the preliminary recommendation (odds ratio 3.87, 95% CI 1.33–13.35, p = 0.02).

Conclusions

Increased engagement of patients and their families and caregivers in PC was associated with changing the preliminary recommendation of Conitec about the adoption of technologies into the public health system in Brazil.
Exercise mitigates Dapagliflozin-induced skeletal muscle atrophy in STZ-induced diabetic rats
Authors: Yang Xudong , Wang Lifeng , Zhang Liangzhi , Zhai Xia , Sheng Xiusheng , Quan Helong , Lin Hengjun
Published: July 2023

Background

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are commonly used in the management of type 2 diabetes mellitus (T2DM) and have been found to worsen the reduction of skeletal muscle mass in individuals with T2DM. This study aims to examine the potential of exercise in mitigating the skeletal muscle atrophy induced by SGLT2i treatment.

Methods

A rat model of T2DM (40 male Sprague-Dawley rats; T2DM induced by a combination of high-fat diet and streptozotocin) was used to examine the effects of six-week treatment with Dapagliflozin (DAPA, SGLT2i) in combination with either aerobic exercise (AE) or resistance training (RT) on skeletal muscle. T2DM-eligible rats were randomized into the T2DM control group (CON, n = 6), DAPA treatment group (DAPA, n = 6), DAPA combined with aerobic exercise intervention group (DAPA + AE, n = 6), and DAPA combined with resistance training intervention group (DAPA + RT, n = 6). To assess the morphological changes in skeletal muscle, myosin ATPase and HE staining were performed. mRNA expression levels of Atrogin-1, MuRF1, and Myostatin were determined using quantitative PCR. Furthermore, protein expression levels of AKT, p70S6K, mTOR, FoXO1/3A, NF-κB, and MuRF1 were examined through western blotting.

Results

Both the administration of DAPA alone and the combined exercise intervention with DAPA resulted in significant reductions in blood glucose levels and body weight in rats. However, DAPA alone administration led to a decrease in skeletal muscle mass, whereas RT significantly increased skeletal muscle mass and muscle fiber cross-sectional area. The DAPA + RT group exhibited notable increases in both total protein levels and phosphorylation levels of AKT and p70S6K in skeletal muscle. Moreover, the DAPA, DAPA + AE, and DAPA + RT groups demonstrated downregulation of protein expression (FoXO1/3A) and mRNA levels (Atrogin-1, MuRF1, and Myostatin) associated with muscle atrophy.

Conclusions

Our findings provide support for the notion that dapagliflozin may induce skeletal muscle atrophy through mechanisms unrelated to protein metabolism impairment in skeletal muscle, as it does not hinder protein metabolic pathways while reduces muscle atrophy-related genes. Additionally, our observations reveal that RT proves more effective than AE in enhancing skeletal muscle mass and muscle fiber cross-sectional area in rats with T2DM by stimulating protein anabolism within the skeletal muscle.
An analysis of the effect of fiscal expenditure on the income distribution of Chilean households
Authors: Garrido Nicolas , Morales Jeffrey
Published: July 2023

This study analyzes the effect of government spending on income distribution in Chile for 2016 using a multiplier model with the Social Accounting Matrix. The results indicate that increasing fiscal expenditure has a regressive effect on the income share of households in the richest quintile and widens the income gap between the two poorest quintiles and the third and fourth quintiles. When the effect of fiscal expenditure is measured by its nominal impact, households with the highest income receive approximately ten times more income than those with the lowest income. Thus, the regressivity of the income share of the richest households conceals an unequal distribution of the nominal income generated by the fiscal expenditure. Using counterfactual simulations, we suggested that fiscal expenditures could become more equalitarian through policies affecting the distribution of labor payments.
Parenting profiles: motivation toward health-oriented physical activity and intention to be physically active
Authors: Vega-Díaz Marta , González-García Higinio , De Labra Carmen
Published: July 2023

Introduction

Parents influence their sons’ and daughters’ interest in practicing and maintaining physical activity through parenting patterns.

Objective

To identify perceived parenting style profiles and examine whether the participants differed in their motivation toward health-oriented physical activity and the intention to be physically active.

Method

A sample of 296 participants completed a series of self-report measures and a latent profile analysis (LPA) was performed.

Results

Two profiles emerged as the most suitable: profile (a) with average scores in parenting variables, and profile (b) with high scores in parenting variables. The results revealed significant differences in integrated regulation and in amotivation, reporting higher scores for profile (b) in the parenting variables love/affection, hostility/aggression, and indifference/neglect, and average in undifferentiated/rejection and control.

