bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility, acceptability, and short-term impact of a brief sexually transmitted infection intervention targeting U.S. Military personnel and family members
Authors: Kunz Anjali , Moodley Amber , Colby Donn J. , Soltis Michele , Robb-McGrath Wesley , Fairchok Alexandra , Faestel Paul , Jungels Amanda , Bender Alexis A. , Kamau Edwin , Wingood Gina , DiClemente Ralph , Scott Paul
Published: April 2022

Background

Over the past 10 years, incidence of sexually transmitted infections (STIs) has increased to record numbers in the United States, with the most significant increases observed among adolescents and young adults. The US military, where the majority of active duty personnel are 18–30 years old, has seen similar increases. However, the US military does not yet have a standardized, service-wide program for STI education and prevention.

Methods

The KISS intervention (Knocking out Infections through Safer-sex and Screening) was adapted from an evidence-based intervention endorsed by the US Centers for Disease Control and Prevention and consisted of a one-time, small group session. Content included STI/HIV knowledge and prevention, condom use skills, and interpersonal communication techniques. The intervention was pilot tested for feasibility and acceptability among a population of service members and medical beneficiaries at Joint Base Lewis-McChord in Washington state.

Results

A total of 79 participants aged 18–30 years were consented to participate in the pilot study and met entry criteria, 66/79 (82.5%) attended the intervention session, and 46/66 (69.7%) returned at 3 months for the final follow-up assessment. The intervention sessions included 31 male (47.0%) and 35 female (53.0%) participants. Almost all participants felt comfortable discussing sexual issues in the group sessions, reported that they intended to practice safer sex after the intervention, and would also recommend the intervention to friends. Knowledge about STI/HIV prevention significantly increased after the intervention, and intervention effects were maintained at 3 months. About one-fifth of participants tested positive for N. gonorrhea or C. trachomatis infection at enrollment, while none had recurrent STIs at the final visit. Use of both male and female condoms increased after the intervention.

Conclusions

The KISS intervention was feasible to implement in the military setting and was acceptable to the active duty service members and other medical beneficiaries who participated in the pilot project. Further studies are needed to determine if the KISS intervention, or others, effectively decrease STI incidence in active duty personnel and would be appropriate for more widespread implementation.

Trial Registration

Retrospectively registered as the pilot phase of clinicaltrials.gov NCT04547413, “Prospective Cohort Trial to Assess Acceptability and Efficacy of an Adapted STI/HIV Intervention Behavioral Intervention Program in a Population of US Army Personnel and Their Medical Beneficiaries—Execution Phase.”
Hyaluronic acid as an adjunct to microfracture in the treatment of osteochondral lesions of the talus: a systematic review of randomized controlled trials
Authors: Dilley Julian E. , Everhart Joshua S. , Klitzman Robert G.
Published: April 2022

Background

Osteochondral lesions of the talus (OLT) are common after ankle trauma. Studies have shown that bioactive substances, such as hyaluronic acid (HA), alone, or in combination, with surgical treatment could improve cartilage regeneration and repair, but the effect of HA on patient reported outcomes is unclear.

Methods

Literature searches were performed across four databases (PubMed, SPORTDiscus, Scopus, and The Cochrane Library) for randomized controlled trials in which at least one treatment arm involved use of HA as an adjunct to microfracture to treat patients with OLT. Primary outcomes included the American Orthopaedic Foot and Ankle Society scores (AOFAS), and the Visual Analog Scale (VAS) for pain. The level of evidence and methodological quality were evaluated using the Modified Coleman Methodology Score (MCMS).

Results

Three randomized studies were eligible for review with a total of 132 patients (35, 40, 57 patients, respectively) and follow-up ranged from 10.5 to 25 months. Utilization of HA at the time of microfracture resulted in greater improvement in AOFAS scores compared to microfracture alone. The pooled effect size was moderate (Standardized Mean Difference [SMD] 0.45, 95% Confidence Interval [CI] 0.06, 0.84; P = .02) and between-study heterogeneity was low (I-squared = 0%). Utilization of HA during microfracture also led to greater improvement in VAS-pain scores compared to microfracture alone. The pooled effect size was very large (SMD -3.86, 95% CI -4.75, − 2.97; P < .001) and heterogeneity was moderate (I-squared = 69%).

Conclusion

Hyaluronic acid injection as an adjunct to arthroscopic MF in OLT provides clinically important improvements in function and pain at short-term follow-up compared to MF alone. Future longer-term follow-up studies are warranted to investigate the durability of MF with HA for treatment of OLT.
Early effects of ovariectomy on bone microstructure, bone turnover markers and mechanical properties in rats
Authors: Guo Xingman , Yu Xiyue , Yao Qianqian , Qin Jian
Published: April 2022

Background

Fragility fracture is one of the most serious consequences of female aging, which can increase the risk of death. Therefore, paying attention to the pathogenesis of postmenopausal osteoporosis (PMOP) is very important for elderly women.

