bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving teamwork and communication in the operating room by introducing the theatre cap challenge
Authors: van Dalen Anne Sophie HM , Swinkels Jan A , Coolen Stan , Hackett Robert , Schijven Marlies P
Published: January 2022

Objective

One of the steps of the Surgical Safety Checklist is for the team members to introduce themselves. The objective of this study was to implement a tool to help remember and use each other’s names and roles in the operating theatre.

Methods

This study was part of a pilot study in which a video and medical data recorder was implemented in one operating theatre and used as a tool for postoperative multidisciplinary debriefings. During these debriefings, name recall was evaluated. Following the implementation of the medical data recorder, this study was started by introducing the theatre cap challenge, meaning the use of name (including role) stickers on the surgical cap in the operating theatre.

Findings

In total, 41% (n = 40 out of 98) of the operating theatre members were able to recall all the names of their team at the team briefings. On average 44.8% (n = 103) was wearing the name sticker.

Conclusions

The time-out stage of the Surgical Safety Checklist might be inadequate for correctly remembering and using your operating theatre team members’ names. For this, the theatre cap challenge may help.
Evaluating serum level of thymidylate synthase in post burn keloid patients before and after intralesional injection of 5-fluorouracil
Authors: Ezzat Mohamad Noha , Abd El Raheem Talal Ahmed , Mahmoud Rania Hosny , Osama Hamed Nehal
Published: January 2022

Background

Keloids are fibrous lesions formed at the site of trauma due to types I and III collagen irregular production. The presence of thymidylate synthase (TS) is a must for DNA synthesis and repairs causing cell death. 5-fluorouracil (5-FU) is a fluorinated pyrimidine analogue acting as an anti-metabolic agent that inhibits thymidylate synthase and interferes with ribo-nucleic acid (RNA) synthesis.

Objectives

we aimed to evaluate the level of thymidylate synthase in post burn keloid patients before and after intralesional injection of 5-fluorouracil.

Methods

The study included 20 keloid patients and 20 healthy subjects as a control. Serum TS was estimated using commercially available enzyme-linked immunosorbent assay (ELISA) kits before and after treatment with 5-fluorouracil.

Results

There was a statistically significant difference in TS levels before and after 5-FU treatment (p < 0.05). Also, results have shown that 5-FU injection has good satisfactory results in treatment of keloid causing reduction in scar volume and symptoms improvement (90% of the patients improved). On the other hand, there was no statistically significant difference in TS levels and the outcomes of the treatment.

Conclusion

Our findings suggest that intralesional 5-FU injection in keloid has very satisfactory results. However, thymidylate synthase enzyme has a minimal role in evaluating the treatment of keloid, so further studies are required to elaborate the relation between this enzyme and keloid scars.
Chronic Spontaneous Urticaria Triggered by the AstraZeneca/Oxford COVID-19 Vaccine with Achieved Remission: A Case Report
Authors: Brooks Stephanie G , De Jong Anna M , Abbaslou Mina , Sussman Gordon
Published: January 2022

New adverse reactions to the COVID-19 vaccines are being identified as vaccination rates increase worldwide. Recently, there have been two reports of Moderna (mRNA-1273) vaccine induced relapse of chronic spontaneous urticaria (CSU) that was previously well controlled. Herein, we report a case of AstraZeneca/Oxford (ChAdOx1) vaccine triggered CSU in a patient with no history of CSU with achieved remission.
An Epidemiologic, Longitudinal, and Discordant-Twin Study of the Association Between Gambling Disorder and Suicidal Behaviors
Authors: Slutske Wendy S. , Davis Christal N. , Lynskey Michael T. , Heath Andrew C. , Martin Nicholas G.
Published: January 2022

Gambling disorder is associated with suicidal behaviors, but it is not clear whether the association is due to common etiologic factors or to gambling disorder being causally related to suicidality. This question was examined from the perspective of epidemiologic, longitudinal, and discordant-twin studies. The results suggested that the causes of the association with disordered gambling differed for suicidal ideation, plan, and attempt and differed for men and women. The association of suicidal thoughts with disordered gambling was noncausally explained by common genetic influences among women but not men. Conversely, there was evidence consistent with a potentially causal influence of disordered gambling on suicide attempt among men but not women, which might have been related to gambling-related financial problems. The use of monetary data to identify individuals experiencing financial harms associated with their gambling may represent a more practicable target for screening, intervention, and prevention and may reduce gambling-related financial crises, thereby warding off a potential gambling-related suicide attempt.
Associations between Dentition Status and Nutritional Status in Community-Dwelling Older Adults
Authors: Honeywell S. , Samavat H. , Touger-Decker R. , Parrott J.S. , Hoskin E. , Zelig R.
Published: January 2022

Background/Objective:

Older adults are at higher risk of malnutrition. The aim of this study was to explore associations between nutritional status and dentition status among older adults seeking care in a dental clinic.

Methods:

This was a cross-sectional study of data from older adults (65–89 y) who received care at a northeastern US urban dental school clinic between June 2015 and June 2020 (N = 305). Clinical and demographic data were obtained from the electronic health record; nutritional status was determined using the Self–Mini Nutritional Assessment (Self-MNA), and odontograms and digital radiography were used to determine dental data. Adjusted multivariable models were used to explore associations between variables.

