bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility and Usability of EnergyPoints: A Mobile Health App to Guide Acupressure Use for Cancer Symptom Management
Authors: Beck Susan L. , Smith Ryan , Mindes Janet , Beck Karl , Leah Kim JungYoon , Weitzman Matthew , Stone Jennifer A. M. , Veleber Susan , Dudley William N.
Published: January 2024

Objective:

To examine the feasibility and usability of EnergyPoints™, an innovative mobile health app that teaches and guides people with cancer to implement daily acupressure to self-manage their fatigue and sleep disturbances.

Methods and Intervention:

The study used an integrated agile, human-centered approach. Adults (age 18 years and over) with cancer experiencing at least moderate fatigue, and living in the Greater New York City community, were recruited from social media, patient advocacy groups, and referrals. Twenty participants (in 3 sprints of 3, 5, and 12) were video-recorded thinking aloud while using the app for the first time. They then used the app at home to self-administer acupressure (twice daily for 1 week) while continuously wearing a fitness tracker. Each participant completed an exit interview and modified Computer System Usability Questionnaire post-participation.

Results:

Participants were ages 40 to 76 years and 65% female; 65% were non-Hispanic white. Mean pass rates per ritual exceeded 80%. Users completed (totally or partially) greater than 90% of stimulating acupressure and 70% of relaxing acupressure rituals. Sprint 3 SPs totally completed at least 1 ritual 87% of the time. The majority agreed or strongly agreed the app was easy to use (90%), easy to learn (85%), easy to understand (75%), and effective in helping perform self-acupressure (85%). In an analysis of ease of completing 5 key tasks, all successfully completed the tasks; 3 users required some assistance. Of 654 usability statements, those coded as personal experience/context (197), content related to acupressure learning (105), and content related to the onboarding/profile (71) were most frequent. The design team integrated recommendations into the app before the next sprint.

Conclusions:

Findings supported feasibility and usability, as well as acceptability, and led to significant alterations and improvements. EnergyPoints™ offers an opportunity to mainstream acupressure and help cancer survivors self-manage their symptoms.
Effectiveness of an Intensive, Functional, and Gamified Rehabilitation Program on Upper Limb Function in People With Stroke (EnteRtain): A Multicenter Randomized Clinical Trial
Authors: Ali A. Sulfikar , Kumaran D. Senthil , Unni Amritha , Sardesai Sanjukta , Prabhu Vasudeva , Nirmal Punitha , Pai Aparna R. , Guddattu Vasudeva , Arumugam Ashokan
Published: January 2024

Background1

Despite a growing interest in gaming rehabilitation for upper limb (UL) recovery post-stroke, studies investigating the effects of game-based rehabilitation incorporating functional games are lacking.

Objective

To investigate the efficacy of an intensive, functional, gamified rehabilitation program compared to task-based training on UL motor function in acute/sub-acute stroke survivors.

Methods

This randomized, multicenter, single-blind, clinical trial comprises 120 participants with unilateral stroke who were randomized to receive either gamified training (n = 64) using the ArmAble™ [experimental group (EG)] or task-based training (n = 56) in conjunction with conventional therapy for 2 hours per day, 6 days per week for 2 weeks, followed by UL rehabilitation for another 4 weeks at home. Primary outcomes evaluated by a blinded assessor included the Fugl-Meyer Assessment-Upper Extremity (FM-UE), and Action Research Arm Test (ARAT). Data were analyzed using a linear mixed-effect regression model.

Results

The mean (standard deviation) age of the participants was 54.4 ± 11.7 years (78.1% men) in the EG and 57.7 ± 10.9 years (73.2% men) in the comparator group (CG). The median (interquartile range) time since stroke was 30.0 (54.0) days in the EG and 22.5 (45.0) days in the CG. Following the 2-week intervention, a statistically significant improvement was observed in the EG for the FM-UE [between-group mean differences (95% confidence interval): −3.9 (−6.5, −1.3); P = .003]; but not for the ARAT [−2.9 (−5.8, 0.0); P = .051]. Gains at 6 weeks were significantly greater in the EG for both FM-UE [−3.9 (−6.5, −1.3); P = .003]; and ARAT [−3.0 (−5.9, −0.0); P = .046].

Conclusion

Gamified rehabilitation using the ArmAble™ device has shown immediate and short-term improvement in UL function after acute/sub-acute stroke.

Clinical Trials Registry Number:

CTRI/2020/09/027651
Impact of Frailty in Patients Undergoing Minimally Invasive Mitral Valve Surgery
Authors: Wisniewski Alex M. , Young Steven D. , Do-Nguyen Chi Chi , Hawkins Robert B. , Romano Matthew P. , Teman Nicholas R. , Ailawadi Gorav
Published: January 2024

Objective:

Psoas muscle size is a reliable marker of sarcopenia and frailty that correlates with adverse outcomes after cardiac surgery. However, its use in mitral and minimally invasive cardiac surgery is lacking. We sought to determine whether frailty, as measured by psoas muscle index, increases surgical risk for minimally invasive mitral valve surgery.

