bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between headache-attributed disability and lost productivity: 2. Empirical evidence from population-based studies in nine disparate countries
Authors: Thomas Hallie , Kothari Simple Futarmal , Husøy Andreas , Jensen Rigmor Højland , Katsarava Zaza , Tinelli Michela , Steiner Timothy J.
Published: December 2021

Background

Headache disorders are disabling, with major consequences for productivity, yet the literature is silent on the relationship between headache-attributed disability and lost productivity, often erroneously regarding the two as synonymous. We evaluated the relationship empirically, having earlier found that investment in structured headache services would be cost saving, not merely cost-effective, if reductions in headache-attributed disability led to > 20% pro rata recovery of lost productivity.

Methods

We used individual participant data from Global Campaign population-based studies conducted in China, Ethiopia, India, Nepal, Pakistan and Russia, and from Eurolight in Lithuania, Luxembourg and Spain. We assessed relationships in migraine and probable medication-overuse headache (pMOH), the most disabling common headache disorders. Available symptom data included headache frequency, usual duration and usual intensity. We used frequency and duration to estimate proportion of time in ictal state (pTIS). Disability, in the sense used by the Global Burden of Disease study, was measured as the product of pTIS and disability weight for the ictal state. Impairment was measured as pTIS * intensity. Lost productivity was measured as lost days (absence or < 50% productivity) from paid work and corresponding losses from household work over the preceding 3 months. We used Spearman correlation and linear regression analyses.

Results

For migraine, in a linear model, we found positive associations with lost paid worktime, significant (p < 0.05) in many countries and highly significant (p < 0.001) in some despite low values of R2 (0–0.16) due to high variance. With lost household worktime and total lost productivity (paid + household), associations were highly significant in almost all countries, although still with low R2 (0.04–0.22). Applying the regression equations for each country to the population mean migraine-attributed disability, we found pro rata recoveries of lost productivity in the range 16–56% (> 20% in all countries but Pakistan). Analysing impairment rather than disability increased variability. For pMOH, with smaller numbers, associations were generally weaker, occasionally negative and mostly not significant.

Conclusion

Relief of disability through effective treatment of migraine is expected, in most countries, to recover > 20% pro rata of lost productivity, above the threshold for investment in structured headache services to be cost saving.
Assessing Bos taurus introgression in the UOA Bos indicus assembly
Authors: Naji Maulana M. , Utsunomiya Yuri T. , Sölkner Johann , Rosen Benjamin D. , Mészáros Gábor
Published: December 2021

Background

Reference genomes are essential in the analysis of genomic data. As the cost of sequencing decreases, multiple reference genomes are being produced within species to alleviate problems such as low mapping accuracy and reference allele bias in variant calling that can be associated with the alignment of divergent samples to a single reference individual. The latest reference sequence adopted by the scientific community for the analysis of cattle data is ARS_UCD1.2, built from the DNA of a Hereford cow (Bos taurus taurus—B. taurus). A complementary genome assembly, UOA_Brahman_1, was recently built to represent the other cattle subspecies (Bos taurus indicus—B. indicus) from a Brahman cow haplotype to further support analysis of B. indicus data. In this study, we aligned the sequence data of 15 B. taurus and B. indicus breeds to each of these references.

Results

The alignment of B. taurus individuals against UOA_Brahman_1 detected up to five million more single-nucleotide variants (SNVs) compared to that against ARS_UCD1.2. Similarly, the alignment of B. indicus individuals against ARS_UCD1.2 resulted in one and a half million more SNVs than that against UOA_Brahman_1. The number of SNVs with nearly fixed alternative alleles also increased in the alignments with cross-subspecies. Interestingly, the alignment of B. taurus cattle against UOA_Brahman_1 revealed regions with a smaller than expected number of counts of SNVs with nearly fixed alternative alleles. Since B. taurus introgression represents on average 10% of the genome of Brahman cattle, we suggest that these regions comprise taurine DNA as opposed to indicine DNA in the UOA_Brahman_1 reference genome. Principal component and admixture analyses using genotypes inferred from this region support these taurine-introgressed loci. Overall, the flagged taurine segments represent 13.7% of the UOA_Brahman_1 assembly. The genes located within these segments were previously reported to be under positive selection in Brahman cattle, and include functional candidate genes implicated in feed efficiency, development and immunity.

Conclusions

We report a list of taurine segments that are in the UOA_Brahman_1 assembly, which will be useful for the interpretation of interesting genomic features (e.g., signatures of selection, runs of homozygosity, increased mutation rate, etc.) that could appear in future re-sequencing analysis of indicine cattle.
ddPCR allows 16S rRNA gene amplicon sequencing of very small DNA amounts from low-biomass samples
Authors: Abellan-Schneyder Isabel , Schusser Andrea Janina , Neuhaus Klaus
Published: December 2021

Background

One limiting factor of short amplicon 16S rRNA gene sequencing approaches is the use of low DNA amounts in the amplicon generation step. Especially for low-biomass samples, insufficient or even commonly undetectable DNA amounts can limit or prohibit further analysis in standard protocols.