Results:

The sample was 53.8% female with a median age of 72.0 y. The median Self-MNA score was 13, reflective of normal nutritional status; 29.5% were at risk of or had malnutrition. Median numbers of teeth and posterior and anterior occluding pairs of teeth (POP, AOP) were 18.0, 2.0, and 5.0, respectively. Those with normal nutritional status had significantly more teeth, POPs, and AOPs than those at risk of or with malnutrition (P = 0.015, P = 0.015, and P = 0.039, respectively). Every additional unit increase in the number of natural or restored teeth or POP was associated with significantly lower odds of being at risk of or with malnutrition (3% and 13%, respectively). Having functional dentition was associated with 46% lower odds of being at risk of or with malnutrition.

Conclusion:

This study demonstrated that older adults who had more teeth, better occlusion, and functional dentition were more likely to be of normal nutritional status than those who had less teeth, had poorer occlusion, and lacked functional dentition. Further research with larger, more diverse samples and varied measures of dentition are needed to better understand the associations between nutritional status and dentition status.

Knowledge Transfer Statement:

The findings from this study suggest that older adults with fewer teeth and therefore less efficient occlusion are at higher risk for malnutrition than those with more teeth and better occlusion. Health care professionals should include screening for dentition and malnutrition as part of their routine practice to identify patients who may have tooth loss and be at risk of malnutrition and refer them accordingly for interventions to optimize oral health and nutritional status.
Technical Standards from Newly Established Medical Schools: A Review of Disability Inclusive Practices
Authors: Stauffer Catherine , Case Ben , Moreland Christopher J. , Meeks Lisa M.
Published: January 2022

Introduction

Technical standards document US medical school's nonacademic criteria necessary for admission, persistence, and graduation and communicate the school's commitment to disability inclusion and accommodation but are considered one of the largest barriers for students with disabilities. Calls for more inclusive technical standards have increased in recent years, yet the impact of this work on changing technical standards has not been measured. The establishment of 15 new US MD- and DO-granting medical schools between 2017 to 2020 offered a unique opportunity to evaluate differences in the inclusive nature of newly developed technical standards.

Method

We conducted a document analysis of 15 newly formed medical schools’ technical standards to determine the availability and inclusive nature of the standards as they pertain to students with sensory and mobility disabilities. Technical standards were coded for: ease of obtaining technical standards, the school's stated willingness to provide reasonable accommodations, the origin of responsibility for accommodation request and implementation, and the school's openness to intermediaries or auxiliary aids.

Results

Of the 15 schools, 73% of the technical standards were not easy to locate online. Few (13%) included language that support disability accommodations. Most (73%) used language that was coded as ‘restrictive’ for students with physical or sensory disabilities. Coding of the newly accredited US MD and DO medical schools suggests that newly created technical standards are more restrictive than those in previous studies.

Conclusions

Efforts to create more inclusive technical standards have not yet been realized. Newly formed US MD- and DO-granting medical schools may perpetuate historically restrictive technical standards that serve as barriers to applicants with disabilities. Future research should evaluate the role of medical school accrediting bodies to go beyond simply requiring technical standards to ensuring that the standards are readily available and appropriately convey the availability of reasonable accommodations for students with disabilities.
How will state medical boards handle cases involving disclosure and apology for medical errors?
Authors: Wojcieszak Doug
Published: January 2022

Surveys were sent to 68 American state medical boards, including territories of the United States, inquiring how they handle—or will handle—cases involving disclosure and apology after medical errors. Surveys were not sent to specialty boards. Thirty-eight state medical boards ( n  =  38, 56%) responded to the survey, with 31 completing the survey (46% completion rate) and seven boards ( n  =  7) providing explanations for nonparticipation and other thoughts; 30 boards did not respond in any manner. Boards that completed the survey indicated that disclosure and apology and other positive post-event behavior by physicians are likely to be viewed favorably and disclosing physicians will not be easy targets for disciplinary measures, though boards also stressed they view each case on the merits and patient safety is their top priority. Recommendations are made for policy makers and other stakeholders.
Upregulation of cAMP prevents antibody-mediated thrombus formation in COVID-19
Authors: Zlamal Jan , Althaus Karina , Jaffal Hisham , Häberle Helene , Pelzl Lisann , Singh Anurag , Witzemann Andreas , Weich Karoline , Bitzer Michael , Malek Nisar , Göpel Siri , Bösmüller Hans , Gawaz Meinrad , Mirakaj Valbona , Rosenberger Peter , Bakchoul Tamam
Published: January 2022

