bluuebunny/crossref_metadata_2025 huggingface dataset:
Semen Parameters Changes in Adolescents With Clinical Varicocele after Magnified Subinguinal Varicocelectomy: A Prospective Controlled Study
Authors: Shebl Salah E. , Sabry Khaled
Published: December 2022

Background:

Previously, we highlighted the benefits of magnified subinguinal varicocelectomy over conservative treatment on the semen of a small group of adolescents with varicoceles. In this report, we presented changes of semen parameters of 47 adolescents who underwent magnified subinguinal varicocelectomy (MSV) and followed-up for 6 months.

Methods:

The present prospective controlled study was conducted on 47 adolescents with varicocele who underwent MSV and were followed up for 6 months. In addition, age and sex-matched patients were added as control group. The primary outcome of this study was to assess the postoperative change in semen analysis parameters.

Results:

A significant increase in sperm volume from 2.5 (1.9–3) to 3.2 (2.6–4) mL at the end of the sixth month of follow-up. Likewise, the sperm count increased from 10.8 (3.51–21.6) to 20.3 (9.6–35) million. Notably, the percentage of rapid and slow sperms increased significantly from a median of 5% (0%–10%) and 15% (10 -20%) to a median of 10% (5%–15%) and 17.5% (15%–25%), respectively. The percentage of sperm with progressive movement increased from 35% (30%–40%) to 59% (45%–69%). The vitality of the sperms increased significantly as well. While the percentage of sperms with abnormal morphology decreased significantly at the end of follow-up.

Conclusion

Our findings support the safety and efficacy of MSV in patients with clinically detectable varicocele. MSV has improved the semen parameters of the included patients, including sperm motility, volume, count, and total progressive motility, which may positively impact their fertility potential.
Active domain adaptation method for label expansion problem
Authors: Zhang Ruicong , Bao Yu , Weng Qinle , Li Zhongtian , Li Yonggang
Published: December 2022

Over the past few years, cross-domain fault detection methods based on unsupervised domain adaptation (UDA) have gradually matured. However, existing methods usually assume that the source and target domains have the same label domain space, but ignore the problem of label expansion in the target domain. The source domain of such problems lacks transferable knowledge of newly added health categories, so the domain invariant features extracted by the UDA model only have a large correlation with the source domain health categories, but lack the key features to distinguish the newly added health categories. We found that most of the diagnostic results of this type of samples are distributed at the decision boundary of the source domain health category, and this special distribution means that the newly added health category samples have a high amount of information. Therefore, this paper considers using active learning to select samples of newly added health categories in the target domain to assist model training, and proposes an active domain adaptation intelligent fault detection framework LDE-ADA to deal with the label expansion problem. Finally, on the rotating machinery dataset, the analysis and comparison are carried out through six transfer tasks. The results show that when there is one new health category, the accuracy of LDE-ADA will increase by about 9.39% in the case of labeling three samples per round and training for 20 rounds. Experiments show that this method is an effective method to deal with the label expansion problem.
Perception of Brazilian and Portuguese students about health promotion in university environments
Authors: Catrib Ana M. F. , Sousa Isabelle C. , Abdon Ana P. V. , Carioca Antônio A. F. , Caldas José M. P.
Published: December 2022

Objective:

to compare different perceptions of Brazilian and Portuguese health students about health promotion in the university.

Method:

cross-sectional, descriptive analytical study that included 669 university students in the health courses of two universities, one Brazilian and the other Portuguese. The Instrument of Assessment for Health Promotion at University was used in both institutions and the comparisons were performed with the Chi-square test and odds ratio estimation.

Results:

there was a predominance of students aged up to 24 years (89.2%) and females (78.3%). In general, Portuguese university students have better perceptions of the physical activity, eating habits and psychosocial factors domains ( p < 0.001). Brazilian university students presented better perceptions in the domains of environmental factors and complementary and alternative therapies ( p < 0.001).

Conclusions:

the results show that Brazilian and Portuguese students have significant differences in their perception of aspects related to health promotion at university. It is concluded that the university environment is a promising field to carry out educational practices that promote health and that this context differs between countries.
Topographical Characterization of the Young, Healthy Human Femoral Medial Condyle
Authors: Salinas Evelia Y. , Otarola Gaston A. , Kwon Heenam , Wang Dean , Hu Jerry C. , Athanasiou Kyriacos A.
Published: December 2022

Objective

The medial femoral condyle of the knee exhibits some of the highest incidences of chondral degeneration. However, a dearth of healthy human tissues has rendered it difficult to ascertain whether cartilage in this compartment possesses properties that predispose it to injuries. Assessment of young, healthy tissue would be most representative of the tissue’s intrinsic properties.

Design

This work examined the topographical differences in tribological, tensile, and compressive properties of young (n = 5, 26.2 ± 5.6 years old), healthy, human medial femoral condyles, obtained from viable allograft specimens. Corresponding to clinical incidences of pathology, it was hypothesized that the lowest mechanical properties would be found in the posterior region of the medial condyle, and that tissue composition would correspond to the established structure-function relationships of cartilage.