Methods:

Patients undergoing isolated minimally invasive mitral surgery via right minithoracotomy were identified. Patients who underwent maze, tricuspid intervention, and those who were emergent were excluded. Total psoas muscle area was calculated using the average cross-sectional area at the L3 vertebra on computed tomography scan and indexed to body surface area. Sarcopenia was defined as <25th gender-specific percentile. Patients were stratified by sarcopenia status and outcomes compared.

Results:

Of 287 total patients, 192 patients met inclusion criteria. Sarcopenic patients were 6 years older (66 vs 60 years, P = 0.01), had lower preoperative albumin levels (4.0 vs 4.3 g/dL, P < 0.001), and had higher Society of Thoracic Surgeons risk of morbidity/mortality (13.1% vs 9.0%, P = 0.003). Operative major morbidity or mortality was 6.4% versus 5.5% ( P = 0.824), while the 1-year mortality rate was 2.1% versus 0% ( P = 0.08). After risk adjustment, psoas index did not predict operative morbidity or mortality. However, sarcopenia was associated with higher odds of readmission (odds ratio = 0.74, P = 0.02).

Conclusions:

Contrary to other cardiac operations, for patients undergoing isolated minimally invasive mitral valve surgery, sarcopenia was not associated with increased perioperative risk except for higher readmission rates. Minimally invasive surgical approaches should be strongly considered as the approach of choice in frail patients.
Research encouraging off-label use of quetiapine: A systematic meta-epidemiological analysis
Authors: Grabitz Peter , Saksone Lana , Schorr Susanne Gabriele , Schwietering Johannes , Bittlinger Merlin , Kimmelman Jonathan
Published: January 2024

Background:

Researchers often conduct small studies on testing a drug’s efficacy in off-label indications. If positive results from these exploratory studies are not followed up by larger, randomized, double-blinded trials, physicians cannot be sure of a drug’s clinical value. This may lead to off-label prescriptions of ineffective treatments. We aim to describe the way clinical studies fostered off-label prescription of the antipsychotic drug quetiapine (Seroquel).

Methods:

In this systematic meta-epidemiological analysis, we searched EMBASE, MEDLINE, Cochrane CENTRAL and PsycINFO databases and included clinical studies testing quetiapine for unapproved indications between May 1995 and May 2022. We then assessed the frequency with which publications providing low-level evidence suggesting efficacy of quetiapine for off-label indications was not followed up by large, randomized and double-blinded trials within 5 years.

Results:

In total, 176 published studies were identified that reported potential efficacy of quetiapine in at least 26 indications. Between 2000 and 2007, publication of exploratory studies suggesting promise for off-label indications rapidly outpaced publication of confirmatory trials. In the 24 indications with a minimum of 5 years of follow-up from the first positive exploratory study, 19 (79%) were not followed up with large confirmatory trials within 5 years. At least nine clinical practice guidelines recommend the use of quetiapine for seven off-label indications in which published confirmatory evidence is lacking.

Conclusion:

Many small, post-approval studies suggested the promise of quetiapine for numerous off-label indications. These findings generally went unconfirmed in large, blinded, randomized trials years after first being published. The imbalance of exploratory and confirmatory studies likely encourages ineffective off-label treatment.
Birth setting decisions during COVID-19: A comparative qualitative study
Authors: Holdren Sarah , Crook Laura , Lyerly Anne
Published: January 2024

Background:

The COVID-19 pandemic resulted in an increased number of out-of-hospital births in the United States and other nations. While many studies have sought to understand the experiences of pregnant and birthing people during this time, few have compared experiences across birth locations.

Objective:

The purpose of this study is to compare the narratives and decision-making processes of those who gave birth in and out of hospitals during the pandemic.

Design:

We conducted semi-structured narrative interviews with 24 women who gave birth during the COVID-19 pandemic.

Methods:

Interviews were transcribed and coded, and a thematic narrative analysis was employed. Final themes and exemplary quotes were determined in discussion among the research team.

Results:

Results from narrative analysis revealed three themes that played into participants’ birth location decisions: (1) birth efficacy and values, (2) diverse definitions of safety, and (3) childcare and other logistics. In each of these themes, participants who gave birth in birthing centers, at the hospital, and at home describe their individualized approach to achieving a supportive birth environment while mitigating the risk of labor complications and COVID-19 infection.

Conclusion:

Our study suggests that for some childbearing people, the pandemic did not change birthing values or decisions but rather brought enhanced clarity to their individual needs during birth and perceived risks, benefits, and limitations of each birthing space. This study further highlights the need for improved structural support for birthing people to access a range of safe and supportive birthing environments.
Prevalence and factors influencing anemia in women of reproductive age visiting a tertiary care hospital (Jinnah Postgraduate Medical Center) in Karachi: A cross-sectional study
Authors: Ashraf Farheen , Nafees Uddin Muhammad Musab , Mustafa Muhammad Saqlain , Mughal Zaib Un Nisa , Atif Aleem Sajid
Published: January 2024

Introduction:

Anemia is a significant public health concern, primarily affecting young children, pregnant and postpartum women, and menstruating adolescent girls and women. This study aimed to evaluate the prevalence of anemia and associated factors in women of reproductive age visiting a tertiary care hospital in Karachi, Pakistan.