Thromboembolic events are frequently reported in patients infected with the SARS-CoV-2 virus. The exact mechanisms of COVID-19-associated hypercoagulopathy, however, remain elusive. Recently, we observed that platelets (PLTs) from patients with severe COVID-19 infection express high levels of procoagulant markers, which were found to be associated with increased risk for thrombosis. In the current study, we investigated the time course as well as the mechanisms leading to procoagulant PLTs in COVID-19. Our study demonstrates the presence of PLT-reactive IgG antibodies that induce marked changes in PLTs in terms of increased inner-mitochondrial transmembrane potential (Δψ) depolarization, phosphatidylserine (PS) externalization, and P-selectin expression. The IgG-induced procoagulant PLTs and increased thrombus formation were mediated by ligation of PLT Fc-γ RIIA (FcγRIIA). In addition, contents of calcium and cyclic-adenosine-monophosphate (cAMP) in PLTs were identified to play a central role in antibody-induced procoagulant PLT formation. Most importantly, antibody-induced procoagulant events, as well as increased thrombus formation in severe COVID-19, were inhibited by Iloprost, a clinically approved therapeutic agent that increases the intracellular cAMP levels in PLTs. Our data indicate that upregulation of cAMP could be a potential therapeutic target to prevent antibody-mediated coagulopathy in COVID-19 disease.
GATA2 deficiency elevates interferon regulatory factor-8 to subvert a progenitor cell differentiation program
Authors: Johnson Kirby D. , Soukup Alexandra A. , Bresnick Emery H.
Published: January 2022

Cell type-specific transcription factors control stem and progenitor cell transitions by establishing networks containing hundreds of genes and proteins. Network complexity renders it challenging to discover essential versus modulatory or redundant components. This scenario is exemplified by GATA2 regulation of hematopoiesis during embryogenesis. Loss of a far upstream Gata2 enhancer (−77) disrupts the GATA2-dependent transcriptome governing hematopoietic progenitor cell differentiation. The aberrant transcriptome includes the transcription factor interferon regulatory factor 8 (IRF8) and a host of innate immune regulators. Mutant progenitors lose the capacity to balance production of diverse hematopoietic progeny. To elucidate mechanisms, we asked if IRF8 is essential, contributory, or not required. Reducing Irf8, in the context of the −77 mutant allele, reversed granulocytic deficiencies and the excessive accumulation of dendritic cell committed progenitors. Despite many dysregulated components that control vital transcriptional, signaling, and immune processes, the aberrant elevation of a single transcription factor deconstructed the differentiation program.
Eculizumab precision-dosing algorithm for thrombotic microangiopathy in children and young adults undergoing HSCT
Authors: Mizuno Kana , Dandoy Christopher E. , Teusink-Cross Ashley , Davies Stella M. , Vinks Alexander A. , Jodele Sonata
Published: January 2022

Transplant-associated thrombotic microangiopathy (TA-TMA) is a fatal posttransplant complication of hematopoietic stem cell transplantation. We recently reported that survival for TA-TMA has been improved by early intervention with eculizumab, a complement C5 inhibitor, guided by pharmacokinetic/pharmacodynamic (PK/PD) model-informed precision dosing. However, patients with gastrointestinal bleeding showed poor survival, even when treated with more frequent doses. Our objective was to develop separate models in bleeding and nonbleeding patients with TA-TMA and to propose precision dosing algorithms. Eculizumab PK/PD was analyzed in 19 bleeding and 38 nonbleeding patients (0.5-29.9 years of age). A complement activation biomarker (sC5b-9) and body weight were identified as significant determinants of eculizumab clearance regardless of bleeding. Eculizumab clearance after the first dose was higher in bleeding than in nonbleeding patients (83.8 vs 61.3 mL/h per 70 kg; P = .07). The high clearance was maintained over treatment doses in bleeding patients, whereas nonbleeding patients showed a time-dependent decrease in clearance. sC5b-9 levels were highest before the first dose and decreased over time, regardless of bleeding complications. A Monte Carlo Simulation analysis showed that the current dosing protocols recommended for atypical hemolytic uremic syndrome had <15% probability of attaining the target concentration of >100 μg/mL eculizumab in nonbleeding patients. We identified an intensified loading protocol to reach 80% target attainment. Our data clearly showed the need for individualized dosing for patients with significant bleeding and for ongoing dose adjustments to optimize outcomes. The developed models will be incorporated into a clinical decision guideline for precision dosing to improve outcomes in children and young adults with TA-TMA.
Photocatalytic degradation of tetracycline in aqueous systems under visible light irridiation using needle-like SnO2 nanoparticles anchored on exfoliated g-C3N4
Authors: Oluwole Adewumi Olufemi , Olatunji Olatunde Stephen
Published: January 2022

Background

Pharmaceuticals is one of the groups of contaminants of emerging concern that are resistant to decomposition or removal by most of the existing water and wastewater treatment procedures, hence the need to develop techniques to facilitate the removals of this group of organic contaminants from water systems. In this study, needle-like SnO2 nanoparticles was synthesised and loaded on exfoliated g-C3N4 nanosheet through a hydrothermal method, for use as sensitive visible light induce-photocatalyst for the decomposition of tetracycline in aqueous systems. The synthesised composites was characterized and analysed for the nature of the heterojunction between the SnO2 nanoparticle and g-C3N4 nanosheet using microscopic and spectroscopic techniques.

Results

The composites were of improved surface properties and enhanced visible-light absorption. The synthesised SnO2/g-C3N4 nanocomposites with various amounts of SnO2 (10–50 mg), employed in the degradation of tetracycline under visible light irradiation, were of good degradation efficiency. The degradation efficiencies of tetracycline by 1 wt.%, 2 wt.%, 3 wt.% and 5 wt.% SnO2/g-C3N4 photocatalyst were 81.54%, 90.57%, 95.90% and 92.15% as compared to g-C3N4 and SnO2 with 40.92% and 51.32% degradation efficiencies. The synergistic interaction between the needle-like SnO2 and exfoliated g-C3N4 nanosheet promoted the separation of photogenerated electron holes pairs, which enhanced their migration rate between SnO2 and g-C3N4 heterojunction, thereby facilitating the degradation of tetracycline. The ·O2− was noted to be the major reactive species in the photocatalytic of the 3 wt.% SnO2/g-C3N4 nanocomposite.