Results

Young’s modulus, ultimate tensile strength, aggregate modulus, and shear modulus in the posterior region were 1.0-, 2.8-, 1.1-, and 1.0-fold less than the values in the anterior region, respectively. Surprisingly, although glycosaminoglycan content is thought to correlate with compressive properties, in this study, the aggregate and shear moduli correlated more robustly to the amount of pyridinoline crosslinks per collagen. Also, the coefficient of friction was anisotropic and ranged 0.22-0.26 throughout the condyle.

Conclusion

This work showed that the posteromedial condyle displays lower tensile and compressive properties, which correlate to collagen crosslinks and may play a role in this region’s predisposition to injuries. Furthermore, new structure-function relationships may need to be developed to account for the role of collagen crosslinks in compressive properties.
Enterprising Academics: Heterarchical Policy Networks for Artificial Intelligence in British Higher Education
Authors: Gellai Dániel Béla
Published: December 2022

Purpose

There is limited scholarship on artificial intelligence (AI) in higher education governance, despite the growing prevalence of AI-powered technologies in many fields, including education. However, as the technology is still nascent and has yet to reach its full potential, ideas and arguments abound, championing or cautioning against the use of these technologies.

Design/Approach/Methods

To fill this gap in research on policy networks and AI in British higher education, this article employs network ethnography and discourse analysis to study how ideas about AI-powered technologies in higher education circulate in policy networks in the United Kingdom.

Findings

The findings evidence a policy network showing signs of a heterarchy permeated by neoliberal rationales and populated by policy actors actively promoting artificial intelligence technologies to be used in education.

Originality/Value

This paper builds on existing research by looking at the university and not-for-profit sectors, in addition to the governmental and educational technology sectors. Using network ethnography, this article expands our understanding of the policy actors involved and critically analyzes ideas regarding the use of AI in education.
Normothermic Versus Hypothermic Norwood Procedure
Authors: Keizman Eitan , Mishaly David , Ram Eilon , Urtaev Soslan , Tejman-Yarden Shai , Tirosh Wagner Tal , Serraf Alain E
Published: December 2022

Background

Either deep hypothermia with circulatory arrest or hypothermic perfusion with antegrade selective cerebral perfusion is used during the Norwood procedure for hypoplastic left heart syndrome. Normothermic perfusion has been described for pediatric patients. The aim of this study was to compare the early outcomes of patients undergoing the Norwood procedure with antegrade selective cerebral perfusion under hypothermia with the procedure under normothermia.

Methods

From 2005 to 2020, 117 consecutive patients with hypoplastic left heart syndrome underwent the Norwood procedure: 68 (58.2%) under hypothermia and 49 (41.8%) under normothermia. Antegrade selective cerebral perfusion flow was adjusted to maintain right radial arterial pressure above 50 mm Hg, and a flow rate of 40 to 50 mL kg−1 min−1. Baseline characteristics, operative data, and postoperative outcomes including lactate recovery time were compared.

Results

The baseline characteristics and cardiovascular diagnosis were similar in both groups. The normothermic group had a significantly shorter bypass time (in minutes) of 90.31 (±31.60) versus 123.63 (±25.33), a cross-clamp time of 45.24 (±16.35) versus 81.93 (±16.34), and an antegrade selective cerebral perfusion time of 25.61 (±13.84) versus 47.30 (±14.35) ( P < .001). There were no statistically significant differences in the immediate postoperative course, or in terms of in-hospital mortality, which totaled 9 (18.4%) in the normothermic group, and 10 (14.9%) in the hypothermic group ( P = .81).

Conclusion

The normothermic Norwood procedure with selective cerebral perfusion is feasible and safe in terms of in-hospital mortality and short-term outcomes. It is comparable to the standard hypothermic Norwood with selective cerebral perfusion.
Understanding Philosophies of Higher Education between Countries in China’s Belt and Road Initiative: Analysis of University Mottos Based on Natural Language Processing Technology
Authors: Wang Hengli , Lu Qiuyun
Published: December 2022

University mottos have been demonstrated to convey educational philosophies, but few studies have investigated the educational philosophies reflected by university mottos from countries along the “One Belt, One Road” (OBOR) route, with applying the analytical approaches like text mining and natural language processing (NLP). This present investigation constructed a database of university mottos from 1,535 universities in 61 countries along the OBOR route and applied NLP technology to explore the similarities and differences of educational philosophies among the universities along the OBOR route. Methods of NLP used in this article included text mining, cluster analysis, and Latent Dirichlet Allocation (LDA) topic model. The social network analysis (SNA) model was used to further analyze the interconnection and exchange of educational philosophies expressed through university mottos. Based on the five identified topic categories, we concluded that countries along the OBOR route have the same basic educational philosophy for higher education but have different emphases due to cultural differences, such as the different emphases on virtue education, collectivism, and individualism. Education for sustainability is another focus of higher education philosophy reflected by the topic categories of university mottos, which is consistent with the United Nations Sustainable Development Goals, for example, quality education. In addition to demonstrating the BRI impact on educational philosophies of countries along the OBOR route, this present investigation could also contribute to the growing body of knowledge about international cooperation and communication of higher education under the framework of BRI, for a globalized, shared and sustainable education in the post-COVID era.
Implicit Semantic Role of Material on the Quality of Living Space Using Semantic Differential Technique
Authors: Hatami Zade Negin , Yazdanfar Seyed-Abbas , Norouzian-Maleki Saeid
Published: December 2022