Conclusion

The combination of perceived parenting style variables in the profiles seems to influence people’s motivation toward health-oriented physical activity. As such, it is crucial to understand parenting from a multivariate approach, mostly in interventions to adjust parenting styles to the most suitable combination.
The AHAWOMEN project: study protocol of a multi-design research for exploring HAPA predictors of exercise in postmenopausal women
Authors: Godoy-Izquierdo Débora , Lara-Moreno Raquel , Ogallar-Blanco Adelaida , González Juan , de Teresa Carlos , Mendoza Nicolás
Published: July 2023

Background

The postmenopausal period can represent an opportunity for women to improve their health and well-being. The Active and Healthy Ageing in Women during early postmenopause (AHAWOMEN) study aims to identify the key determinants of an active lifestyle among middle-aged women, with a focus on the stages and the social-cognitive variables outlined in the Health Action Process Approach (HAPA) model, a theoretical framework for understanding health behaviour change. We expected that HAPA factors and processes of intention creation (motivational phase) and action adoption (volitional phase) will be significant predictors of exercise initiation and maintenance, supporting both the HAPA tenets and the efficacy of HAPA-based interventions.

Methods/design

This study was approved by the authors’ Institutional Review Committee. Postmenopausal women aged between 45 and 65 years will voluntarily participate. The participants will be allocated to one of three groups: Intervention-Initiators (n = 100, random allocation), Control-Sedentary (n = 100, random allocation) or Control-Active (n = 100, non-random allocation). The intervention group will engage in a supervised exercise programme lasting at least 3 months, supplemented with a HAPA-based intervention for behaviour change. The sedentary control group will not receive any intervention to change their physical activity, while the active control group will consist of women who are already regularly adhering to an active lifestyle. Study variables will be measured at baseline and postintervention phases, as well as at 1, 3, 6 and 12-month follow-ups. The predictors of exercise behaviour in the different phases of the behavioural change process will be explored and compared within and between groups throughout the study. These analyses will help identify the factors that determine the adoption of a healthy active behaviour. Additionally, the effectiveness of the model and the intervention for changing active behaviour will be evaluated.

Discussion

This paper describes the rationale, development and methods used in the AHAWOMEN project. Supporting women who intend to become active can help them to translate their goals into sustainable action. Verifying that the HAPA predictions are applicable to postmenopausal women’s adoption of exercise would provide the basis for designing effective interventions for promoting healthy and active ageing that are also tailored to the experiences of middle-aged women.

Trial registration

ISRCTN16251361. Registration date: 01/06/2023 (retrospectively registered).
Modules in robust but low-efficiency phyllosphere fungal networks drive saponin accumulation in leaves of different Panax species
Authors: Zhang Guozhuang , Shi Liping , Liu Congsheng , Mao Renjun , Xia Bing , Huang Zhixin , Wei Xiuye , Wu Lixuan , Zheng Yuqing , Wei Guangfei , Xu Jia , Gao Shuangrong , Chen Shilin , Dong Linlin
Published: July 2023

Background

The phyllosphere mycobiome plays a crucial role in plant fitness and ecosystem functions. The complex microbial ecological networks (MEN) formed by these fungi remain poorly understood, particularly with regard to their organization strategy and their contributions to plant secondary metabolites such as saponin.

Results

In this study, we constructed six MENs from leaf epiphytic and endophytic mycobiomes of three Panax species distributed in the northeast and southwest ends of mainland China. Hub nodes were absent in these MENs, which were significantly more complex, robust, and less efficient compared to random graphs (P < 0.05), indicating a hub-independent high-robustness strategy to maintain structural homeostasis. The important roles of specific MEN modules in shaping leaf saponin profiles of each Panax species were proved by multiple machine learning algorithms. Positive regulation modules (PRMs) of total saponin content were further identified, which exhibited more deterministic ecological assembly and comprised of highly connected nodes as well as higher proportion of plant-associated fungal guilds compared to other network members, indicating their tight links with host plant. The significant and direct effects (P < 0.05) of PRMs on total saponin accumulation were validated by well-fitted structural equation models (χ2 < 0.3, P > 0.5). Taxonomic analysis revealed that Pleosporales and Chaetothyriales were significantly overrepresented by positive regulation taxa (PRT) of total saponin content (FDR < 0.05). Across PRT identified in three Panax species, Epicoccum and Coniothyrium were conservatively present, while species-specific taxa such as Agaricales were also found, indicating the conservatism and specificity of plant-fungi interactions associated with leaf saponin accumulation in Panax genus.