Results

Using a newly established protocol, very low DNA input amounts were found sufficient for reliable detection of bacteria using 16S rRNA gene sequencing compared to standard protocols. The improved protocol includes an optimized amplification strategy by using a digital droplet PCR. We demonstrate how PCR products are generated even when using very low concentrated DNA, unable to be detected by using a Qubit. Importantly, the use of different 16S rRNA gene primers had a greater effect on the resulting taxonomical profiles compared to using high or very low initial DNA amounts.

Conclusion

Our improved protocol takes advantage of ddPCR and allows faithful amplification of very low amounts of template. With this, samples of low bacterial biomass become comparable to those with high amounts of bacteria, since the first and most biasing steps are the same. Besides, it is imperative to state DNA concentrations and volumes used and to include negative controls indicating possible shifts in taxonomical profiles. Despite this, results produced by using different primer pairs cannot be easily compared.
Combined application of biochar and nitrogen fertilizer promotes the activity of starch metabolism enzymes and the expression of related genes in rice in a dual cropping system
Authors: Ali Izhar , Ullah Saif , Iqbal Anas , Quan Zhao , Liang He , Ahmad Shakeel , Muhammad Ihsan , Amanullah  , Imran  , Guo Zixiong , Wei Shangqing , Jiang Ligeng
Published: December 2021

Background

Overuse of chemical fertilizer highly influences grain filling rate and quality of rice grain. Biochar is well known for improving plant growth and grain yield under lower chemical fertilization. Therefore field trials were conducted in the early and late seasons of 2019 at Guangxi University, China to investigate the effects of combined biochar (B) and nitrogen (N) application on rice yield and yield components. There were a total of eight treatments: N1B0, 135 kg N ha− 1+ 0 t B ha− 1; N2B0,180 kg N ha− 1+ 0 t B ha− 1; N1B1,135 kg N ha− 1+ 10 t B ha− 1; N1B2,135kg N ha− 1+ 20 t B ha− 1; N1B3,135 kg N ha− 1+ 30 t B ha− 1; N2B1,180 kg N ha− 1+ 10 t B ha− 1; N2B2,180 kg N ha− 1+ 20 t B ha− 1; and N2B3,180 kg N ha− 1+ 30 t B ha− 1.

Results

Biochar application at 30 t ha− 1combined with low N application (135 kg ha− 1) increased the activity of starch-metabolizing enzymes (SMEs) during the early and late seasons compared with treatments without biochar. The grain yield, amylose concentration, and starch content of rice were increased in plots treated with 30 t B ha−1and low N. RT-qPCR analysis showed that biochar addition combined with N fertilizer application increased the expression of AGPS2b, SSS1, GBSS1, and GBSE11b, which increased the activity of SMEs during the grain-filling period.

Conclusion

Our results suggest that the use of 20 to 30 t B ha− 1coupled with 135 kg N ha− 1 is optimal for improving the grain yield and quality of rice.
Genomic regions and candidate genes linked with Phytophthora capsici root rot resistance in chile pepper (Capsicum annuum L.)
Authors: Lozada Dennis N. , Nunez Guillermo , Lujan Phillip , Dura Srijana , Coon Danise , Barchenger Derek W. , Sanogo Soumaila , Bosland Paul W.
Published: December 2021

Background

Phytophthora root rot, caused by Phytophthora capsici, is a major disease affecting Capsicum production worldwide. A recombinant inbred line (RIL) population derived from the hybridization between ‘Criollo de Morellos-334’ (CM-334), a resistant landrace from Mexico, and ‘Early Jalapeno’, a susceptible cultivar was genotyped using genotyping-by-sequencing (GBS)-derived single nucleotide polymorphism (SNP) markers. A GBS-SNP based genetic linkage map for the RIL population was constructed. Quantitative trait loci (QTL) mapping dissected the genetic architecture of P. capsici resistance and candidate genes linked to resistance for this important disease were identified.

Results

Development of a genetic linkage map using 1,973 GBS-derived polymorphic SNP markers identified 12 linkage groups corresponding to the 12 chromosomes of chile pepper, with a total length of 1,277.7 cM and a marker density of 1.5 SNP/cM. The maximum gaps between consecutive SNP markers ranged between 1.9 (LG7) and 13.5 cM (LG5). Collinearity between genetic and physical positions of markers reached a maximum of 0.92 for LG8. QTL mapping identified genomic regions associated with P. capsici resistance in chromosomes P5, P8, and P9 that explained between 19.7 and 30.4% of phenotypic variation for resistance. Additive interactions between QTL in chromosomes P5 and P8 were observed. The role of chromosome P5 as major genomic region containing P. capsici resistance QTL was established. Through candidate gene analysis, biological functions associated with response to pathogen infections, regulation of cyclin-dependent protein serine/threonine kinase activity, and epigenetic mechanisms such as DNA methylation were identified.