Living spaces have been recognized as one of the functional spaces of housing. Materials and textures are regarded as some of the features of the space. The present study sought to analyze the components of the different materials (brick, stone, glass, metal, concrete, and wood) and their semantic role in living spaces. The materials’ characteristics were coded and then semantic differentials was conducted to quantify the measurement. The significant factors of materials were defined as acceptability, motivative, capability, and resistance for brick; persistence, admiration, and purity for concrete; creativeness, resilience, and capacity for wood; fatigue and limpidity for glass; strength and durability for stone; and minimal and interweaving for metal. The results of the present study indicated that the implicit meaning of acceptability in brick was based on nostalgia, traditionality, and warmth. Furthermore, the industriality, modernity, coldness, and artificiality of concrete represented the explicitness and transparency and the industriality of glass indicated limpidity. The resilience of wood was based on stagnation, strength, and solitude. Finally, the rigidity, beauty, and coldness of stone indicated the power and strength, while simplicity, solitude, and stress-induced demonstrated the tangle of metal that can affect the application and achievement of desired living space.
Occupation as a gendered-role and outcome in systemic sclerosis
Authors: Alkhamees Fatema , Hoi Yun Yu Oriana , Wang Mianbo , Hudson Marie
Published: December 2022

Objective:

Sex and gender are of growing scientific interest in disease onset and course. While sex differences have been shown to exist in systemic sclerosis, there is a paucity of data on gender. Our objective was to examine the association between occupation, a gender-related role and outcomes in systemic sclerosis.

Methods:

An occupation score ranging from 0 to 100, with lower scores representing occupations traditionally held by men and higher scores traditionally held by women, was constructed using the National Occupational Classification 2016 and data from Statistics Canada. Subjects in the Canadian Scleroderma Research Group registry were assigned an occupation score based on self-reported occupation. Multivariate models, adjusted for sex, age, smoking and education were used to estimate the independent effect of occupation score on systemic sclerosis outcomes.

Results:

We included 1104 subjects, of which 961 were females (87%) and 143 (13%) males. There were differences between females versus males: disease duration (9.9 vs 7.6 years, p = 0.002), diffuse disease (35% vs 54%, p < 0.001), interstitial lung disease (28% vs 37%, p = 0.021) and pulmonary hypertension (10% vs 4%, p = 0.033), but not pain, response to treatment and mortality. The median occupation scores differed between females and males (84.3 (interquartile range 56.8, 89.4) vs 24.9 (4.3, 54.1), p < 0.001). The Spearman correlation between sex and occupation score was 0.44, indicating a weak correlation. In adjusted analyses, occupation score was not an independent predictor of disease subset (diffuse vs limited), interstitial lung disease, pulmonary hypertension, pain, response to treatment or mortality.

Conclusion:

We did not find independent associations between an occupation score, a gender-related role and outcomes in systemic sclerosis. These results should be interpreted with caution as occupation may be a poor measure of gender. Future research using a validated measure of gender will be needed to generate robust data on the effect of gender in systemic sclerosis.
Prediction model of poorly differentiated colorectal cancer (CRC) based on gut bacteria
Authors: Qi Zhang , Zhibo Zuo , Jing Zhuang , Zhanbo Qu , Shugao Han , Weili Jin , Jiang Liu , Shuwen Han
Published: December 2022

Background

The mortality of colorectal cancer is high, the malignant degree of poorly differentiated colorectal cancer is high, and the prognosis is poor.

Objective

To screen the characteristic intestinal microbiota of poorly differentiated intestinal cancer.

Methods

Fecal samples were collected from 124 patients with moderately differentiated CRC and 123 patients with poorly differentiated CRC, and the bacterial 16S rRNA V1-V4 region of the fecal samples was sequenced. Alpha diversity analysis was performed on fecal samples to assess the diversity and abundance of flora. The RDP classifier Bayesian algorithm was used to analyze the community structure. Linear discriminant analysis and Student's t test were used to screen the differences in flora. The PICRUSt1 method was used to predict the bacterial function, and six machine learning models, including logistic regression, random forest, neural network, support vector machine, CatBoost and gradient boosting decision tree, were used to construct a prediction model for the poor differentiation of colorectal cancer.

Results

There was no significant difference in fecal flora alpha diversity between moderately and poorly differentiated colorectal cancer (P > 0.05). The bacteria that accounted for a large proportion of patients with poorly differentiated and moderately differentiated colorectal cancer were Blautia, Escherichia-Shigella, Streptococcus, Lactobacillus, and Bacteroides. At the genus level, there were nine bacteria with high abundance in the poorly differentiated group, including Bifidobacterium, norank_f__Oscillospiraceae, Eisenbergiella, etc. There were six bacteria with high abundance in the moderately differentiated group, including Megamonas, Erysipelotrichaceae_UCG-003, Actinomyces, etc. The RF model had the highest prediction accuracy (100.00% correct). The bacteria that had the greatest variable importance in the model were Pseudoramibacter, Megamonas and Bifidobacterium.