Conclusions

These findings provide a foundation for understanding mechanisms maintaining the steady state of phyllosphere mycobiome in healthy plant, and offer clues for engineering phyllosphere mycobiome to improve the accumulation of bioactive secondary metabolites on the basis of network modules.
Prevalence and trends of polypharmacy in U.S. adults, 1999–2018
Authors: Wang Xiaowen , Liu Keyang , Shirai Kokoro , Tang Chengyao , Hu Yonghua , Wang Ying , Hao Yuantao , Dong Jia-Yi
Published: July 2023

Background

Polypharmacy is one of the most important health issues for its potential impacts on disease burden and healthcare costs. The aim of this study was to update a comprehensive picture of prevalence and trends in polypharmacy over 20 years in U.S. adults.

Methods

Participants included 55,081 adults aged ≥ 20 from the National Health and Nutrition Examination Survey, January 1, 1999, through December 31, 2018. The simultaneously use of ≥ 5 drugs in one individual was defined as polypharmacy. National prevalence and trends in polypharmacy were evaluated among U.S. adults within different demo-socioeconomic status and pre-existing diseases.

Results

From 1999–2000 to 2017–2018, the overall percentages of adults with polypharmacy remained on the rise, increasing from 8.2% (7.2–9.2%) to 17.1% (15.7–18.5%) (average annual percentage change [AAPC] = 2.9%, P = .001). The polypharmacy prevalence was considerably higher in the elderly (from 23.5% to 44.1%), in adults with heart disease (from 40.6% to 61.7%), and in adults with diabetes (from 36.3% to 57.7%). Also, we observed a greater increase rate of polypharmacy in men (AAPC = 4.1%, P < .001), in the Mexican American (AAPC = 6.3%, P < .001), and in the non-Hispanic Black (AAPC = 4.4%, P < .001).

Conclusions

From 1999–2000 to 2017–2018, the prevalence of polypharmacy is continually increasing in U.S. adults. The polypharmacy was especially higher in the older, in patients with heart disease, or diabetes. The high prevalence urges the healthcare providers and health policymakers to manage polypharmacy among specific population groups.
The frequency and impact of tramadol addiction on acute aneurysmal subarachnoid hemorrhage: cross-sectional multicenter study
Authors: Elbassiony Ahmed , Khedr Eman M. , Hegazy Ahmed , Ragab Omar Abdelaleem , Al-Shami Hieder , Soliman Radwa K. , Shoyb Ahmed , Aly Ahmed
Published: July 2023

Background

Arterial hypertension, cigarette smoking, excessive alcohol abuse and drug addiction such as cocaine all are known risk factors for aneurysmal subarachnoid hemorrhage (SAH). However, there is little information on whether tramadol addiction should also be considered as a risk factor for SAH. The purpose of this study was to investigate the prevalence and the impact of tramadol addiction on the symptomatology of intracranial aneurysmal SAH. We recruited 237 cases with acute aneurysmal ASH with a mean age of 52.3 ± 11.8 ranging from 17 to 86 years old.

Results

There were 124 males and 113 females; 43 cases had a history of tramadol addiction (18.1%). Tramadol addicts were significantly younger, more likely to be male (97.7%), and more commonly associated with seizure onset compared with non-addicts. Multiple aneurysms, wide neck, and sizable aneurysms were significantly more common in tramadol than non-tramadol addicts as were dissecting aneurysms. There is a high association of acute aneurysmal SAH with tramadol addiction, especially in young patients.

Conclusions

Tramadol addiction might be regarded as modifiable risk factor of aneurysmal ASH and tramadol addicts had a worse presentation than non-tramadol addicts. If this finding is proved, it will be of great importance in managing patients with ruptured and un-ruptured intracranial aneurysms. Tramadol is available over-counter in some countries, more studies are needed.
New connections between brand and environmentally sustainable businesses in the Amazon forest and local business owner’s perception
Authors: Vidal Santos Luiz Diego , Rodrigues Holanda Francisco Sandro , de Menezes Pedro Vinícius Bertulino , de Santana Oliveira Catuxe Varjão , Schervinski Villwock Ana Paula , Pedrotti Alceu
Published: July 2023