Conclusions

Results support the genetic complexity of the P. capsici–Capsicum pathosystem and the possible role of epigenetics in conferring resistance to Phytophthora root rot. Significant genomic regions and candidate genes associated with disease response and gene regulatory activity were identified which allows for a deeper understanding of the genomic landscape of Phytophthora root rot resistance in chile pepper.
Anthropometric measures and the risk of developing atrial fibrillation: a Swedish Cohort Study
Authors: Zia Isac , Johnson Linda , Memarian Ensieh , Borné Yan , Engström Gunnar
Published: December 2021

Aims

Obesity is a risk factor for several cardiovascular diseases (CVDs), including atrial fibrillation (AF). However, it is less clear whether overall fat or abdominal fat distribution are most important for risk of developing AF. This study investigates how different anthropometric measures correlate to the risk of developing clinical AF in the Malmö Diet and Cancer cohort (MDC-cohort).

Methods

The MDC-cohort (n = 25,961) was examined in 1991–1996. The endpoint was clinical AF diagnosed in a hospital setting, and retrieved via linkage with national registers. Hazard Ratios (HR) for incident AF was calculated in relation to quartiles of body mass index (BMI), waist circumference, waist hip ratio, waist height ratio, body fat percentage, weight and height, using Cox regression with adjustment for age, biological (e.g. blood pressure, diabetes, blood lipid levels), and socioeconomic risk factors.

Results

After adjustment for multiple risk factors, the risk of AF was significantly increased in the 4th versus 1st quartile of weight (HR for men/women = 2.02/1.93), BMI (HR = 1.62/1.52), waist circumference (HR = 1.67/1.63), waist to hip ratio (HR = 1.30/1.24), waist to height ratio (1.37/1.39) and body fat percentage (HR = 1.21/1.45) in men/women. Measures of overall weight (BMI, weight) were slightly more predictive than measures of abdominal obesity (waist hip ratio and waist height ratio) both in men and women.

Conclusion

All measures of obesity were associated with increased risk of developing AF. Both overall obesity and abdominal obesity were related to incidence of AF in this population-based study, although the relationship for overall obesity was stronger.
The roles of predictors in cardiovascular risk models - a question of modeling culture?
Authors: Wallisch Christine , Agibetov Asan , Dunkler Daniela , Haller Maria , Samwald Matthias , Dorffner Georg , Heinze Georg
Published: December 2021

Background

While machine learning (ML) algorithms may predict cardiovascular outcomes more accurately than statistical models, their result is usually not representable by a transparent formula. Hence, it is often unclear how specific values of predictors lead to the predictions. We aimed to demonstrate with graphical tools how predictor-risk relations in cardiovascular risk prediction models fitted by ML algorithms and by statistical approaches may differ, and how sample size affects the stability of the estimated relations.

Methods

We reanalyzed data from a large registry of 1.5 million participants in a national health screening program. Three data analysts developed analytical strategies to predict cardiovascular events within 1 year from health screening. This was done for the full data set and with gradually reduced sample sizes, and each data analyst followed their favorite modeling approach. Predictor-risk relations were visualized by partial dependence and individual conditional expectation plots.

Results

When comparing the modeling algorithms, we found some similarities between these visualizations but also occasional divergence. The smaller the sample size, the more the predictor-risk relation depended on the modeling algorithm used, and also sampling variability played an increased role. Predictive performance was similar if the models were derived on the full data set, whereas smaller sample sizes favored simpler models.

Conclusion

Predictor-risk relations from ML models may differ from those obtained by statistical models, even with large sample sizes. Hence, predictors may assume different roles in risk prediction models. As long as sample size is sufficient, predictive accuracy is not largely affected by the choice of algorithm.
Risk factors of early postoperative bowel obstruction for patients undergoing selective colorectal surgeries
Authors: Yang Shuguang , Zhao Huiying , Yang Jianhui , An Youzhong , Zhang Hua , Bao Yudi , Gao Zhidong , Ye Yingjiang
Published: December 2021

Objective

Postoperative bowel obstruction was one of the most severe complications in patients who received colorectal surgeries. This study aimed to explore risk factors of early postoperative obstruction and to construct a nomogram to predict the possibility of occurrence.

Methods

The records of 1437 patients who underwent elective colorectal surgery in Peking University People’s Hospital from 2015 to 2020 were retrospectively collected. Risk factors of early postoperative bowel obstruction were identified by logistic regression analysis and a nomogram was then constructed. Bootstrap was applied to verify the stability of the model.

Results

COPD, hypothyroidism, probiotic indications, duration of antibiotics, and time to postoperative feeding were identified as independent risk factors and were put into a nomogram for predicting early postoperative bowel obstruction. The nomogram showed robust discrimination, with the area under the receiver operating characteristic curve was 0.894 and was well-calibrated.

Conclusion

A nomogram including independent risk factors of COPD, hypothyroidism, probiotic indications, duration of antibiotics, and time to postoperative feeding were established to predict the risk of early postoperative bowel obstruction.
Remote activity monitoring for family caregivers of persons living with dementia: a mixed methods, randomized controlled evaluation
Authors: Gaugler Joseph E. , Zmora Rachel , Mitchell Lauren L. , Finlay Jessica , Rosebush Christina E. , Nkimbeng Manka , Baker Zachary G. , Albers Elizabeth A. , Peterson Colleen M.
Published: December 2021

Background

The goal of the present study was to determine whether a remote activity monitoring (RAM) system benefited caregivers who aided relatives with Alzheimer’s disease or related dementias (ADRD) living at home. We hypothesized that over 18 months, families randomly assigned to receive RAM technology in the home of the person with ADRD would experience statistically significant (p < .05): 1) improvements in caregiver self-efficacy and sense of competence when managing their relative’s dementia; and 2) reductions in caregiver distress (e.g., burden, role captivity, and depression).