Conclusion

The degree of pathological differentiation of colorectal cancer was related to gut flora, and poorly differentiated colorectal cancer had some different bacterial flora, and intestinal bacteria can be used as biomarkers for predicting poorly differentiated CRC.
Maize (Zea mays L.) responses to salt stress in terms of root anatomy, respiration and antioxidative enzyme activity
Authors: Hu Dandan , Li Rongfa , Dong Shuting , Zhang Jiwang , Zhao Bin , Ren Baizhao , Ren Hao , Yao Haiyan , Wang Ziqiang , Liu Peng
Published: December 2022

Background

Soil salt stress is a problem in the world, which turns into one of the main limiting factors hindering maize production. Salinity significantly affects root physiological processes in maize plants. There are few studies, however, that analyses the response of maize to salt stress in terms of the development of root anatomy and respiration.

Results

We found that the leaf relative water content, photosynthetic characteristics, and catalase activity exhibited a significantly decrease of salt stress treatments. However, salt stress treatments caused the superoxide dismutase activity, peroxidase activity, malondialdehyde content, Na+uptake and translocation rate to be higher than that of control treatments. The detrimental effect of salt stress on YY7 variety was more pronounced than that of JNY658. Under salt stress, the number of root cortical aerenchyma in salt-tolerant JNY658 plants was significantly higher than that of control, as well as a larger cortical cell size and a lower root cortical cell file number, all of which help to maintain higher biomass. The total respiration rate of two varieties exposed to salt stress was lower than that of control treatment, while the alternate oxidative respiration rate was higher, and the root response of JNY658 plants was significant. Under salt stress, the roots net Na+and K+efflux rates of two varieties were higher than those of the control treatment, where the strength of net Na+efflux rate from the roots of JNY658 plants and the net K+efflux rate from roots of YY7 plants was remarkable. The increase in efflux rates reduced the Na+toxicity of the root and helped to maintain its ion balance.

Conclusion

These results demonstrated that salt-tolerant maize varieties incur a relatively low metabolic cost required to establish a higher root cortical aerenchyma, larger cortical cell size and lower root cortical cell file number, significantly reduced the total respiration rate, and that it also increased the alternate oxidative respiration rate, thereby counteracting the detrimental effect of oxidative damage on root respiration of root growth. In addition, Na+uptake on the root surface decreased, the translocation of Na+to the rest of the plant was constrained and the level of Na+accumulation in leaves significantly reduced under salt stress, thus preempting salt-stress induced impediments to the formation of shoot biomass.
Long-standing diabetes mellitus increases concomitant pancreatic cancer risk in patients with intraductal papillary mucinous neoplasms
Authors: Yamaguchi Atsushi , Tazuma Susumu , Tamaru Yuzuru , Kusunoki Ryusaku , Kuwai Toshio , Kouno Hirotaka , Toyota Naoyuki , Sudo Takeshi , Kuraoka Kazuya , Kohno Hiroshi
Published: December 2022

Background

When monitoring patients with an intraductal papillary mucinous neoplasm (IPMN), it is important to consider both IPMN-derived carcinoma and concomitant ductal adenocarcinoma (PDAC). The latter is thought to have a poorer prognosis. We retrospectively analyzed the risk factors for concomitant PDAC in IPMN.

Methods

In total, 547 patients with pancreatic cysts, including IPMNs inappropriate for surgery on initial diagnosis, encountered from April 2005 to June 2019, were reviewed. We performed surveillance by imaging examination once or twice a year.

Results

Five IPMNs with high-grade dysplasia and one IPMN associated with invasive carcinoma were encountered. In comparison, 14 concomitant PDACs were encountered. The prognosis was very poor for concomitant PDACs. All 14 PDAC patients had IPMNs. In patients with IPMNs, long-standing diabetes mellitus was the only significant risk factor for concomitant PDAC in both univariate and multivariate analyses (P < 0.001 and P < 0.01, respectively). Furthermore, patients with IPMNs and diabetes mellitus had a high frequency of concomitant PDACs (9.5%, 9/95) in a median 48-month surveillance period.

Conclusions

When monitoring IPMNs, the development of not only IPMN-derived carcinomas but also concomitant PDACs should be considered. During this period, it may be prudent to concentrate on patients with other risk factors for PDAC, such as long-standing diabetes mellitus.
The hsa_circ_0039857/miR-338-3p/RAB32 axis promotes the malignant progression of colorectal cancer
Authors: Xu Pei , Cheng Siying , Wang Xianwei , Jiang Shuming , He Xiaoyan , Tang Lina , Wu Ning , Yang Zhirong
Published: December 2022

Background

Colorectal cancer (CRC) is a prevalent malignancy of the gastrointestinal. Circular RNAs (circRNAs) act as important roles in CRC malignant progression. However, the role of circ_0039857 in CRC is still unclear. Therefore, this study aimed to explore the function and mechanism of hsa_circ_0039857 in the CRC.

Methods

The mRNA and protein expression were measured via RT-qPCR. RNase R assay and Actinomycin D were employed to evaluate the stability of circ_0039857. Functional experiments, such as proliferation and apoptosis, were applied to study the function of circ_0039857 in CRC cells. The underlying mechanisms of circ_0039857 were then analyzed by bioinformatics, dual-luciferase reporter gene assay, RNA pull-down and rescue experiments.

Results

We revealed that circ_0039857 was significantly enhanced in CRC. Circ_0039857 was stabler than linear RNA in cells and valuable for the disease diagnosis. In addition, circ_0039857 knockdown inhibited proliferation and promoted apoptosis. Mechanistically, circ_0039857 positively regulated the expression of RAB32 via sponging miR-338-3p.