Conclusion

The fabricated SnO2 nanoparticles anchored on exfoliated g-C3N4 showed good performance for the decomposition of tetracycline in water, with possible application on other pharmaceuticals having same moiety (similar chemical structures).
Investigation of genetic relationships within three Miscanthus species using SNP markers identified with SLAF-seq
Authors: Chen Zhiyong , He Yancen , Iqbal Yasir , Shi Yanlan , Huang Hongmei , Yi Zili
Published: January 2022

Background

Miscanthus, which is a leading dedicated-energy grass in Europe and in parts of Asia, is expected to play a key role in the development of the future bioeconomy. However, due to its complex genetic background, it is difficult to investigate phylogenetic relationships in this genus. Here, we investigated 50 Miscanthus germplasms: 1 female parent (M. lutarioriparius), 30 candidate male parents (M. lutarioriparius, M. sinensis, and M. sacchariflorus), and 19 offspring. We used high-throughput Specific-Locus Amplified Fragment sequencing (SLAF-seq) to identify informative single nucleotide polymorphisms (SNPs) in all germplasms.

Results

We identified 257,889 SLAF tags, of which 87,162 were polymorphic. Each tag was 264–364 bp long. The obtained 724,773 population SNPs were used to investigate genetic relationships within three species of Miscanthus. We constructed a phylogenetic tree of the 50 germplasms using the obtained SNPs and grouped them into two clades: one clade comprised of M. sinensis alone and the other one included the offspring, M. lutarioriparius, and M. sacchariflorus. Genetic cluster analysis had revealed that M. lutarioriparius germplasm C3 was the most likely male parent of the offspring.

Conclusions

As a high-throughput sequencing method, SLAF-seq can be used to identify informative SNPs in Miscanthus germplasms and to rapidly characterize genetic relationships within this genus. Our results will support the development of breeding programs with the focus on utilizing Miscanthus cultivars with elite biomass- or fiber-production potential for the developing bioeconomy.
Combined therapy with early initiation of infliximab following drainage of perianal fistulising Crohn’s disease: a retrospective cohort study
Authors: Zhu Ping , Sun Jin-fang , Gu Yun-fei , Chen Hong-jin , Xu Min-min , Li You-ran , Yang Bo-lin
Published: January 2022

Background

Recent studies have confirmed that combined surgery and anti-TNF therapy could improve outcomes in patients with perianal fistulising Crohn’s disease (PFCD). However, the optimal timing for infliximab infusion after surgical intervention is uncertain. We aimed to determine the long-term efficacy of early initiation of infliximab following surgery among PFCD patients.

Methods

We performed a retrospective cohort study of PFCD patients who received combined infliximab and surgical treatment between 2010 and 2018 at a tertiary referral hospital. Patients were grouped according to the time interval between surgery and infliximab infusion, with < 6 weeks into early infliximab induction group and > 6 weeks into delayed infliximab induction group. The primary outcome was to compare surgical re-intervention between early and delayed infliximab induction groups. The secondary outcomes were fistula healing and predictors associated with these outcomes of early infliximab induction approach.

Results

One hundred and seventeen patients were included (73 in early infliximab induction, 44 in delayed infliximab induction). The median interval between surgery and infliximab initiation was 9.0 (IQR 5.5–17.0) days in early infliximab induction group and 188.0 (IQR 102.25–455.75) days in delayed infliximab induction group. After followed-up for a median of 36 months, 61.6% of patients in early infliximab induction group and 65.9% in delayed infliximab induction group attained fistula healing (p = 0.643). The cumulative re-intervention rate was 23%, 32%, 34% in early infliximab induction group and 16%, 25%, 25% in delayed infliximab induction group, at 1, 2, and 3 years respectively (p = 0.235). Presence of abscess at baseline (HR = 5.283; 95% CI, 1.61–17.335; p = 0.006) and infliximab maintenance therapy > 3 infusions (HR = 3.691; 95% CI, 1.233–11.051; p = 0.02) were associated with re-intervention in early infliximab induction group. Presence of abscess at baseline also negatively influenced fistula healing (HR = 3.429, 95% CI, 1.216–9.668; p = 0.02).