Methods

An embedded mixed methods design was utilized, where 179 dementia caregivers were randomly assigned to receive RAM or not. Caregivers were surveyed bi-annually over an 18-month period to collect quantitative and qualitative data on RAM’s effects. Semi-structured interviews with 30 caregivers were completed following the 18-month data collection period to explore more in-depth how and why RAM was perceived as helpful or not.

Results

Growth curve models showed no direct or moderation effect of RAM on dementia caregiver outcomes. The qualitative data revealed a complex utilization process of RAM influenced by the care environment/context as well as the temporal progression of ADRD and the caregiving trajectory.

Conclusions

The findings suggest the need for developing more effective mechanisms to match appropriate technologies with the heterogeneous needs and care contexts of people living with ADRD and their caregivers. A triadic approach that incorporates professional care management alongside passive monitoring systems such as RAM may also enhance potential benefits.

Trial registration

ClinicalTrials.govNCT03665909, retrospectively registered on 11 Sept 2018.
Social connection and physical health outcomes among long-term care home residents: a scoping review
Authors: Lem Kaitlyn , McGilton Katherine S. , Aelick Katelynn , Iaboni Andrea , Babineau Jessica , Hewitt Colborne Debbie , Edwards Cathleen , Bretzlaff Monica , Lender Dee , Gibson Josie-Lee , Bethell Jennifer
Published: December 2021

Background

Social connection is recognized as an important determinant of health and well-being. The negative health impacts of poor social connection have been reported in research in older adults, however, less is known about the health impacts for those living in long-term care (LTC) homes. This review seeks to identify and summarize existing research to address the question: what is known from the literature about the association between social connection and physical health outcomes for people living in LTC homes?

Methods

A scoping review guided by the Arksey & O’Malley framework was conducted. Articles were included if they examined the association between social connection and a physical health outcome in a population of LTC residents.

Results

Thirty-four studies were included in this review. The most commonly studied aspects of social connection were social engagement (n = 14; 41%) and social support (n = 10; 29%). A range of physical health outcomes were assessed, including mortality, self-rated health, sleep, fatigue, nutrition, hydration, stress, frailty and others. Findings generally support the positive impact of social connection for physical health among LTC residents. However, most of the studies were cross-sectional (n = 21; 62%) and, of the eleven cohort studies, most (n = 8; 73%) assessed mortality as the outcome. 47% (n = 16) were published from 2015 onwards.

Conclusions

Research has reported positive associations between social connection and a range of physical health outcomes among LTC residents. These findings suggest an important role for social connection in promoting physical health. However, further research is needed to consider the influence of different aspects of social connection over time and in different populations within LTC homes as well as the mechanisms underlying the relationship with health.
Patients’ thoughts on their falls in a rehabilitation hospital: a qualitative study of patients with stroke
Authors: Aihara Saika , Kitamura Shin , Dogan Masayuki , Sakata Sachiko , Kondo Kunitsugu , Otaka Yohei
Published: December 2021

Background

Patients with stroke in rehabilitation wards are at an increased risk of falling. Although patients’ participation in establishing medical safety is considered crucial, there is limited evidence on their perspectives of falls. This study aims to comprehensively elucidate the subjective falling experience of patients with stroke who have been admitted to rehabilitation wards.

Methods

Twenty-three consecutive patients with stroke (44 to 90 years) who experienced a fall during hospitalisation were interviewed within 1 week after the fall, and thematic analysis was used to analyse the data.

Results

Five themes surrounding fall events were extracted from the narratives: ‘Psychological background before the action’, ‘Support for the action’, ‘Direct causes of the fall’, ‘Patients’ awareness after the fall’, and ‘Changes in attitudes and behaviours after the fall’. ‘Psychological background before the action’ comprised hastiness or hesitation to call for help. Participants often took an action based on ‘Support for the action’ derived from their past experiences of moving safely, their confidence, and/or motivation to challenge themselves to move. ‘Direct causes of the fall’ consisted of unfamiliar actions, training fatigue, the surrounding environment, reduced physical function due to paralysis, lack of attention, overconfidence in their ability, and insufficient prediction of falls. ‘Patients’ awareness after the fall’ consisted of re-affirming difficult movements, the need for rehabilitation, a reduced ability to move, an increased risk of falling, the need for attention while moving, a fear of falling, and a lack of lessons learned from falling. Finally, patients demonstrated ‘Changes in attitudes and behaviours after the fall’ such as embodying a positive attitude to cope with the risk of falling or behavioural changes to reduce the risk of falling.