Conclusion

This study demonstrated that circ_0039857 knockdown suppressed CRC malignant progression through miR-338-3p/RAB32 axis. Most importantly, this will help us to better understand the circRNA network in CRC, and may find potential biomarkers and targets for CRC clinical treatment.
Goldmann and modified Goldmann tonometry measuring intraocular pressure changes in eyes which underwent myopic laser in situ Keratomileusis and photorefractive keratectomy
Authors: Ang Robert Edward T. , Rixon Andrew , Kilgore Khin , Schweitzer Justin
Published: December 2022

Purpose

Compare intraocular pressure (IOP) measured by a standard Goldmann applanation tonometer prism (IOPg) and a modified correcting applanation tonometer surface Goldmann prism (IOPc) before and after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK).

Methods

Goldmann tonometry was analyzed in a retrospective, cross-sectional study, using both GAT and modified-GAT prisms pre-operatively and at the 3 month post-operative appointment on 120 eyes (64 patients) who received LASIK (n = 58) or PRK (n = 62). Demographics, central corneal thickness (CCT), manifest refraction and corneal curvature (CC) data was collected at each visit as well as surgical parameters, including maximum ablation depth.

Results

Mean paired IOP following LASIK decreased by − 3.28 ± 3.2 mmHg measured by IOPg and − 1.93 ± 3.3 mmHg by IOPc (p ≤ 0.0001). Mean paired IOP following PRK reduced by − 1.92 ± 3.6 mmHg measured by IOPg and − 1.06 ± 3.6 mmHg by IOPc (p ≤ 0.0001). Increased LASIK ablation depth and post-procedural change in CCT trended toward a statistically significant reduction in IOPg (p = 0.07,p = 0.12), but not IOPc (p = 0.18,p = 0.32). PRK ablation depth was not associated with a reduction in IOPg or IOPc.

Discussion

The modified Goldmann (IOPc) prism measured less of an IOP reduction following LASIK and PRK compared to the standard (IOPg) prism, and the IOP reduction with both prisms was associated with the degree of myopic correction.

What is already known and the residual query

Corneal refractive surgery generally demonstrates significant postoperative Goldmann IOP reductions. Presumably, this is due to corneal biomechanical changes for which a newer method of Goldmann IOP measurement may be able to compensate.

What this study adds

A modified, corneal conforming Goldmann prism demonstrates significantly less IOP reduction following myopic LASIK and PRK compared to the standard flat Goldmann prism.

How this study might affect research, practice or policy

A newer, modified Goldmann prism may help detect glaucoma and OHT at an earlier stage in patients which have undergone LASIK or PRK. The findings corroborate predicted corneal biomechanical changes following the most common corneal refractive procedures.
Does maturity estimation, 2D:4D and training load measures explain physical fitness changes of youth football players?
Authors: Silva Rui Miguel , Clemente Filipe Manuel , González-Fernández Francisco , Nobari Hadi , Haghighi Hamed , Cancela Carral José Ma.
Published: December 2022

Objectives

The purpose of the present study was two-fold: (1) To analyse physical fitness changes of youth football players after a full-season; and (2) to examine whether physical fitness changes are explainable by estimated maturity status, 2digit:4digit ratio (2D:4D) from each hand and training load (TL) measures.

Methods

Twenty-seven youth elite Under-15 football players were daily monitored for training load measures during 38 weeks. At the beginning and at the end of the season, all players were assessed for physical fitness. Also, the maturity status estimation and the length of the second and fourth digits of both hands were collected at the beginning of the season.

Results

Significant differences were found for all physical fitness measures after the season. The second and fourth digits of left and right hands had negative moderate correlations with change of direction (COD) changes (r=-.39 to − 0.45 |p = .05 to 0.02). Also, the maturity offset measure had negative moderate correlations with COD changes (r=-.40 |p = .04). From the reported significant correlations, the maturity offset, Left 4D, Right 2D and Right 4D significantly predicted the Mod.505 COD test changes (β = 0.41,p = .04; β = -0.41,p = .04; β = -0.45,p = .02; and β = -0.44,p = .03, respectively).

Conclusion

The maturity offset and the 2D:4D measures have the potential to predict COD performance changes over-time in youth football players. Given the lack of associations between the maturity estimation, 2D:4D and training load measures, with the overall physical fitness measures, coaches should rely only at COD changes.
Disrupted topological organization of functional brain networks in Alzheimer’s disease patients with depressive symptoms
Authors: Guo Zhongwei , Liu Kun , Li Jiapeng , Zhu Haokai , Chen Bo , Liu Xiaozheng
Published: December 2022

Background

Depression is a common symptom of Alzheimer’s disease (AD), but the underlying neural mechanism is unknown. The aim of this study was to explore the topological properties of AD patients with depressive symptoms (D-AD) using graph theoretical analysis.

Methods

We obtained 3-Tesla rsfMRI data from 24 D-AD patients, 20 non-depressed AD patients (nD-AD), and 20 normal controls (NC). Resting state networks were identified using graph theory analysis. ANOVA with a two-samplet-test post hoc analysis in GRETNA was used to assess the topological measurements.