Conclusion

Although no clear benefit was shown compared with delayed infliximab induction group, early initiation of infliximab after surgery could achieve promising results for PFCD patients. Before infliximab infusion, durable drainage is required for patients with concomitant abscess or prolonged infliximab maintenance therapy.
Control in the Hospital by Extensive Clinical rules for Unplanned hospitalizations in older Patients (CHECkUP); study design of a multicentre randomized study
Authors: Linkens Aimée E. M. J. H. , Milosevic Vanja , van Nie Noémi , Zwietering Anne , de Leeuw Peter W. , van den Akker Marjan , Schols Jos M. G. A. , Evers Silvia M. A. A. , Gonzalvo Carlota Mestres , Winkens Bjorn , van de Loo Bob P. A. , de Wolf Louis , Peeters Lucretia , de Ree Monique , Spaetgens Bart , Hurkens Kim P. G. M. , van der Kuy Hugo M.
Published: January 2022

Background

Due to ageing of the population the incidence of multimorbidity and polypharmacy is rising. Polypharmacy is a risk factor for medication-related (re)admission and therefore places a significant burden on the healthcare system. The reported incidence of medication-related (re)admissions varies widely due to the lack of a clear definition. Some medications are known to increase the risk for medication-related admission and are therefore published in the triggerlist of the Dutch guideline for Polypharmacy in older patients. Different interventions to support medication optimization have been studied to reduce medication-related (re)admissions. However, the optimal template of medication optimization is still unknown, which contributes to the large heterogeneity of their effect on hospital readmissions. Therefore, we implemented a clinical decision support system (CDSS) to optimize medication lists and investigate whether continuous use of a CDSS reduces the number of hospital readmissions in older patients, who previously have had an unplanned probably medication-related hospitalization.

Methods

The CHECkUP study is a multicentre randomized study in older (≥60 years) patients with an unplanned hospitalization, polypharmacy (≥5 medications) and using at least two medications from the triggerlist, from Zuyderland Medical Centre and Maastricht University Medical Centre+ in the Netherlands. Patients will be randomized. The intervention consists of continuous (weekly) use of a CDSS, which generates a Medication Optimization Profile, which will be sent to the patient’s general practitioner and pharmacist. The control group will receive standard care. The primary outcome is hospital readmission within 1 year after study inclusion. Secondary outcomes are one-year mortality, number of emergency department visits, nursing home admissions, time to hospital readmissions and we will evaluate the quality of life and socio-economic status.

Discussion

This study is expected to add evidence on the knowledge of medication optimization and whether use of a continuous CDSS ameliorates the risk of adverse outcomes in older patients, already at an increased risk of medication-related (re)admission. To our knowledge, this is the first large study, providing one-year follow-up data and reporting not only on quality of care indicators, but also on quality-of-life.

Trial registration

The trial was registered in the Netherlands Trial Register on October 14, 2018, identifier: NL7449 (NTR7691). https://www.trialregister.nl/trial/7449.
Distinct trajectories of perinatal depression in Chinese women: application of latent growth mixture modelling
Authors: Hong Lan , Le Tao , Lu Yinping , Shi Xiang , Xiang Ludan , Liu Meng , Zhang Wenmiao , Zhou Meixi , Wang Jiangling , Xu Dongwu , Yu Xin , Zhao Ke
Published: January 2022

Background

Current research on perinatal depression rarely pays attention to the continuity and volatility of depression symptoms over time, which is very important for the early prediction and prognostic evaluation of perinatal depression. This study investigated the trajectories of perinatal depression symptoms and aimed to explore the factors related to these trajectories.

Methods

The study recruited 550 women during late pregnancy (32 ± 4 weeks of gestation) and followed them up 1 and 6 weeks postpartum. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Latent growth mixture modelling (LGMM) was used to identify trajectories of depressive symptoms during pregnancy.

Results

Two trajectories of perinatal depressive symptoms were identified: “decreasing” (n = 524, 95.3%) and “increasing” (n = 26, 4.7%). History of smoking, alcohol use and gestational hypertension increased the chance of belonging to the increasing trajectories, and a high level of social support was a protective factor for maintaining a decreasing trajectory.

Conclusions

This study identified two trajectories of perinatal depression and the factors associated with each trajectory. Paying attention to these factors and providing necessary psychological support services during pregnancy would effectively reduce the incidence of perinatal depression and improve patient prognosis.
The impact of prenatal screening tests on prenatal diagnosis in Taiwan from 2006 to 2019: a regional cohort study
Authors: Hsiao Ching Hua , Chen Ching Hsuan , Cheng Po Jen , Shaw Steven W. , Chu Woei Chyn , Chen Ran Chou
Published: January 2022

Background

The purpose of this study is to evaluate the impact of prenatal screening tests on prenatal diagnosis in Taiwan’s 14 years from 2006 to 2019.

Methods

The prenatal screening methods evolved from the second-trimester serum screening to combined first-trimester screening (cFTS) and then followed by the non-invasive cell-free DNA prenatal test (NIPT). The data used by the Department of Statistics, the Ministry of Health and Welfare and Department of Household Registration, Ministry of the Interior public website.

Results

This regional registry-based cohort retrospective study examined a total of 2,775,792 births from January 2006 to December 2019. The proportion of advanced maternal age (AMA) pregnancies increased from 11.63% in 2006 to 30.94% in 2019. Overall, invasive diagnostic testing was used in 87.22% of AMA pregnancies. The prenatal detection rate of trisomy 21 and 18 increased from 74.1% and 83.3% in 2006 to 96.9% and 98.8% in 2019, respectively.