The debate surrounding entrepreneurship in the Amazon rainforest region highlights the importance of sustainable actions developed by local brands. However, limited attention has been given to entrepreneur's perspectives regarding the outcome of their applied practices. The objective of this study was to understand the entrepreneurs’ perception based on their business models concerning the connection to the Amazon brand and the aspects of sustainable use of its natural resources. The study was performed through semi-structured interviews with seven Amazonian product brands entrepreneurs utilizing Grounded Theory. The results demonstrate that entrepreneurs understand that reaching the social dimension relies on the articulation of three main factors: entrepreneurs, the native people, and the shared traditional knowledge and culture. It is observed that the political dimension is still underdeveloped in the region with limited application of its effects on products. Additionally, the economic dimension is not significantly favored by the utilization of environmentally sustainable brands. Lastly, the territorial dimension depends on the establishment of permanent protection areas, as well as agroforestry systems.
Comparison of methods to engage diverse stakeholder populations in prioritizing PrEP implementation strategies for testing in resource-limited settings: a cross-sectional study
Authors: Hicks Sarah , Abuna Felix , Odhiambo Ben , Dettinger Julia C. , Ngumbau Nancy , Gómez Laurén , Sila Joseph , Oketch George , Sifuna Enock , Weiner Bryan J. , John-Stewart Grace C. , Kinuthia John , Wagner Anjuli D.
Published: July 2023

Background

There is a lack of consensus about how to prioritize potential implementation strategies for HIV pre-exposure prophylaxis (PrEP) delivery. We compared several prioritization methods for their agreement and pragmatism in practice in a resource-limited setting.

Methods

We engaged diverse stakeholders with clinical PrEP delivery and PrEP decision-making experience across 55 facilities in Kenya to prioritize 16 PrEP delivery strategies. We compared four strategy prioritization methods: (1) “past experience surveys” with experienced practitioners reflecting on implementation experience (N = 182); (2 and 3) “pre- and post-small-group ranking” surveys before and after group discussion (N = 44 and 40); (4) “go-zone” quadrant plots of perceived effectiveness vs feasibility. Kendall’s correlation analysis was used to compare strategy prioritization using the four methods. Additionally, participants were requested to group strategies into three bundles with up to four strategies/bundle by phone and online survey.

Results

The strategy ranking correlation was strongest between the pre- and post-small-group rankings (Tau: 0.648; p < 0.001). There was moderate correlation between go-zone plots and post-small-group rankings (Tau: 0.363; p = 0.079) and between past-experience surveys and post-small-group rankings (Tau: 0.385; p = 0.062). For strategy bundling, participants primarily chose bundles of strategies in the order in which they were listed, reflecting option ordering bias. Neither the phone nor online approach was effective in selecting strategy bundles. Participants agreed that the strategy ranking activities conducted during the workshop were useful in prioritizing a final set of strategies.

Conclusions

Both experienced and inexperienced stakeholder participants’ strategy rankings tended to prioritize strategies perceived as feasible. Small group discussions focused on feasibility and effectiveness revealed moderately different priorities than individual rankings. The strategy bundling approach, though less time- and resource-intensive, was not effective. Future research should further compare the relative effectiveness and pragmatism of methodologies to prioritize implementation strategies.
Experimental prosopis management practices and grassland restoration in three Eastern African countries
Authors: Eschen René , Bekele Ketema , Jumanne Yohana , Kibet Staline , Makale Fernadis , Mbwambo John Richard , Megersa Berhanu , Mijay Mahamood , Moyo Francis , Munishi Linus , Mwihomeke Mickfanaka , Nunda Winnie , Nyangito Moses , Witt Arne , Schaffner Urs
Published: July 2023