Results

Our results demonstrate that the three groups show characteristic properties of a small-world network. NCs showed significantly larger global and local efficiency than D-AD and nD-AD patients. Compared with nD-AD patients, D-AD patients showed decreased nodal centrality in the pallidum, putamen, and right superior temporal gyrus. They also showed increased nodal centrality in the right superior parietal gyrus, the medial orbital portion of the right superior frontal gyrus, and the orbital portion of the right superior frontal gyrus. Compared with nD-AD patients, NC showed decreased nodal betweenness in the right superior temporal gyrus, and increased nodal betweenness in medial orbital part of the right superior frontal gyrus.

Conclusions

These results indicate that D-AD is associated with alterations of topological structure. Our study provides new insights into the brain mechanisms underlying D-AD.
How effective is the health promotion policy in Sichuan, China: based on the PMC-Index model and field evaluation
Authors: Yang Yanlin , Tang Jing , Li Zhixin , Wen Jin
Published: December 2022

Background

Many countries around the world highlight the health in all policies (HiAP). However, most of the related research focused on the influential factors and implementation strategies, with less concern on the evaluation of HiAP. In response to HiAP's call, the Chinese government has proposed health promotion policies (HPPs) in counties or districts, the evaluation of HPPs in sample counties or districts of Sichuan province in China is an essential basis for optimizing policy content, improving policy implementation, and ensuring health promotion's continuous and efficient operation.

Methods

This paper established an evaluation system for HPPs based on the PMC-Index model and then quantitatively analyzed 37 representative HPPs from the pilot areas in Sichuan province. In addition, a team of experts conducted a field assessment.

Results

The results showed that the average PMC index of 37 HPPs was 7.091, and correlation analysis showed that there was a significant correlation between the PMC index and expert score.

Conclusions

This study indicates that the overall consistency of HPPs was good and proves a connection between the formulation and implementation of HPPs.
Predictors of peri-implant bone remodeling outcomes after the osteotome sinus floor elevation: a retrospective study
Authors: Wang Xingxing , Sun Lijuan , Wang Lei , Shi Shaojie , Zhang Sijia , Song Yingliang
Published: December 2022

Background

This study aimed to evaluate the radiographic outcomes of implants after osteotome sinus floor elevation (OSFE), and further identify the separate predictors for these radiographic outcomes.

Methods

In this retrospective cohort study, a total of 187 implants were inserted into 138 patients using the OSFE technique. Seventy-four patients in the grafted group, and 64 patients in the non-grafted group completed this study. The vertical bone gain (VBG) and marginal bone loss (MBL) at 3 years following surgery were assessed as outcome variables. Based on extensive literature results, variables considered potential predictors of outcome variables included sex, age, tooth position, implant length, implant diameter, with or without grafting materials, residual bone height, sinus width, bone density, and sinus membrane thickness. Subsequently, the binary logistic regression analysis was applied with VBG and MBL as dependent variables, respectively. The receiver operating characteristic curve (ROC) with its area under the curve (AUC) was performed to further determine the predictive value of these predictors.

Results

One hundred and six implants in grafted group and 81 implants in the non-grafted group were analyzed. The average VBG was 2.12 ± 1.94 mm for the grafted group and 0.44 ± 1.01 mm for the non-grafted group at 3 years (P < 0.05). The mean MBL was 1.54 ± 1.42 mm for the grafted group and 1.13 ± 1.69 mm for the non-grafted group at 3 years (P > 0.05). After the adjustment for confounders, logistic regression analysis demonstrated that implant length, grafting, residual bone height, and sinus membrane thickness were predictors of VBG. The odds ratio for VBG was 3.90, 4.04, 4.13 and 2.62, respectively. Furthermore, grafting exhibited the largest AUC at 0.80. While tooth position and implant length were predictors of MBL, the odds ratio for MBL was 3.27 and 7.85, respectively. Meanwhile, implant length exhibited the largest AUC at 0.72.

Conclusions

OSFE with or without simultaneous grafting materials both showed predictable clinical outcomes. Additionally, the present study is the first quantitative and significant verification that VBG has a significant association with sinus membrane thickness, as well as residual bone height, implant length and grafting. Whereas tooth position and implant length are markedly associated with MBL.
PA applicant U.S. citizenship status and likelihood of program matriculation
Authors: Showstark Mary , Bessette Michael , Barry Carey L. , Najmabadi Shahpar , Rolls Joanne , Hamilton Catherine , Valentin Virginia L. , Quella Alicia , Honda Trenton
Published: December 2022

Background

Barriers to matriculation into Physician Assistant (PA) programs and entry into the PA profession have disproportionate impact on historically marginalized groups. This study evaluates if U.S. citizenship status is associated with likelihood of matriculation in PA Programs.

Methods

Data from five Centralized Applicant Services for Physician Assistants (CASPA) admissions cycles (2012-2021) was evaluated cross-sectionally for the primary outcome of binary matriculation status (yes/no). Bivariate and multivariate logistic regression was utilized to investigate associations between self-identified U.S. citizenship status and likelihood of PA program matriculation. Models controlled for important potential confounders, including age, gender, race/ethnicity, non-native English speaker, patient care experience hours, total undergraduate grade point average (GPA), and number of applications submitted to various programs.