Conclusion

During the second-trimester and cFTS periods, the percentage of AMA pregnancies increased every year and the number of invasive procedures also accompany with increased percentage of AMA. However, during the period that NIPT were implemented, the percentage of invasive procedures decreased.
Parental care status and sexual risk behavior in five nationally-representative surveys of sub-Saharan African nations
Authors: Neville Sarah Elizabeth , Saran Indrani , Crea Thomas M.
Published: January 2022

Background

About 10% of children worldwide do not live with either of their biological parents, and although some of these children are orphans, many have living parents. While research shows that orphaned children in Sub-Saharan Africa tend to engage in more sexual risk behaviors than their peers, possibly due to decreased parental oversight and support, it is unclear if these effects also apply to children separated from their living parents. Exploring the question of whether living without parents, regardless of whether they are deceased, is linked to greater sexual risk-taking, this study is the first, to our knowledge, to examine correlates of parental care status in a multi-country, nationally-representative analysis.

Methods

This study was a secondary analysis of the Centers for Disease Control and Prevention’s Violence Against Children Surveys from Kenya, Malawi, Tanzania, Nigeria, and Zambia. We conducted logistic regressions on N = 6770 surveys of youth aged 13 to 17 years to determine if living with their biological parents predicted the odds of engaging in risky sexual behavior, controlling for demographic factors including orphanhood. Post-hoc regressions examined specific risk behaviors.

Results

Compared to those living with both parents, youth not living with either parent had heightened odds of engaging in any sexual risk behavior, even when controlling for orphanhood (OR = 2.56, 95% CI: [1.96, 3.33]). Non-parental care predicted heightened odds of non-condom use (OR = 3.35, 95% CI: [2.38, 4.72]), early sexual debut (OR = 1.80, 95% CI: [1.31, 2.46]), and more sexual partners (β = .60, p < .001).

Conclusions

This study extends prior research linking orphanhood and sexual risk behavior, lending credence to the idea that it is not parental death, but rather parental absence, that leads to sexual risk in youth. Public health programming in Sub-Saharan Africa should consider targeting not only “orphaned youth,” but all children separated from their parents.
Obesity indicators as mediators of association between daytime napping and type 2 diabetes mellitus: the Guangzhou Biobank Cohort Study
Authors: Xiao Jing Yi , Zhang Wei Sen , Jiang Chao Qiang , Jin Ya Li , Zhu Feng , Cheng Kar Keung , Lam Tai Hing , Xu Lin
Published: January 2022

Objective

To examine the mediating effect of obesity indicators on the association between daytime napping and type 2 diabetes mellitus (T2DM) qualitatively and quantitatively using baseline data from the Guangzhou Biobank Cohort Study.

Methods

Twenty-nine thousand three hundred fifty-five participants aged 50+ years were included in this cross-sectional study. Mediation analysis was used to assess the mediating effect of body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) on the association between daytime napping and T2DM after adjustment for sex, age, education, occupation, smoking status, alcohol use and physical activity.

Results

The mean (standard deviation) age of participants was 61.5 ( 7.1) years. The prevalence of T2DM and daytime napping was 12.5% and 65.2%, respectively. After adjustment for potential confounders, WC, WHR and WHtR showed partial mediating effects on the association between daytime napping and T2DM, with the proportion (95% confidence interval) of mediation effect being 10.17% (8.14–14.43%), 14.91% (11.95–21.24%) and 9.36% (7.49–13.29%), respectively. No mediating effect of BMI or HC on the association between daytime napping and T2DM was found.

Conclusions

Our results showed significant mediating effects of WC, WHR and WHtR on the association between daytime napping and T2DM, suggesting that waist circumference management could be important in daytime nappers.
Association between work-related musculoskeletal symptoms and quality of life among dental students: a cross-sectional study
Authors: Sezer Berkant , Kartal Sinan , Sıddıkoğlu Duygu , Kargül Betül
Published: January 2022

Background

Dental students are frequently affected by work-related musculoskeletal symptoms (WMSs) due to reasons such as working conditions, difficult education process and long work periods. The aim of the study was to investigate the frequency and anatomical distribution of WMSs, and its effect on the quality of life (QoL) in dental students.

Methods

Sociodemographic and health-related characteristics of one-hundred and five dental students were recorded. WMSs were scored by the participants with the Nordic Musculoskeletal Questionnaire. Then, participants were asked to evaluate their QoL by scoring the World Health Organization Quality of Life-Brief Form. Differences between independent groups for continuous variables were evaluated by Student’s t-test and ANOVA as appropriate. Linear regression analysis was performed to determine the effect of demographic and health-related parameters in predicting the QoL subscales.

Results

The most common painful region in the last 12 months was the neck (66.7%). The body region with the most WMSs in the last 7 days was the upper back (43.8%). Physical health-related QoL of those with diagnosed musculoskeletal symptoms, and general health-related QoL of those using medicine due to any musculoskeletal symptoms were found to be statistically significantly lower (p = 0.018, p = 0.041, respectively). It was observed that the general and physical health, psychological well-being, and social relationship of the participants who reported the presence of neck pain in the last 7 days were statistically significantly lower (p = 0.003, p < 0.001, p = 0.004, p = 0.012; respectively). According to multiple regression analyses, pain occurrence in the body in the last 12 months and/or in the last 7 days had a negative impact on the participants’ general and physical health, psychological well-being, social relationship, and environmental status and related QoL (p = 0.026, p = 0.047, p = 0.021, p = 0.001, p = 0.027, respectively).