Objective:

The primary objective was to determine the prevalence of anemia in women of reproductive age, while the secondary objective was to investigate potential causes of anemia within this demographic group.

Design:

A prospective cross-sectional approach was employed, adhering to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. A questionnaire-based method was used to assess anemia, and data were collected from women aged 14 to 40 years.

Method:

The study was conducted at the Jinnah Postgraduate Medical Center from January to May 2023. The study was approved by the Institutional Review Board of Jinnah Sindh Medical University (Institutional Review Board reference number JSMU/IRB/2023/699). A sample of 397 women was included, and various demographic and lifestyle factors were assessed.

Results:

In this study of 397 participants, 71.5% were found to have anemia, primarily microcytic anemia (48.2%). Anemia prevalence was highest among the 14–18 years age group (80.7%) and those from lower socioeconomic backgrounds (73.6%). Factors such as frequent tea consumption, irregular mealtimes, and pica consumption were associated with higher anemia rates. Pregnant women and those with more children were at a heightened risk of anemia.

Conclusion:

The study reveals a notable prevalence of anemia among women of reproductive age with a surprising emphasis on younger individuals and lower socioeconomic groups. Dietary habits, lifestyle choices, and pregnancy status play significant roles in anemia development. Targeted interventions are essential, particularly for younger women, those from disadvantaged backgrounds, and pregnant individuals, to combat anemia effectively in this region.
Working memory prioritisation effects in tactile immediate serial recall
Authors: Roe Daisy , Allen Richard J , Elsley Jane , Miles Christopher , Johnson Andrew J
Published: January 2024

There is a growing body of evidence that higher-value information can be prioritised for both visual and auditory working memory. The present study examines whether valuable items can similarly be prioritised for the tactile domain. Employing an immediate serial recall procedure (ISR), participants reconstructed a 6-item tactile sequence by moving their fingers in the order of original stimulation. Participants were informed either that one serial position was worth notionally more points (prioritisation condition) or that all items were of equal value (control condition). For Experiment 1 ( N = 48), significant boosts in correct recall were evident when serial positions 4 or 5 were more valuable (i.e., prioritisation effects). Experiment 2 ( N = 24) demonstrated that the prioritisation effect persisted with concurrent articulation, suggesting that task performance was not a function of verbal recoding and rehearsal of the tactile information. Importantly, a significant recall cost for low-value (non-prioritised) items within the sequence was evident for both experiments. Taken together, these findings demonstrate that (1) prioritisation effects transfer to the tactile domain and (2) finite attentional resources can be deliberately and strategically redistributed to specific items within a sequence, dependent upon the prevailing task demands.
Epidemiology and Sex-Specific Analysis of Basketball-Related Lower Extremity Fractures: A 10-Year Analysis of National Injury Data
Authors: Yendluri Avanish , Chiang Joshua J. , Nietsch Katrina S. , Obana Kyle K. , Trofa David P. , Kelly John D. , Parisien Robert L.
Published: January 2024

Background:

Basketball-related fractures involving the lower extremities frequently present to emergency departments (ED) in the United States (US). This study aimed to identify the primary mechanisms, distribution, and trends of these injuries.

Hypothesis:

We hypothesize that (1) lower extremity fracture frequency will decrease from 2013 to 2022, (2) the ankle will be the most common fracture site, and (3) noncontact twisting will be the most common injury mechanism.

Study Design:

Descriptive epidemiological.

Level of Evidence:

Level 3.

Methods:

The National Electronic Injury Surveillance System (NEISS) was queried for lower extremity fractures from basketball presenting to US EDs from January 1, 2013 to December 31, 2022. Patient demographics, injury location, and disposition were recorded. The injury mechanism was characterized using the provided narrative. National estimates (NEs) were calculated using the NEISS statistical sample weight. Injury trends were evaluated by linear regression.

Results:

There were 6259 cases (NE: 185,836) of basketball-related lower extremity fractures. Linear regression analysis of annual trends demonstrated a significant decrease in lower extremity fractures over the study period (2013-2022: P = 0.01; R2 = 0.64). The most common injury mechanism was a noncontact twisting motion (NE: 49,897, 26.9%) followed by jumping (NE: 39,613, 21.3%). The ankle was the most common fracture site (NE: 69,936, 37.6%) followed by the foot (NE: 49,229, 26.49%). While ankle and foot fractures decreased significantly ( P < 0.05), fractures of the lower leg, knee, toe, and upper leg showed no significant trends ( P = 0.09, 0.75, 0.07, and 0.85, respectively).

Conclusion:

Basketball-related lower extremity fractures decreased from 2013 to 2022, with the ankle being the most common fracture site and most fractures arising from a noncontact twist. Increasing utilization of outpatient clinics may have contributed to the decline, particularly for ankle and foot fractures. The prevalence of ankle fractures and twisting-related injuries reinforces the importance of protective footwear and targeted strengthening protocols.
Managing patients’ reports of abdominal pain and irritable bowel syndrome-like symptoms during quiescent inflammatory bowel disease: a role for shared sensemaking
Authors: Huisman Danielle , Fernhout Felice , Moxham Faye , Norton Christine , Bannister Kirsty , Moss-Morris Rona
Published: January 2024

Background

Patients with inflammatory bowel disease (IBD) are often faced with distressing and confusing abdominal pain during remission. Some people respond adversely to healthcare professionals’ (HCPs) suggestions that this pain and related symptoms are due to secondary irritable bowel syndrome (IBS). Exploring how HCPs view, manage, and explain pain during quiescent disease may provide insights into how communication can be improved to increase understanding and mitigate negative responses.