Results

Non-U.S. citizen status was statistically associated with persistent lower likelihood of PA program matriculation compared to U.S. citizenship. Odds of matriculation were 41% [OR 0.59 (95% CI: 0.51, 0.68; p <.001)] to 51% [OR 0.49 (95% CI: 0.41, 0.58; p <.001)] lower in unadjusted models. Odds were 32% [OR 0.68 (95% CI: 0.56, 0.83; p <.001)] to 42% OR 0.58 (95% CI: 0.48, 0.71; p <.001) lower when adjusting for important covariates. The lowest likelihood occurred in 2012-2013 with 51% lower odds of matriculation and in 2016-2017 with 42% lower odds when accounting for important covariates.

Discussion

PA programs are charged with improving diversity of clinically practicing PAs to improve health outcomes and better reflect patient populations. This analysis shows that non-U.S. citizenship may be a barrier to PA school acceptance. PA schools should raise awareness and create means and accessibility for admissions for this underrepresented group.
Availability of stroke services and hospital facilities at different hospital levels in Thailand: a cross-sectional survey study
Authors: Kumluang Suthasinee , Geue Claudia , Langhorne Peter , Wu Olivia
Published: December 2022

Background

Stroke has one of the biggest burden of disease in Thailand and all health regions have been tasked to develop their service delivery to achieve the national key performance indicators set out by the Thai service plan strategy 2018–2022. Our aim was to characterise stroke services and hospital facilities by investigating differences in facilities across different hospital levels in Thailand.

Methods

Self-complete questionnaires were distributed to 119 hospitals in 12 health regions between November–December 2019. Participants were health professionals whose main responsibilities are related to stroke service provision in their hospital. Descriptive statistics were used to report differences of stroke service provision between advanced-level, standard-level and mid-level referral hospitals.

Results

Thirty-eight (32% response rate) completed questionnaires were returned. All advanced-level, standard-level (100%) and 55% of mid-level referral hospitals provided stroke units. Neurologists were available in advanced-level (100%) and standard-level referral hospitals (50%). Standard-level and mid-level referral hospitals only had a quarter of rehabilitation physicians compared to advanced-level referral hospital. Home-based rehabilitation was provided at 100% in mid-level but only at 16% and 50% in advanced-level and standard-level referral hospitals.

Conclusions

Setting up a stroke unit, as a national goal that was set out in the service plan strategy 2018–2022, was achieved fully (100%) in advanced-level and standard-level referral hospitals including key essential supportive components. However, capacity in hospitals was found to be limited and stroke service delivery needs to be improved especially at mid-level referral hospitals. This should include regular organisational surveys and the use of electronic records to facilitate monitoring of clinical/health outcomes of patients.
Population-based cohort study: proton pump inhibitor use during pregnancy in Sweden and the risk of maternal and neonatal adverse events
Authors: Breddels Esmee M. , Simin Johanna , Fornes Romina , Lilja Engstrand Helene , Engstrand Lars , Bruyndonckx Robin , Brusselaers Nele
Published: December 2022

Background

Approximately half of all women suffer from heartburn at some stage during pregnancy. The most effective treatment is proton pump inhibitors, but the safety of use during pregnancy cannot be guaranteed. This study aimed to elucidate the effect of proton pump inhibitors on the risk of pre-eclampsia, gestational diabetes mellitus, preterm birth, an Apgar score at 5 min below 7, and a child being small or large for its gestational age.

Methods

This Swedish population-based study included 1,089,514 live singleton deliveries between July 2006 and December 2016 in Sweden. Multiple logistic regression was used to model the outcomes as a function of the covariates. Results were presented as odds ratios with 95% confidence intervals.

Results

In 1.4% of all pregnancies, the mother used proton pump inhibitors in the period from 3 months before the last menstrual period up to delivery. The use of proton pump inhibitors was associated with higher odds of pre-eclampsia (odds ratio = 1.19, 1.10–1.29), gestational diabetes mellitus (odds ratio = 1.29, 1.16–1.43), preterm birth (odds ratio = 1.23, 1.14–1.32), and small for gestational age (odds ratio = 1.27, 1.16–1.40) and lower odds of large for gestational age (odds ratio = 0.84, 0.77–0.91). No significant association was found with a low Apgar score 5 min after birth.

Conclusions

Proton pump inhibitor use was associated with a higher risk of pre-eclampsia, gestational diabetes, preterm birth, and being born small for gestational age.
Physician emigration from Nigeria and the associated factors: the implications to safeguarding the Nigeria health system
Authors: Onah Cosmas Kenan , Azuogu Benedict Ndubueze , Ochie Casmir Ndubuisi , Akpa Christian Obasi , Okeke Kingsley Chijioke , Okpunwa Anthony Okoafor , Bello Hassan Muhammad , Ugwu George Onyemaechi
Published: December 2022

Background

Adequate Human Resources for Health is indispensable to achieving Universal Health Coverage and physicians play a leading role. Nigeria with low physician–population ratio, is experiencing massive exodus of physicians. This study investigated emigration intention of physicians, the factors influencing it and discussed the implications to guide policy formulation and reforms, curtail the trend and safeguard the country’s health system.

Methods

Through cross-sectional survey, 913 physicians from 37 States were interviewed with semi-structured questionnaire using Google form shared via WhatsApp and Telegram forums of Nigeria Medical Association. Data were analysed with IBM-SPSS version-25 and charts were created with Microsoft-Excel. Chi-square and multiple regression tests were done with p-value set at 0.05.