Conclusions

The results of this study show that dental students’ body regions, especially the neck and the back, are affected by WMSs. These negative changes observed in the body had a negative effect on the QoL of the dental students.
Benefits of semiology taught using near-peer tutoring are sustainable
Authors: Gripay Benjamin , André Thomas , De Laval Marie , Peneau Brice , Secourgeon Alexandre , Lerolle Nicolas , Annweiler Cédric , Justeau Grégoire , Connan Laurent , Martin Ludovic , Bière Loïc
Published: January 2022

Background

Near-peer tutoring appears to be an efficient approach for teaching clinical skills. However, the clinical experience gained in the form of student medical internships may offset any interest in such tutoring programme. We then investigated the long-term benefits of this programme.

Methods

This study was conducted in a medical school that experimented in near-peer tutoring for semiology intended for undergraduate medical students. Objective Structured Clinical Examinations and a written semiology test were used to assess students’ clinical skills immediately on its conclusion and repeated one and 2 years after the tutoring was completed.

Results

116 students were evaluated initially (80 tutored and 36 untutored), 38 at 1 year (16 tutored and 22 untutored), 42 at 2 years (21 tutored and 21 untutored). In the global score for Objective Structured Clinical Examinations: at 1 year, the tutored group scored 14.0 ± 1.05 and the untutored group scored 11.3 ± 2.3 (p < 0.001), at 2 years, the tutored group scored 15.1 ± 1.5 and the untutored group scored 12.4 ± 2.2 (p < 0.001). We found a similar but smaller difference for the written semiology test. The difference for Objective Structured Clinical Examinations between tutored and untutored students vanished over time for cross-cutting skills.

Conclusions

Near-peer tutoring in semiology for undergraduate medical students led to better results that remained with the passing of time. Though internships do allow an improvement in the clinical skills of untutored students, they did not reach the level of tutored students.
Health care providers’ awareness on medical management of children with autism spectrum disorder: cross-sectional study in Russia
Authors: Mukhamedshina Y. O. , Fayzullina R. A. , Nigmatullina I. A. , Rutland C. S. , Vasina V. V.
Published: January 2022

Background

Autism spectrum disorder (ASD) is a complex developmental range of conditions that involves difficulties with social interaction and restricted/repetitive behaviors. Unfortunately, health care providers often experience difficulties in diagnosis and management of individuals with ASD, and may have no knowledge about possible ways to overcome barriers in ASD patient interactions in healthcare settings. At the same time, the provision of appropriate medical services can have positive effects on habilitative progress, functional outcome, life expectancy and quality of life for individuals with ASD.

Methods

This online survey research study evaluated the awareness and experience of students/residents (n = 247) and physicians (n = 100) in the medical management of children with ASD. It also gathered the views and experiences of caregivers to children with ASD (n = 158), all based in Russia.

Results

We have established that the Russian medical community has limited ASD knowledge among providers, and have suggested possible reasons for this. Based on results from online surveys completed by students/residents, non-psychiatric physicians, and caregivers of children diagnosed with ASD, the main problems pertaining to medical management of individuals with ASD were identified. Possible problem solving solutions within medical practice were proposed.

Conclusions

The results from this study should be considered when implementing measures to improve healthcare practices, and when developing models for effective medical management, due to start not only in Russia but also in a number of other countries.
Brazilian private health system: history, scenarios, and trends
Authors: Cruz June Alisson Westarb , da Cunha Maria Alexandra Viegas Cortez , de Moraes Thyago Proença , Marques Sandro , Tuon Felipe Francisco , Gomide Arivelton Loeschke , de Paula Linhares Gisele
Published: January 2022

Background

Health care is a complex economic and social system, which combines market elements and public and social interest. This combination in Brazil, like systems in China and United States of America, is operationalized through the public and private system. The sector represents approximately 9% of the country’s GDP, of which 56% is privately sourced and 44% is of public origin. In the private sector includes a structure with 711 private health institutions, 47 million beneficiaries and revenues of US$30 billion a year.

Methods

Therefore, this research describes and analyzes the complementarity of Private Health before the Brazilian Unified Health System, highlighting its main characteristics, scenarios, and trends in the face of the health system and the Brazilian market. This descriptive and exploratory research uses secondary data from various sources, submitted to quantitative data analysis methods. The object of the research is the history of private health in Brazil and its main actors.

Results

The data are organized into three groups, each with its approach of collection and analysis. Thus, it is perceived as the notorious growth of large operators, to the detriment of operators with a lower concentration of beneficiaries; the increasing concentration of the market through mergers and acquisitions promoted by large publicly traded corporations, especially in regions with a lower rate of private health coverage; and the growth of the sector through business plans, whose central characteristic is the dependence on the country’s employability rate.