Conclusions

Comprehensive information on patients’ perspectives before and after the fall was elucidated, uncovering many aspects including the psychological background for why patients engaged in risky behaviours resulting in falls, presence of positive thinking, and behaviour after the fall. By incorporating the patients’ views on fall incidences and their assessment, we can develop appropriate prevention strategies against falls.
Dementia care and the role of guideline adherence in primary care: cross-sectional findings from the DemTab study
Authors: Lech Sonia , O’Sullivan Julie L. , Drewelies Johanna , Herrmann Wolfram , Spang Robert P. , Voigt-Antons Jan-Niklas , Nordheim Johanna , Gellert Paul
Published: December 2021

Background

General practitioners (GPs) play a key role in the care of people with dementia (PwD). However, the role of the German Dementia Guideline in primary care remains unclear. The main objective of the present study was to examine the role of guideline-based dementia care in general practices.

Methods

A cross-sectional analysis of data obtained from the DemTab study was conducted. Descriptive analyses of sociodemographic and clinical characteristics for GPs (N = 28) and PwD (N = 91) were conducted. Adherence to the German Dementia Guideline of GPs was measured at the level of PwD. Linear Mixed Models were used to analyze the associations between adherence to the German Dementia Guideline and GP factors at individual (age, years of experience as a GP, frequency of utilization of guideline, perceived usefulness of guideline) and structural (type of practice, total number of patients seen by a participating GP, and total number of PwD seen by a participating GP) levels as well as between adherence to the German Dementia Guideline and PwD’s quality of life.

Results

Self-reported overall adherence of GPs was on average 71% (SD = 19.4, range: 25–100). Adherence to specific recommendations varied widely (from 19.2 to 95.3%) and the majority of GPs (79.1%) reported the guideline as only partially or somewhat helpful. Further, we found lower adherence to be significantly associated with higher numbers of patients (γ10 = − 5.58,CI = − 10.97, − 0.19,p = .04). No association between adherence to the guideline and PwD’s quality of life was found (γ10 = −.86,CI = − 4.18, 2.47,p = .61).

Conclusion

The present study examined the role of adherence to the German Dementia Guideline recommendations in primary care. Overall, GPs reported high levels of adherence. However, major differences across guideline recommendations were found. Findings highlight the importance of guidelines for the provision of care. Dementia guidelines for GPs need to be better tailored and addressed. Further, structural changes such as more time for PwD may contribute to a sustainable change of dementia care in primary care.

Trial registration

The DemTab trial was prospectively registered with the ISRCTN registry (Trial registration number:ISRCTN15854413). Registered 01 April 2019.
Assessment of frailty in elderly patients attending a multidisciplinary wound care centre: a cohort study
Authors: Espaulella-Ferrer Mariona , Espaulella-Panicot Joan , Noell-Boix Rosa , Casals-Zorita Marta , Ferrer-Sola Marta , Puigoriol-Juvanteny Emma , Cullell-Dalmau Marta , Otero-Viñas Marta
Published: December 2021

Background

The incidence of frailty and non-healing wounds increases with patients’ age.

Knowledge of the relationship between frailty and wound healing progress is greatly lacking.

Methods

The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centres (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at 6 months or upon wound healing. Wounds were followed up every 2 weeks. To analyse the relationship between two variables was used the Chi-square test and Student’s or the ANOVA model. The t-test for paired data was used to analyse the evolution of the frailty index during follow-up.

Results

A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at 6 months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p = 0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p = 0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p = 0.637). Wound healing rate is statically significantly higher in non-frail patients (8.9% wound reduction/day, P25-P75 3.34–18.3%/day;AQ6 p = 0.044) in comparison with frail patients (3.26% wound reduction/day, P25-P75 0.8–8.8%/day).

Conclusion

Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.
What do geriatric rehabilitation patients and experts consider relevant? Requirements for a digitalised e-coach for sustainable improvement of nutrition and physical activity in older adults – a qualitative focus group study
Authors: Happe Lisa , Hein Andreas , Diekmann Rebecca
Published: December 2021

Background

During geriatric rehabilitation, attempts are made to increase the patients’ health and functional capacity. In order to maintain these improvements in the medium- and long-term, behavioural changes regarding mobility and nutrition are also targeted, but these are often not sustainable. International studies show positive effects on the sustainability of the improvement of physical activity behaviour in healthy seniors through the use of electronic devices and software applications. Comparable approaches that include nutrition topics or combine them and were additionally developed for geriatric rehabilitation patients (≥70 years) to date are not known. The aim of this study was to identify what geriatric rehabilitation patients require from an electronic coaching system (e-coach) to support them in improving their nutritional and physical activity behaviour, and what content and features physiotherapists and dieticians consider relevant.

Method

Focus group interviews (09–11/2019) were conducted in a geriatric rehabilitation centre in Germany with patients aged 70 years and older, relatives and experts (physiotherapists and nutritionists). The focus groups were recorded, transcribed verbatim and analysed using content analysis.

Results

Three focus groups with patients and relatives (n = 17, 65% female, 16 (94%) in age category 70–99 years) and one focus group with experts (2 dieticians and 1 physiotherapist) were conducted. Relevant contents and feedback elements for nutrition and physical activity in old age were identified. The patients’ comments show that an e-coach must offer obvious benefits for the older persons and promote motivation in order to be used. The willingness to change nutrition and physical activity behaviour and the previous experiences in these areas are very heterogeneous, therefore content should be adaptable to different requirements.