Results

The mean age of respondents is 37.6 ± 7.9 years; majority of them are males (63.2%), married (75.5%) with postgraduate qualifications (54.1%) and working in public health facilities (85.4%). Whereas 13% and 19.3% are, respectively, satisfied with their work and willing to continue practice in Nigeria, 43.9% want to emigrate and 36.8% are undecided about future location of their practice. The commonest reasons for emigration are poor remuneration (91.3%), rising insecurity (79.8%) and inadequate diagnostic facilities (61.8%). Physicians working in public health facilities are 2.5 times less satisfied than their counterparts in non-public sector (AOR = 0.4; 95% CI = 0.3–0.8). Physicians in their thirties, forties and fifties are 3.5 (95% CI = 1.5–8.0), 5.5 (95% CI = 2.1–14.5) and 13.8 (95% CI = 3.9–49.3) times, respectively, more willing to retain practice in Nigeria than those younger and those satisfied with their work are 4.7 (AOR = 4.7, 95% CI = 2.9–7.4) times more willing to practice in Nigeria than those not satisfied.

Conclusion

Majority of Nigerian physicians want to emigrate for professional practice and top among the push factors are poor remuneration, rising insecurity and inadequate diagnostic facilities. The observed trend portends danger to the country’s health system due to the foreseeable negative consequences of physician deficit to the system. We recommend upward review of physician remuneration, a root cause analysis of insecurity to determine workable preventive measures and increased funding of the health sector to improve the diagnostic infrastructure, retain physicians and save the health system from imminent collapse.
Health facility users’ knowledge, perceptions, and practices about infant feeding in the context of option B+ in South Africa: a qualitative study
Authors: Nsibande Duduzile Faith , Magasana Vuyolwethu , Zembe Wanga , Kindra Gurpreet , Mogashoa Mary , Goga Ameena , Ramokolo Vundli
Published: December 2022

Background

HIV and sub-optimal infant feeding practices remain important threats to child growth, development, and survival in low- and middle-income countries. To our knowledge, few studies have explored health service users’ perspective of infant feeding in the context of WHO Option B+ policy to prevent vertical HIV transmission (PMTCT). This paper is a sub-analysis of qualitative data from a mixed-methods multi-level process evaluation of Option B+ implementation in South Africa (SA). In this study we explored health facility users’ infant feeding knowledge, perceptions, and practices one year after SA adopted the 2016 updated World Health Organization prevention of mother-to-child transmission of HIV Option B+ infant feeding guidelines.

Methods

Nineteen focus group discussions (FGDs) were held with six groups of men and women whose infants were aged < 6 months. Participants were attending randomly selected primary health care facilities within six purposively selected priority districts. The six groups included in the FGDs were: (i) adolescent girls and young women living with HIV (WHIV), (ii) adolescent girls and young women not living with HIV (WNHIV), (iii) older postnatal WHIV (iv) older postnatal WNHIV (v) pregnant women, and (vi) men. Data collection took place between April and December 2018. Data analysis involved coding and thematic framework analysis.

Results

Women and men have suboptimal knowledge of the recommended breastfeeding duration and exclusive breastfeeding, especially for HIV-exposed infants. Most women received sub-optimal infant feeding counselling and mixed messages from health care workers. Fewer WHIV initiated breastfeeding at birth compared to WNHIV. Most parents believed that HIV-exposed infants should be breastfed for 6 months and many postnatal women on antiretroviral drugs and younger mothers lacked confidence to breastfeed beyond 6 months. Mixed feeding was predominant among all women due to individual, family, and socio-structural barriers. Many men were supportive on infant feeding; however, they lacked the appropriate information and skills to influence their partners’ infant feeding decisions.

Conclusions

Differences in breastfeeding practices between WHIV and WNHIV are highly influenced by the lack of knowledge of infant feeding policy recommendations. Multiple-level factors deter many mothers from adhering to recommended guidelines. Appropriate ongoing infant feeding counselling and breastfeeding support are required for women and their partners.
Ductus arteriosus banding to regulate excessive pulmonary blood flow in a neonate with necrotizing enterocolitis and complex congenital heart disease, including pulmonary atresia and total anomalous pulmonary venous return: a case report
Authors: Oyasu Takayoshi , Hayakawa Mineji , Ebuoka Noriyoshi , Oba Junichi
Published: December 2022

Background

Patients with right isomerism have accompanying complex congenital heart disease, which is characterized by pulmonary atresia and total anomalous pulmonary venous return. Balanced regulation of the systemic and pulmonary circulation is essential for successful management, especially for cases complicated with necrotizing enterocolitis (NEC).

Case presentation

A 6-day-old male neonate with a single ventricle, pulmonary atresia, patent ductus arteriosus (DA), and total anomalous pulmonary venous return associated with right isomerism was admitted because of dyspnea, cyanosis, and melena. The patient presented circulatory incompetence due to excessive pulmonary blood flow, resulting in NEC. The patient underwent DA banding and colectomy following continuous intravenous infusion of prostaglandin E1 at six days. Subsequently, his condition improved, reaching a systemic oxygen saturation of around 80%. He underwent a bidirectional Glenn procedure and closure of colectomy at the ages of 5 and 6 months, respectively.

Conclusion

DA banding can be an alternative to placing an aortopulmonary shunt, which is conventional in patients with ductus-dependent pulmonary circulation, because DA banding is feasible without cardiopulmonary bypass.