Methods

In-depth semi-structured interviews were conducted with 12 IBD-nurses ( n = 4) and gastroenterologists ( n = 8) working in the United Kingdom or the Netherlands. Reflexive thematic analysis was used to analyse interviews.

Results

Findings suggest that HCPs pay relatively little attention to pain when there is no underlying pathology and prefer to concentrate on objectifiable causes of symptoms and treating disease activity ( Theme 1: Focus on disease activity, not pain and associated symptoms). Explanations of abdominal pain and IBS-like symptoms during remission were not standardised ( Theme 2: Idiosyncratic and uncertain explanations for pain during remission). Processes of shared decision-making were outlined and shared sensemaking was reported as a strategy to enhance acceptance of IBS explanations ( Theme 3: Shared decision making versus shared sensemaking).

Conclusion

Future work should focus on establishing how pain during remission may be best defined, when to diagnose IBS in the context of IBD, and how to explain both to patients. The formulation of standardised explanations is recommended as they might help HCPs to adopt practices of shared sensemaking and shared decision-making. Explanations should be adaptable to specific symptom presentations and different health literacy levels.
Vasculitis and cerebral hemorrhage due to Streptococcus gordonii infectious endocarditis: A case report
Authors: Arias Velásquez César Augusto , Quiroz Álvarez Juan Esteban , Urrego Callejas Tomás
Published: January 2024

Infective endocarditis is an infection of the heart with systemic consequences, both infectious and non-infectious. Infective endocarditis can affect several systems, one of which is the central nervous system. The most common form of presentation is ischemic stroke; however, intracranial hemorrhage can occur due to immune-mediated damage to the vessel wall. The former further complicates cardiac surgical procedures when necessary. We present here the case of a 21-year-old male patient, with no personal medical history, who presented with intracranial hemorrhage due to a vasculitis phenomenon, caused by Streptococcus gordonii infective endocarditis. The patient underwent emergency drainage of the intracranial hemorrhage and minimally invasive valve surgery in 17 days, with satisfactory postoperative recovery and follow-up.
Late onset psychosis in a case of 15q11.2 BP1-BP2 microdeletion (Burnside–Butler) syndrome: A case report and literature review
Authors: Das Soumitra , Shet Vallabh , Palakodeti Sanjana , Pokhrel Prakriti , Ansari Maliha , Qutaish Osama , Rao Mukund , Ravilla Shyam
Published: January 2024

Burnside–Butler syndrome is an inheritable genetic condition characterized by the partial deletion of specific genetic material located on chromosome 15q11. Individuals diagnosed with this particular medical condition display a variety of neuropsychiatric disorders, including psychosis, aggression, mood disorders, anxiety disorders, developmental disorders involving learning difficulties, language delays, autism spectrum disorders, and attention-deficit/hyperactivity disorder. The authors discuss the case of a 51-year-old Caucasian female diagnosed with Burnside–Butler syndrome at 8 years. The article highlights the importance of raising awareness regarding the complex nature and delayed onset of neuropsychiatric symptoms associated with this syndrome. It also emphasizes the need for comprehensive evaluation and multidisciplinary care for individuals affected by this uncommon condition.
Systemic embolization due to non-bacterial thrombotic endocarditis: An autopsy case report and mini review of the literature
Authors: Tisch Carmen , Ernst Daniel , Falke Monika , Speicher Philip , Ziaka Mairi
Published: January 2024

Nonbacterial thrombotic endocarditis is a rare, non-infectious complication associated with hypercoagulable states, such as malignancies and autoimmune diseases. Due to the difficulty distinguishing marantic endocarditis from infective endocarditis, the diagnosis is often delayed or even a postmortem finding. We present the case of a 70-year-old Caucasian female with marantic endocarditis secondary to metastatic duodenal adenocarcinoma. The patient presented with a short history of memory deficits, personality disturbances, and left homonymous hemianopia. Diffusion-weighted magnetic resonance imaging showed multi-territorial bihemispheric cerebral infarctions. Transthoracic echocardiography revealed native mitral valve endocarditis, and serial blood cultures remained negative. Despite antibiotic therapy, the patient’s condition continuously deteriorated, and she died within 3 weeks after her initial presentation. Postmortem examination showed a non-bacterial thrombotic endocarditis. Early clinical suspicion and prompt diagnosis are of decisive importance for the survival of the patients.
All that glitters is not gold: Why randomized controlled trials are bronze standard (at best) in determining best practices for the treatment of posttraumatic stress disorder
Authors: Smith Jennifer Rae
Published: January 2024