Conclusion

Experts and patients identified quite similar contents, barriers and facilitators for a nutrition and physical activity e-coach. The e-coach needs to be able to address different points of behaviour change, enable adaptations to the individual patient and convince the older person that using it will help them to improve their nutrition and physical activity. It is also important that the e-coach is easy to use and can be easily integrated into the patient’s everyday life after rehabilitation.
Profiles of immune cell infiltration and immune-related genes in the tumor microenvironment of osteosarcoma cancer
Authors: Liu Ruixuan , Hu Yuhang , Liu Tianyi , Wang Yansong
Published: December 2021

Backgrounds

Osteosarcomas are one of the most common primary malignant tumors of bone. It primarily occurs in children and adolescents, with the second highest incidence among people over 50 years old. Although there were immense improvements in the survival of patients with osteosarcoma in the past 30 years, targetable mutations and agents of osteosarcomas still have been generally not satisfactory. Therefore, it is of great importance to further explore the highly specialized immune environment of bone, genes related to macrophage infiltration and potential therapeutic biomarkers and targets.

Methods

The 11 expression data sets of OS tissues and the 11 data sets of adjacent non-tumorous tissues available in the GEO database GSE126209 were used to conduct immune infiltration analysis. Then, through WGCNA analysis, we acquired the co-expression modules related to Mast cells activated and performed the GO and KEGG enrichment analysis. Next, we did the survival prognosis analysis and plotted a survival curve. Finally, we analyzed the COX multivariate regression of gene expression on clinical parameters and drew forest maps for visualization by the forest plot package.

Results

OS disease-related immune cell populations, mainly Mast cells activated, have higher cell content (p = 0.006) than the normal group. Then, we identified co-expression modules related to Mast cells activated. In sum, a total of 822 genes from the top three strongest positive correlation module MEbrown4, MEdarkslateblue and MEnavajowhite2 and the strongest negative correlation module MEdarkturquoise. From that, we identified nine genes with different levels in immune cell infiltration related to osteosarcoma, eight of which including SORBS2, BAIAP2L2, ATAD2, CYGB, PAMR1, PSIP1, SNAPC3 and ZDHHC21 in their low abundance have higher disease-free survival probability than the group in their high abundances.

Conclusion

These results could assist clinicians to select targets for immunotherapies and individualize treatment strategies for patients with OS.
Factors affecting rehabilitation of infants with Central Coordination Disorders during a three-month-long observation
Authors: Andrzejewska Malgorzata , Hap Katarzyna , Biernat Karolina , Sutkowska Edyta , Demczyszak Iwona , Marciniak Dominik , Kuciel Natalia
Published: December 2021

Background

Central coordination disorders (CCD) encompass various abnormalities observed in infants but early therapy may have an impact on their condition. The aim was to seek factors that may affect the early results of therapy of infants with CCD.

Methods

We analyzed the outcomes of a three-month period of rehabilitation of infants living with CCD. Children were treated at Non-public Specialist Healthcare Institution Medi-Reh in Kalisz in the period from 1 Jan 2014 to 31 Nov 2019. In our retrospective study results of three-month therapy of infants, aged 1 to 6 months, with CCD were analysed regards to the effectiveness and the potential impact of different factors. Therapy and assessment of children were conducted with the use of the Vojta method, which was performed during the first visit (WW) and the follow-up visit (after 3 months- 1WK). The analysis of the influence of various factors on the effect of therapy included: mother's age at the time of delivery, duration of breastfeeding, child APGAR, gestational age in which the child was born, sex of the child, birth weight, age of the child at WW, type of delivery, craniosacral therapy as an additive treatment.

Results

Based on the examination results from 66 medical records it was demonstrated that after active period of the therapy, improvement was observed in 54 (81.81%) (p=0.48) children (condition during WW versus 1WK among the group). The sole factor impacting improvement after 3 months was the age of the child at WW, when the child started therapy. This factor significantly (p=0.002) increased the chance of achieving improvement - by 3.2 times (OR= 3,2; CI= 95). No statistically significant differences were shown for the other studied factors.

Conclusions

Prompt implementation of rehabilitation in children with CCD provides a better chance of improving their motor function. The rehabilitation should be started as soon as possible after the diagnosis is constituted.
Wakȟáŋyeža (Little Holy One) - an intergenerational intervention for Native American parents and children: a protocol for a randomized controlled trial with embedded single-case experimental design
Authors: Brockie Teresa , Haroz Emily E. , Nelson Katie E. , Cwik Mary , Decker Ellie , Ricker Adriann , Littlepage Shea , Mayhew Justin , Wilson Deborah , Wetsit Lawrence , Barlow Allison
Published: December 2021

Background

Trauma within Native American communities compromises parents’ parenting capacity; thus, increasing childrens’ risk for substance use and suicide over the lifespan. The objective of this manuscript is to describe the Wakȟáŋyeža (Little Holy One) intervention and evaluation protocol, that is designed to break cycles of intergenerational trauma, suicide, and substance use among Fort Peck Assiniboine and Sioux parents and their children.