Conclusions

It is possible to perceive an intense trend of concentration of Brazilian private health in large institutions that have capitalized and have a great appetite for growth through mergers and acquisitions, whether from smaller operators or health institutions that integrate their health networks, following complementary health models already consolidated in countries such as China, and the United States of America, among others. This concentration projects a market with fewer options and competitiveness, reduction in transaction costs and increase the operational effectiveness of health care.
RETRACTED ARTICLE: Bone mesenchymal stem
cell-derived exosomal microRNA-7-5p inhibits progression of acute myeloid leukemia by
targeting OSBPL11
Authors: Jiang Duanfeng , Wu Xin , Sun Xiaoying , Tan Wei , Dai Xin , Xie Youbang , Du Ashuai , Zhao Qiangqiang
Published: January 2022

Background

Acute myeloid leukemia (AML) is a malignant clonal disease of
hematopoietic stem- and progenitor-cell origin. AML features massive proliferation of
abnormal blasts and leukemia cells in the bone marrow and the inhibition of normal
hematopoiesis at onset. Exosomes containing proteins or nucleic acids are secreted by
cells; they participate in intercellular communication and serve as key modulators of
hematopoiesis. The purpose of this study was to investigate the effects of exosomes
derived from bone marrow mesenchymal stem cells (BMSCs) on the regulation of AML and
the underlying mechanisms mediated by microRNA (miRNA).

Methods

Dysregulated miR-7-5p in AML patients was identified using qRT-PCR and
its clinical significance was explored. Bioinformatic analysis revealed the target
gene OSBPL11 that could be regulated by miR-7-5p.
The findings were validated using a dual-luciferase reporter assay and western
blotting. The functional genes of the PI3K/AKT/mTOR signaling pathway were
identified, and the functional significance of miR-7-5p in AML cells was determined
using a functional recovery assay. AML cells were co-cultured with exosomes
originating from BMSCs overexpressing miR-7-5p to determine cell–cell regulation by
Exo-miR-7-5p, as well as in vitro and in vivo functional validation via gain- and
loss-of-function methods.

Results

Expression of miR-7-5p was decreased in AML patients and cells.
Overexpression of miR-7-5p curbed cellular proliferation and promoted apoptosis.
Overexpression of OSBPL11 reversed the tumorigenic
properties of miR-7-5p in AML cells in vitro. Exo-miR-7-5p derived from BMSCs induced
formation of AML cells prone to apoptosis and a low survival rate, with OSBPL11 expression inhibited through the PI3K/AKT/mTOR
signaling pathway. Exo-miR-7-5p derived from BMSCs exhibited tumor homing effects in
vitro and in vivo, and inhibited AML development.

Conclusions

Exo-miR-7-5p derived from BMSCs negatively regulates OSBPL11 by suppressing the phosphorylation of the
PI3K/AKT/mTOR signaling pathway, thereby inhibiting AML proliferation and promoting
apoptosis. The data will inform the development of AML therapies based on
BMSC-derived exosomes.

Graphical Abstract
Charge reversal nano-systems for tumor therapy
Authors: Zhang Peng , Chen Daoyuan , Li Lin , Sun Kaoxiang
Published: January 2022

Surface charge of biological and medical nanocarriers has been demonstrated to play an important role in cellular uptake. Owing to the unique physicochemical properties, charge-reversal delivery strategy has rapidly developed as a promising approach for drug delivery application, especially for cancer treatment. Charge-reversal nanocarriers are neutral/negatively charged at physiological conditions while could be triggered to positively charged by specific stimuli (i.e., pH, redox, ROS, enzyme, light or temperature) to achieve the prolonged blood circulation and enhanced tumor cellular uptake, thus to potentiate the antitumor effects of delivered therapeutic agents. In this review, we comprehensively summarized the recent advances of charge-reversal nanocarriers, including: (i) the effect of surface charge on cellular uptake; (ii) charge-conversion mechanisms responding to several specific stimuli; (iii) relation between the chemical structure and charge reversal activity; and (iv) polymeric materials that are commonly applied in the charge-reversal delivery systems.

Graphical Abstract
Psychometric properties of self-reported measures of health-related quality of life in people living with HIV: a systematic review
Authors: Wen Huan , Yang Zhongfang , Zhu Zheng , Han Shuyu , Zhang Lin , Hu Yan
Published: January 2022

Objective

To identify and assess the psychometric properties of patient-reported outcome measures (PROMs) of health-related quality of life (HRQoL) in people living with HIV (PLWH).

Methods

Nine databases were searched from January 1996 to October 2020. Methodological quality was assessed by using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Risk of Bias Checklist. We used the COSMIN criteria to summarize and rate the psychometric properties of each PROM. A modified Grading, Recommendations, Assessment, Development, and Evaluation (GRADE) system was used to assess the certainty of evidence.

Results

Sixty-nine studies reported on the psychometric properties of 30 identified instruments. All studies were considered to have adequate methodological quality in terms of content validity, construct validity, and internal consistency. Limited information was retrieved on cross-cultural validity, criterion validity, reliability, hypothesis testing, and responsiveness. High-quality evidence on psychometric properties was provided for the Medical Outcomes Study HIV Health Survey (MOS-HIV), the brief version of the World Health Organization's Quality of Life Instrument in HIV Infection (WHOQoL-HIV-BREF), 36-Item Short Form Survey (SF-36), Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQoL-HIV), and WHOQoL-HIV.

Conclusions

The findings from the included studies highlighted that among HIV-specific and generic HRQoL PROMs, MOS-HIV, WHOQoL-HIV-BREF, SF-36, MQoL-HIV, and WHOQoL-HIV are strongly recommended to evaluate HRQoL in PLWH in research and clinics based on the specific aims of assessments and the response burden for participants.