The randomized controlled trial (RCT) is considered the gold standard for evaluating the effectiveness of interventions or treatments across fields of physical and psychological medicine. While the RCT is well-placed for issues best addressed with a medical model approach—its origin story, the study and treatment of scurvy, an ideal exemplar—its stature and use must be challenged in cases of experiential phenomena, such as posttraumatic stress disorder (PTSD), where there is no one answer, treatment, or approach that suits all persons. Uncontested, its evidentiary superiority threatens to have deleterious effects on determining best practices for the treatment of PTSD.
Secondary Transition Interventions in Rural Communities: A Systematic Literature Review
Authors: McLucas Alan S. , Therrien William J. , Rowe Dawn A.
Published: January 2024

Nearly 1 million students with individualized education programs (IEPs) live in rural communities in the United States and, to date, no reviews have examined the transition literature related to supporting students in rural settings. The purpose of this review was to examine transition-related functional skill interventions conducted in rural settings. We conducted a systematic review of the experimental literature and identified 19 articles. Interventions reviewed included transition curricula, skill-based interventions, or other interventions (e.g., occupational therapy, interagency collaboration). Few articles included substantive reporting on rurality or the effects of community context on intervention design and implementation. We discuss the paucity of rural transition research and provide recommendations for conducting and reporting future research. Understanding best practice for conducting transition interventions in rural settings requires a framework that considers how the multidimensional elements of a given community influence postsecondary needs and outcomes.
Is Your Résumé/Textbook Up-To-Date? An Audit of AI ATS Résumé Instruction
Authors: Lookadoo Kathryn , Moore Sarah
Published: January 2024

Businesses increasingly use Artificial Intelligence (AI) Applicant Tracking Systems (ATS) to screen job applicants’ résumés. A summative content analysis auditing how 18 business communication, business English, and technical communication textbooks cover résumés and AI ATS found a lack of consensus. The study identified the challenge of offering specific advice on emerging AI technology in textbooks. The article recommends writing and teaching practice changes when discussing emerging technology and creating or using textbook content.
What Will It Take to Eliminate the Immigration Court Backlog? Assessing “Judge Team” Hiring Needs Based on Changed Conditions and the Need for Broader Reform
Authors: Kerwin Donald , Kerwin Brendan
Published: January 2024

Executive Summary

This paper examines the staffing needs of the US Department of Justice’s Executive Office for Immigration Review (EOIR), as it seeks to eliminate an immigration court backlog, which approached 2.5 million pending cases at the end of fiscal year (FY) 2023. A previous study by the Center for Migration Studies of New York (CMS) attributed the backlog to systemic, long-neglected problems in the broader US immigration system. This paper provides updated estimates of the number of immigration judges (IJs) and “judge teams” (IJ teams) needed to eliminate the backlog over ten and five years based on different case receipt and completion scenarios. It also introduces a data tool that will permit policymakers, administrators and researchers to make their own estimates of IJ team hiring needs based on changing case receipt and completion data. Finally, the paper outlines the pressing need for reform of the US immigration system, including a well-resourced, robust, and independent court system, particularly in light of record “encounters” of migrants at US borders in FY 2022 and 2023.
AI’s Role in Improving Social Connection and Oral Health for Older Adults: A Synergistic Approach
Authors: Qi X. , Wu B.
Published: January 2024

This commentary explores the potential of artificial intelligence (AI) in addressing 2 major challenges in geriatric care: oral health deterioration and social disconnection. The article presents a synergistic approach that harnesses AI to improve oral health management through innovative tools like teledentistry, intelligent toothbrushes, and prostheses design and manufacturing, all delivered via software applications and mobile apps employing machine learning and GAN (generative adversarial network). Additionally, it aims to combat social disconnection among isolated older adults by integrating AI-driven companions, virtual social environments, and telehealth platforms, accessible via both text and voice input, to foster social interaction and health care accessibility. The discussion extends to the potential negative impacts of AI, such as exacerbating loneliness with overreliance on AI-enabled apps. Despite these challenges, the article underscores the importance of interdisciplinary collaboration, user-friendly design, data privacy, and ethical considerations in implementing AI. The article concludes by emphasizing the need for ongoing research, investment in digital literacy programs, and interdisciplinary collaboration among stakeholders to optimize the benefits of AI in geriatric care. Through this integrative approach, AI holds promise for enhancing the quality of life and health outcomes for older adults, ensuring meaningful engagement with communities and health care providers while acknowledging and addressing the potential pitfalls associated with AI technology.

Knowledge Transfer Statement:

This study explored how artificial intelligence (AI) can revolutionize geriatric care by improving oral health and alleviating social disconnection among isolated older adults. The findings can guide clinicians in integrating AI tools into practices, assist policymakers in developing AI-inclusive health policies, and inform patients about the potential benefits of AI in enhancing their health outcomes and social connection.
High pillow and spontaneous vertebral artery dissection: A case-control study implicating “Shogun pillow syndrome”
Authors: Egashira Shuhei , Tanaka Tomotaka , Yamashiro Takayuki , Saito Satoshi , Abe Soichiro , Yoshimoto Takeshi , Fukuma Kazuki , Ishiyama Hiroyuki , Yamaguchi Eriko , Hattori Yorito , Ogata Soshiro , Nishimura Kunihiro , Koga Masatoshi , Toyoda Kazunori , Debette Stéphanie , Ihara Masafumi
Published: January 2024

Introduction:

The underlying causes of spontaneous vertebral artery dissection (sVAD) remain insufficiently understood. This study aimed to determine whether high-pillow usage is associated with an increased risk of sVAD and evaluate the frequency of sVAD attributable to high-pillow usage.