Methods

A randomized controlled trial with an embedded single-case experimental design will be used to determine effectiveness of the modular prevention intervention on parent-child outcomes and the added impact of unique cultural lesson-components. Participants include 1) Fort Peck Assiniboine and Sioux parents who have had adverse childhood experiences, and 2) their children (3–5 years). Parent-child dyads are randomized (1:1) to Little Holy One or a control group that consists of 12 lessons taught by Indigenous community health workers. Lessons were developed from elements of 1) the Common Elements Treatment ApproachandFamily Spirit,both evidence-based interventions, and 2) newly created cultural (intervention) and nutrition (control group only) lessons. Primary outcomes are parent (primary caregiver) trauma symptoms and stress. Secondary outcomes include: Parent depression symptoms, parenting practices, parental control, family routines, substance use, historical loss, communal mastery, tribal identity, historical trauma. Child outcomes include, externalizing and internalizing behavior and school attendance. Primary analysis will follow an intent-to-treat approach, and secondary analysis will include examination of change trajectories to determine impact of cultural lessons and exploration of overall effect moderation by age and gender of child and type of caregiver (e.g., parent, grandparent).

Discussion

Many Native American parents have endured adverse childhood experiences and traumas that can negatively impact capacity for positive parenting. Study results will provide insights about the potential of a culturally-based intervention to reduce parental distress – an upstream approach to reducing risk for childrens’ later substance misuse and suicidality. Intervention design features, including use of community health workers, cultural grounding, and administration in Head Start settings lend potential for feasibility, acceptability, sustainability, and scalability.

Trial registration

ClinicalTrials.gov:NCT04201184. Registered 11 December 2019.
Unsuppressed viral load after intensive adherence counselling in rural eastern Uganda; a case of Kamuli district, Uganda
Authors: Ndikabona Geoffrey , Alege John Bosco , Kirirabwa Nicholas Sebuliba , Kimuli Derrick
Published: December 2021

Background

The East Central (EC) region of Uganda has the least viral suppression rate despite having a relatively low prevalence of human immunodeficiency virus (HIV). Although the viral suppression rate in Kamuli district is higher than that observed in some of the districts in the region, the district has one of the largest populations of people living with HIV (PLHIV). We sought to examine the factors associated with viral suppression after the provision of intensive adherence counselling (IAC) among PLHIV in the district.

Methods

We reviewed records of PLHIV and used them to construct a retrospective cohort of patients that started and completed IAC during January – December 2019 at three high volume HIV treatment facilities in Kamuli district. We also conducted key informant interviews of focal persons at the study sites. We summarized the data descriptively, tested differences in the outcome (viral suppression after IAC) using chi-square and t-tests, and established independently associated factors using log-binomial regression analysis with robust standard errors at 5% statistical significance level using STATA version 15.

Results

We reviewed 283 records of PLHIV. The mean age of the participants was 35.06 (SD 18.36) years. The majority of the participants were female (56.89%, 161/283). The viral suppression rate after IAC was 74.20% (210/283). The most frequent barriers to ART adherence reported were forgetfulness 166 (58.66%) and changes in the daily routine 130 (45.94). At multivariable analysis, participants that had a pre-IAC viral load that was greater than 2000 copies/ml [adjusted Prevalence Risk Ratio (aPRR)= 0.81 (0.70 - 0.93), p=0.002] and those that had a previous history of viral load un-suppression [aPRR= 0.79 (0.66 - 0.94), p=0.007] were less likely to achieve a suppressed viral load after IAC. ART drug shortages were rare, ART clinic working hours were convenient for clients and ART clinic staff received training in IAC.

Conclusion

Despite the consistency in drug availability, counselling training, flexible and frequent ART clinic days, the viral suppression rate after IAC did not meet recommended targets. A high viral load before IAC and a viral rebound were independently associated with having an unsuppressed viral load after IAC. IAC alone may not be enough to achieve viral suppression among PLHIV. To improve viral suppression rates after IAC, other complementary services should be paired with IAC.
Efficacy of Er:YAG laser irradiation for decontamination and its effect on biocompatibility of different titanium surfaces
Authors: Huang Peijun , Chen Xue , Chen Zhongren , Chen Min , He Jinzhi , Peng Lin
Published: December 2021

Background

Erbium yttrium–aluminum–garnet (Er:YAG) laser have been shown to be suitable for decontamination of titanium surfaces at a wide range of energy settings, however, high intensity of laser irradiation destroy titanium surface and low intensity cannot remove enough microbial biofilm. The aim of this study was to investigate the optimal energy setting of Er:YAG laser for decontamination of sandblasted/acid-etched (SLA) and hydroxyapatite (HA) titanium surfaces.

Material and methods

After supragingival biofilm construction in vivo, SLA and HA titanium discs were divided into three groups: blank control (BC, clean discs), experimental control (EC, contaminated discs) and experimental groups (EP, contaminated discs irradiated by Er:YAG laser at 40, 70, and 100 mJ/pulse). Scanning electron microscopy (SEM), live/dead bacterial fluorescent detection, and colony counting assay were used to detect the efficacy of laser decontamination. To investigate the effect of laser decontamination on titanium surface biocompatibility, MC3T3-E1 cell adhesion and proliferation activity were examined by SEM and CCK-8 assay.