Woody species have been introduced in many parts of the world to provide economic benefits, but some of those species are now among the worst invaders, causing widespread economic and environmental damage. Management of woody species to restore original ecosystem services, such as biodiverse grassland that can provide fodder and sequester carbon, are needed to limit the impacts of alien species. However, the best management methods, i.e., the most economically efficient and effective way to remove trees and the most effective way to restore or rehabilitate the cleared land, are not developed for many species. In Eastern Africa, prosopis (Prosopis julifora) has invaded large areas of savanna and grassland, thereby affecting, among other things, fodder and water for livestock, access to dry season grazing lands and ultimately pastoral livelihoods. We tested three prosopis treatments (manual uprooting and cut stump and basal bark herbicide application) in combination with three incremental restoration interventions (divots, divots + mulching, divots + mulching + grass seed sowing). The three-year study was replicated in Ethiopia (Afar National Regional State), Kenya (Baringo county) and Tanzania (Moshi district). Prosopis survival and vegetation development, both diversity and biomass, were recorded. The prosopis treatments were all highly effective (between 85 and 100% tree mortality in almost all cases), but the two treatments that involved the complete removal of the aboveground biomass (manual and cut stump) yielded a more productive and more diverse vegetation than the treatment that killed the trees standing (basal bark). Compared to the effect of prosopis removal, the effect of restoration interventions on vegetation composition was small, indicating that most species re-established from the soil seed bank. The results show that it is possible to restore land previously invaded by prosopis. Despite the different rates of vegetation establishment and variation in species composition, the restoration interventions resulted in vegetation that in some cases contained a substantial fraction of perennial grasses. The method chosen to control prosopis depends on the availability of resources, including herbicides, and the need to remove rootstocks if the intention is to plant crops.
3D inversion of multifrequency controlled-source electromagnetic data and its application to geothermal exploration in the Tianzhen region of the northern Datong Basin, China
Authors: Peng Ronghua , Zhou Wenlong , Hu Xiangyun , Liao Weiyang , Wei Meihua , Zhang Changsheng
Published: July 2023

Owing to its sensitivity to hydrothermal alteration and geothermal fluids, the distribution of subsurface electrical conductivity provides critical information for characterizing geothermal systems. For geothermal exploration, the controlled-source electromagnetic (CSEM) technique provides a crucial tool to image the subsurface resistivity structures, especially in areas with strong cultural noise. Usually, land-based CSEM surveys are carried out with dozens of operating frequencies to enhance spatial resolution. However, the 3D inversion of multifrequency CSEM data using the commonly used direct solver is challenging with limited computational resources. In this study, we implement a practical inversion strategy for interpreting 3D multifrequency CSEM data. By combining a hybrid direct-iterative solver with the inexact Gauss-Newton optimization, 3D inversion of CSEM data involving multiple frequencies can be performed effectively on typical workstations. First, we test the effectiveness of the developed approach using synthetic multifrequency 3D CSEM data generated for a simplified geothermal model. The inversion strategy is then applied to the multifrequency CSEM field data collected for the geothermal exploration at Tianzhen region in Shanxi Province, China. The comparison between the inversion results using the sparse data set (six frequencies) and the dense data set (12 frequencies) highlights the necessity of using data from more frequencies in the inversion to improve the resolution. The resulting 3D resistivity model clearly delineates the clay alteration layers and shallow thermal reservoirs of the potential high-temperature geothermal system within the study area, while its deep heat source is not revealed owing to the limited investigation depth of the survey.
Investigating the impact of financial concerns on symptoms of depression in UK healthcare workers: data from the UK-REACH nationwide cohort study
Authors: McBride Martin , Martin Christopher A. , Teece Lucy , Irizar Patricia , Batson Megan , Lagrata Susie , Papineni Padmasayee , Nazareth Joshua , Pan Daniel , Leary Alison , Woolf Katherine , Pareek Manish ,   the UK-REACH Study Collaborative Group
Published: July 2023

Background

Exploration of the association between financial concerns and depression in UK healthcare workers (HCWs) is paramount given the current ‘cost of living crisis’, ongoing strike action and recruitment/retention problems in the National Health Service.

Aims

To assess the impact of financial concerns on the risk of depression in HCWs, how these concerns have changed over time and what factors might predict financial concerns.

Method

We used longitudinal survey data from a UK-wide cohort of HCWs to determine whether financial concerns at baseline (December 2020 to March 2021) were associated with depression (measured with the Public Health Questionnaire-2) at follow-up (June to October 2022). We used logistic regression to examine the association between financial concerns and depression, and ordinal logistic regression to establish predictors of developing financial concerns.

Results

A total of 3521 HCWs were included. Those concerned about their financial situation at baseline had higher odds of developing depressive symptoms at follow-up. Financial concerns increased in 43.8% of HCWs and decreased in 9%. Those in nursing, midwifery and other nursing roles had over twice the odds of developing financial concerns compared with those in medical roles.

Conclusions

Financial concerns are increasing in prevalence and predict the later development of depressive symptoms in UK HCWs. Those in nursing, midwifery and other allied nursing roles may have been disproportionately affected. Our results are concerning given the potential effects on sickness absence and staff retention. Policy makers should act to alleviate financial concerns to reduce the impact this may have on a discontent workforce plagued by understaffing.