Patients and Methods:

This case-control study identified patients with sVAD and age- and sex-matched non-sVAD controls (case-to-control ratio: 1:1) treated at a certified comprehensive stroke center in Japan between 2018 and 2023. The pillow height used at the onset of the index disease was measured and classified into three categories between 12 and 15 cm boundaries. Univariable logistic regression was performed to assess the odds ratio (OR) with a 95% confidence interval (CI) of high-pillow usage for sVAD development. A subgroup of sVAD attributable to high-pillow usage was defined with the following three conditions: high-pillow usage (⩾12 or ⩾15 cm); no minor preceding trauma; and wake-up onset.

Results:

Fifty-three patients with sVAD and 53 non-sVAD controls (42% women, median age: 49 years) were identified. High-pillow usage (⩾12 and ⩾15 cm) was more common in the sVAD group than in the non-sVAD group (34 vs 15%; OR = 2.89; 95%CI = 1.13–7.43 and 17 vs 1.9%; OR = 10.6; 95%CI = 1.30–87.3, respectively). The subgroup of sVAD attributed to high-pillow usage (⩾12 and ⩾15 cm) was found in 11.3% (95%CI = 2.7%–19.8%) and 9.4% (95%CI = 1.5%–17.3%), respectively.

Conclusion:

High-pillow usage was associated with an increased risk of sVAD and accounted for approximately 10% of all sVAD cases. This tentative subgroup of sVAD may represent a distinct spectrum of disease—Shogun pillow syndrome.
HEART Rate Variability Biofeedback for LOng COVID Dysautonomia (HEARTLOC): Results of a Feasibility Study
Authors: Corrado Joanna , Iftekhar Nafi , Halpin Stephen , Li Mengyao , Tarrant Rachel , Grimaldi Jennifer , Simms Alexander , O'Connor Rory J , Casson Alex , Sivan Manoj
Published: January 2024

Introduction:

Post-COVID-19 syndrome, or Long Covid (LC) refers to symptoms persisting 12 weeks after the COVID-19 infection. LC comprises a wide range of dysautonomia symptoms, including fatigue, breathlessness, palpitations, dizziness, pain and brain fog. This study tested the feasibility and estimated the efficacy, of a Heart Rate Variability Biofeedback (HRV-B) programme via a standardised slow diaphragmatic breathing technique in individuals with LC.

Methods:

LC patients underwent a 4-week HRV-B intervention for 10 minutes twice daily for 4 weeks using the Polar H10 ECG (Electrocardiogram) chest strap and Elite HRV phone application. Outcome measures C19-YRSm (Yorkshire Rehabilitation Scale modified), Composite Autonomic Symptom Score (COMPASS-31), WHO Disability Assessment Schedule (WHODAS), EQ5D-5L (EuroQol 5 Dimensions) and Root Mean Square of Successive Differences between heartbeats (RMSSD) using a Fitbit device were recorded before and after the intervention. The study was pre-registered at clinicaltrials.gov NCT05228665.

Results:

A total of 13 participants (54% female, 46% male) completed the study with high levels of independent use of technology, data completeness and intervention adherence. There was a statistically significant improvement in C19YRS-m ( P = .001), COMPASS-31 ( P = .007), RMSSD ( P = .047), WHODAS ( P = .02) and EQ5D Global Health Score ( P = .009). Qualitative feedback suggested participants could use it independently, were satisfied with the intervention and reported beneficial effects from the intervention.

Conclusion:

HRV-B using diaphragmatic breathing is a feasible intervention for LC. The small sample size limits generalisability. HRV-B in LC warrants further exploration in a larger randomised controlled study.
Health equity, care access and quality in headache – part 1
Authors: Tana Claudio , Raffaelli Bianca , Souza Marcio Nattan Portes , de la Torre Elena Ruiz , Massi Daniel Gams , Kisani Najib , García-Azorín David , Waliszewska-Prosół Marta
Published: January 2024

Current definitions of migraine that are based mainly on clinical characteristics do not account for other patient’s features such as those related to an impaired quality of life, due to loss of social life and productivity, and the differences related to the geographical distribution of the disease and cultural misconceptions which tend to underestimate migraine as a psychosocial rather than neurobiological disorder.

Global differences definition, care access, and health equity for headache disorders, especially migraine are reported in this paper from a collaborative group of the editorial board members of the Journal of Headache and Pain. Other components that affect patients with migraine, in addition to the impact promoted by the migraine symptoms such as stigma and social determinants, are also reported.
Union membership and the wage gap between the public and private sectors: evidence from China
Authors: Ma Xinxin
Published: January 2024