Results

Er:YAG laser irradiation at 100 mJ/pulse removed 84.1% of bacteria from SLA titanium surface; laser irradiation at 70 and 100 mJ/pulse removed 76.4% and 77.85% of bacteria from HA titanium surface respectively. Laser irradiation improved MC3T3-E1 cell adhesion on both titanium surfaces. For SLA titanium discs, 100 mJ/pulse group displayed excellent cellular proliferation activity higher than that in BC group (P < 0.01). For HA titanium discs, 70 mJ/pulse group showed the highest activity comparable to BC group (P > 0.05).

Conclusions

With regards to efficient microbial biofilm decontamination and biocompatibility maintenance, Er:YAG laser at 100 mJ/pulse and 70 mJ/pulse are considered as the optimal energy settings for SLA titanium and HA titanium surface respectively. This study provides theoretical basis for the clinical application of Er:YAG laser in the treatment of peri-implantitis.
Comparison of dentoskeletal and soft tissue changes between tooth-borne and tooth-bone-borne hybrid nonsurgical rapid maxillary expansions in adults: a retrospective observational study
Authors: An Jung-Sub , Seo Bo-Yeon , Ahn Sug-Joon
Published: December 2021

Background

Despite the gradual increase in the use of rapid maxillary expansion (RME), specifically RME with the aid of skeletal anchorage in adults, there have been no reports comparing dentoskeletal and soft tissue changes between nonsurgical tooth-borne and tooth-bone-borne RMEs in adults. This study aimed to analyse differences in dentoskeletal and soft tissue changes between tooth-borne and tooth-bone-borne RMEs using a similar appliance design and the same expansion protocol in adult patients.

Methods

Twenty-one patients with tooth-borne expansion (a conventional expansion screw with two premolars and two molar bands for dental anchorage [T-RME]) and the same number of patients with tooth-bone-borne hybrid expansion (a conventional expansion screw with two premolar and two molar bands for dental anchorage and four mini-implants in the palate for skeletal anchorage [H-RME]) were included. Dentoskeletal and soft tissue variables at pretreatment (T1) and after expansion (T2) were measured using posteroanterior and lateral cephalograms and frontal photographs. The sex distribution of the two groups was analysed using the chi-square test, and the change after RME in each group was evaluated using the Wilcoxon signed-rank test. Differences in pretreatment age, expansion duration, post-expansion duration, and dentoskeletal and soft tissue changes after RME between the two groups were determined using the Mann–Whitney U test.

Results

There were no significant differences in the expansion protocol, pretreatment conditions, and sex distribution between the two groups. Despite similar degrees of dental expansion at the crown level between the two groups, H-RME induced increased skeletal and parallel expansion of the maxilla compared to T-RME. After expansion, H-RME demonstrated increased forward displacement of the maxilla without significant changes in the vertical dimension, while T-RME exhibited increased backward displacement of the mandible, increased vertical dimension, and decreased overbite. Both groups showed significant retroclination and extrusion of the maxillary incisors without significant intergroup differences. There were no significant soft tissue changes between the two groups.

Conclusion

This study suggests that using skeletal anchorage in RME may induce increased skeletal and parallel expansion of the maxilla without significant effects on the vertical dimension.
MicroRNA expression profiles in peri-miniscrew implant crevicular fluid in orthodontics: a pilot study
Authors: He Wendan , Yang Yanru , Cai Longgan , Lei Qiaoling , Wang Zhongdong , Che Xiaoxia
Published: December 2021

Background

This study systematically evaluated microRNA (miRNA) expression patterns in peri-miniscrew implant crevicular fluid (PMICF) in orthodontic patients.

Methods

Next-generation sequencing (NGS) was performed to obtain miRNA profiles in PMICF or gingival crevicular fluid (GCF) collected from 3 healthy volunteers (H), 3 peri-implantitis patients (PMSII) and 5 periodontitis patients (P). MiRNA expression patterns were compared between normal and orthodontic PMICF and GCF. Differentially expressed miRNAs were estimated by quantitative real-time PCR (qRT-PCR). Enrichment analyses of the gene targets controlled by these miRNAs were conducted by Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses.

Results

Compared with healthy donors, in PMSII patients, a total of 206 upregulated miRNAs and 152 downregulated miRNAs were detected in PMICF, while periodontitis patients had 333 upregulated miRNAs and 318 downregulated miRNAs. MiR-544a, miR-1245b-3p, miR-1825, miR-4291, miR-3689e, and miR-4477a were chosen randomly for further examination. qRT-PCR examination confirmed that the expression levels of miR-1245b-3p and miR-4291 were higher in PMSII than in H samples and that the expression levels of miR-1825 were higher in PMSII than in P samples. However, contrary to the NGS results, qRT-PCR analysis showed decreased expression of miR544a in PMSII. MiR3689e and miR4477a expression did not differ significantly among all samples. According to GO and KEGG pathway analyses of miR-1825, miR-4291, and miR-1245b-3p high enrichment of target genes involved in the PI3K-AKT signalling pathway was observed.

Conclusions

The NGS analysis of normal and orthodontic PMICF/CGF showed different miRNA profiles, which may lay the foundation for future research on the molecular mechanism of PMSII. miR-4291, miR-1245b-3p and miR-1825 may be used as diagnostic markers and potential therapeutic targets for PMSII.