As trade unions are active in corporations worldwide, their effects on the labor market have attracted global attention. However, there is scarce empirical evidence regarding how trade unions’ effects on the wage gap differ between the public and private sectors, especially in the Chinese context. Using national longitudinal survey data from the China Family Panel Studies for the years 2010, 2012, 2014, 2016, and 2018 and the Blinder-Oaxaca decomposition method, this study estimates unions’ effect on the wage gap between the public and private sectors in China. The results from the Ordinary Least Squares (OLS) method indicate the existence of a significant positive union wage premium nationwide. Additionally, the premium in the public sector is greater than that in the private sector. However, this effect becomes insignificant after accounting for individual heterogeneity using the fixed effects model. The decomposition results based on the OLS method indicate that the union coverage difference (the endowment effect) widens the wage gap between the public and private sectors; conversely, the union wage premium difference (the price effect) narrows the wage gap. These results indicate that a policy expanding union coverage in the private sector may effectively narrow the wage gap between both sectors.
The mysterious anelloviruses: investigating its role in human diseases
Authors: Sabbaghian Mohammad , Gheitasi Hamidreza , Shekarchi Ali Akbar , Tavakoli Ahmad , Poortahmasebi Vahdat
Published: January 2024

Anelloviruses (AVs) that infect the human population are members of the Anelloviridae family. They are widely distributed in human populations worldwide. Torque teno virus (TTV) was the first virus of this family to be identified and is estimated to be found in the serum of 80–90% of the human population. Sometime after the identification of TTV, Torque teno mini virus (TTMV) and Torque teno midi virus (TTMDV) were also identified and classified in this family. Since identifying these viruses, have been detected in various types of biological fluids of the human body, including blood and urine, as well as vital organs such as the liver and kidney. They can be transmitted from person to person through blood transfusions, fecal-oral contact, and possibly sexual intercourse. Recent studies on these newly introduced viruses show that although they are not directly related to human disease, they may be indirectly involved in initiating or exacerbating some human population-related diseases and viral infections. Among these diseases, we can mention various types of cancers, immune system diseases, viral infections, hepatitis, and AIDS. Also, they likely use the microRNAs (miRNAs) they encode to fulfill this cooperative role. Also, in recent years, the role of proliferation and their viral load, especially TTV, has been highlighted to indicate the immune system status of immunocompromised people or people who undergo organ transplants. Here, we review the possible role of these viruses in diseases that target humans and highlight them as important viruses that require further study. This review can provide new insights to researchers.
Genome-wide identification and characterization of NBLRR genes in finger millet (Eleusine coracana L.) and their expression in response to Magnaporthe grisea infection
Authors: Balamurugan Alexander , Mallikarjuna Mallana Gowdra , Bansal Shilpi , Nayaka S. Chandra , Rajashekara Hosahatti , Chellapilla Tara Satyavathi , Prakash Ganesan
Published: January 2024

Background

The nucleotide binding site leucine rich repeat (NBLRR) genes significantly regulate defences against phytopathogens in plants. The genome-wide identification and analysis of NBLRR genes have been performed in several species. However, the detailed evolution, structure, expression of NBLRRs and functional response to Magnaporthe grisea are unknown in finger millet (Eleusine coracana (L.) Gaertn.).

Results

The genome-wide scanning of the finger millet genome resulted in 116 NBLRR (EcNBLRRs1-116) encompassing 64 CC-NB-LRR, 47 NB-LRR and 5 CCR-NB-LRR types. The evolutionary studies among the NBLRRs of five Gramineae species, viz., purple false brome (Brachypodium distachyon (L.) P.Beauv.), finger millet (E. coracana), rice (Oryza sativa L.), sorghum (Sorghum bicolor L. (Moench)) and foxtail millet (Setaria italica (L.) P.Beauv.) showed the evolution of NBLRRs in the ancestral lineage of the target species and subsequent divergence through gene-loss events. The purifying selection (Ka/Ks < 1) shaped the expansions of NBLRRs paralogs in finger millet and orthologs among the target Gramineae species. The promoter sequence analysis showed various stress- and phytohormone-responsive cis-acting elements besides growth and development, indicating their potential role in disease defence and regulatory mechanisms. The expression analysis of 22 EcNBLRRs in the genotypes showing contrasting responses to Magnaporthe grisea infection revealed four and five EcNBLRRs in early and late infection stages, respectively. The six of these nine candidate EcNBLRRs proteins, viz., EcNBLRR21, EcNBLRR26, EcNBLRR30, EcNBLRR45, EcNBLRR55 and EcNBLRR76 showed CC, NB and LRR domains, whereas the EcNBLRR23, EcNBLRR32 and EcNBLRR83 showed NB and LRR somains.

Conclusion

The identification and expression analysis of EcNBLRRs showed the role of EcNBLRR genes in assigning blast resistance in finger millet. These results pave the foundation for in-depth and targeted functional analysis of EcNBLRRs through genome editing and transgenic approaches.
Physical activity advice given by French general practitioners for low back pain and the role of digital e-health applications: a qualitative study
Authors: Dehainault Marion , Gaillard Olivia , Ouattara Bintou , Peurois Matthieu , Begue Cyril
Published: January 2024

Background

Low back pain is the fourth most common reason for consulting a general practitioner (GP) among people aged 40–50 years. Beyond the overall benefits of physical activity (PA) on health (psychological, cardiovascular, etc.), PA for low back pain seems to improve the prognosis in terms of pain, disability, and quality of life. The French National Health Insurance developed media campaigns to promote physical activity with low back pain and a smartphone application (app). Despite the known benefits and campaigns, GPs do not routinely provide advice about physical activity during low back pain consultations. To promote giving physical activity advice for low back pain, there is a need to understand how GPs currently provide this advice and whether technology could help. This study aims to explore the content of physical activity advice for low back pain that GPs provide in France, and their opinion about healthcare smartphone app provided electronically via the internet (e-health apps) as a support for this advice.

Methods

This qualitative study was conducted with semi-structured individual interviews among French GPs. The verbatim was double coded using a coding tree. Thematic analysis was performed using an inductive approach.

Results

Sixteen GPs from Maine et Loire, Sarthe, and Mayenne were included. The thematic analysis identified the following themes: GPs use a global patient-centred approach to physical activity advice for low back pain. The main goal is to enable patients to participate in their care. Advice was almost always general with little information about duration and frequency. The importance of patient-appropriate and easily achievable activities was emphasised. GPs referred patients to physiotherapists to reinforce regular physical activity, maintain motivation and improve patient adherence through supervision and follow-up. GPs knew little about e-health apps but felt they could be useful with young patients. The main barriers to their use included poor internet connection, lack of technical knowledge and no supervision meaning patients could injure themselves.

Conclusions

This is one of the first studies to assess the contents of physical activity advice GPs provide for low back pain. Further research is needed into the implementation of e-health apps for low back pain management.

Trial registration

Not applicable.
Not all carotenoids can reduce the risk of gastric cancer: a systematic review with meta-analysis
Authors: Han Wei , Zhang Wei , Ren Xuan
Published: January 2024

Background

Gastric cancer is characterized by high invasiveness, heterogeneity, and late diagnosis, leading to high incidence and mortality rates. It is a significant public health concern globally. Early prevention is crucial in reducing the occurrence of gastric cancer, and dietary prevention, particularly focusing on carotenoids, has been considered a convenient and effective approach. However, the association between carotenoid intake and gastric cancer incidence remains controversial.

Methods

A systematic search was conducted in PubMed, Ovid Embase, Web of Science, and Cochrane databases from inception to January 5, 2023. Two reviewers independently screened search results, extracted relevant data, and evaluated study quality. Statistical analysis was performed using the "metan" command in STATA 16 software. Random-effects or fixed-effects models were chosen based on the magnitude of heterogeneity among studies.

Results

This study included a total of 35 publications, consisting of 23 case–control studies and 12 cohort studies. Meta-analysis of case–control studies showed that alpha-carotene (OR = 0.71, 95% CI: 0.55–0.92), beta-carotene (OR = 0.62, 95% CI: 0.53–0.72), and lutein (OR = 0.82, 95% CI: 0.69–0.97) significantly reduced the risk of gastric cancer, while beta-cryptoxanthin (OR = 0.88, 95% CI: 0.75–1.04) and lycopene (OR = 0.86, 95% CI: 0.73–1.00) showed no significant correlation. Meta-analysis of cohort studies indicated no significant associations between any of the five carotenoids and gastric cancer incidence (alpha-carotene: RR = 0.81, 95% CI: 0.54–1.23; beta-carotene: RR = 0.86, 95% CI: 0.64–1.16; beta-cryptoxanthin: RR = 0.86, 95% CI: 0.64–1.16; lutein: RR = 0.94, 95% CI: 0.69–1.29; lycopene: RR = 0.89, 95% CI: 0.69–1.14).

Conclusions

The relationship between carotenoids and gastric cancer incidence may vary depending on the type of study conducted. Considering that evidence from cohort studies is generally considered stronger than evidence from case–control studies, and high-quality randomized controlled trials show no significant association between carotenoids and gastric cancer incidence, current evidence does not support the supplementation of carotenoids for gastric cancer prevention. Further targeted research is needed to explore the association between the two.
Association between residential proximity to major roadways and chronic multimorbidity among Chinese older adults: a nationwide cross-sectional study
Authors: Sun Xuange , Liu Xu , Wang Xue , Pang Chang , Yin Zhihua , Zang Shuang
Published: January 2024

Background

Multiple negative health outcomes were linked to residential proximity to major roadways. Nevertheless, there is limited knowledge regarding the association between residential proximity to major roadways and chronic multimorbidity.

Methods

We used data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, which included 12,214 individuals aged ≥ 60. We derived the residential proximity to major roadways from self-reported data, defining chronic multimorbidity as the presence of two or more concurrent chronic diseases. A binary logistic regression model was utilized to investigate the association between residential proximity to major roadways and chronic multimorbidity. The model accounted for some demographic features, socioeconomic conditions, social participation, and health conditions. Subsequently, we conducted subgroup analyses to examine potential interaction effects.

Results

Residential proximity to major roadways was associated with chronic multimorbidity, even after adjusting for confounding factors. Compared with those living > 300 m from major roadways, the OR for those living 201-300 m, 101-200 m, 50-100 m, and < 50 m were increased. When subgroup analyses were conducted using a cutoff point of 200 m, the risk of chronic multimorbidity associated with residential proximity to major roadways was stronger in participants with education levels > 6 years (P = 0.017).

Conclusion

Our findings provide important implications for improving residential area siting, transportation policies, and environmental regulations to reduce the risk of chronic multimorbidity caused by traffic-related exposure.