Methods and materials

Forty 12-week-old female rats were divided into two groups including the ovariectomy (OVX) group and the control group. Four rats in each group were selected at 1, 4, 8, 12 and 16 weeks after operation. Vertebral bones and femurs were dissected completely for micro-Computed Tomography (micro-CT) scanning, biological modulus detection and histomorphological observation.

Results

In OVX group, bone volume/total volume (BV/TV), bone trabecular connection density (Conn.D) and trabecular bone number (Tb.N) decreased significantly with time (P < 0.05). The elastic modulus of femur in OVX group was lower than that in control group, but there was no significant difference between them (P > 0.05). Over time, the tartrate resistant acid phosphatase (TRAP), osteocalcin (BGP), type I procollagen amino terminal propeptide (PINP) and type I collagen carboxy terminal peptide (CTX-I) in OVX group increased significantly (P < 0.05). The micrographs of the OVX group showed sparse loss of the trabecular interconnectivity and widening intertrabecular spaces with time.

Conclusion

The bone loss patterns of vertebral body and femur were different in the early stage of estrogen deficiency. The bone turnover rate of OVX rats increased, however the changes of biomechanical properties weren’t obvious.
A patient with femoral osteitis fibrosa cystica mimicking bone neoplasm: a case report
Authors: Xu Xiao-Long , Yang Cui-Ping , Lu Sheng-Jun , Pei Hong , Chen Shun-Guang , Liao Quan-Ming
Published: April 2022

Background

Osteitis fibrosa cystica is a rare, benign and osteolytic lesion attributed to hyperparathyroidism. The high level of parathyroid hormone cause rapid bone loss.

Case presentation

The patient is a 50-year-old male complaining of severe and persistent pain in the right knee joint. Imaging studies were suspicious for a benign tumor in the right distal femur. Biopsy under CT guidance showed numerous osteoclast aggregation and hemosiderin deposition around the bone trabeculae. Blood tests disclosed significantly elevated parathyroid hormone, serum calcium, serum alkaline phosphatase. Parathyroid ultrasonography and CT scan showed a solid mass in front of the trachea at the thoracic entrance plane. After resection of the mass, the clinical symptoms were relieved and the radiological results were significantly improved, which further confirmed the diagnosis.

Conclusions

Metabolic diseases-associated bone lesions require a comprehensive diagnosis of multiple inspection items. An interprofessional team approach to the diagnosis and treatment of osteitis fibrosa cystica will provide the best outcome.
Application analysis of omental flap isolation and modified pancreaticojejunostomy in pancreaticoduodenectomy (175 cases)
Authors: Deng Shun , Luo Jianhong , Ouyang Yongzhong , Xie Jiangbo , He Zhuo , Huang Bo , Bai Fei , Xiao Ke , Yin Bin , Wang Jinfeng , Xu Biaoming , Zuo Chaohui
Published: April 2022

Background

To explore the application value of free omental wrapping and modified pancreaticojejunostomy in pancreaticoduodenectomy (PD).

Methods

The clinical data of 175 patients who underwent pancreaticoduodenectomy from January 2015 to December 2020 were retrospectively analysed. In total, 86 cases were divided into Group A (omental wrapping and modified pancreaticojejunostomy) and 89 cases were divided into Group B (control group). The incidences of postoperative pancreatic fistula and other complications were compared between the two groups, and univariate and multivariate logistic regression analyses were used to determine the potential risk factors for postoperative pancreatic fistula. Risk factors associated with postoperative overall survival were identified using Cox regression.

Results

The incidences of grade B/C pancreatic fistula, bile leakage, delayed bleeding, and reoperation in Group A were lower than those in Group B, and the differences were statistically significant (P < 0.05). Group A had an earlier drainage tube extubation time, earlier return to normal diet time and shorter postoperative hospital stay than the control group (P < 0.05). The levels of C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT) inflammatory factors 1, 3 and 7 days after surgery also showed significant. Univariate and multivariate logistic regression analyses showed that a body mass index (BMI) ≥ 24, pancreatic duct diameter less than 3 mm, no isolation of the greater omental flap and modified pancreaticojejunostomy were independent risk factors for pancreatic fistula (P < 0.05). Cox regression analysis showed that age ≥ 65 years old, body mass index ≥ 24, pancreatic duct diameter less than 3 mm, no isolation of the greater omental flap isolation and modified pancreaticojejunostomy, and malignant postoperative pathology were independent risk factors associated with postoperative overall survival (P < 0.05).

Conclusions

Wrapping and isolating the modified pancreaticojejunostomy with free greater omentum can significantly reduce the incidence of postoperative pancreatic fistula and related complications, inhibit the development of inflammation, and favourably affect prognosis.
Ultrasonography evaluation on the protective effect of combination therapy of beraprost sodium and aspirin on arteries occlusion and stiffness in patients with type 2 diabetes mellitus - a prospective, randomized study
Authors: Lin Xian , Chen Yuying , Lu Wan , Li Jin , Fu Li , Yin Jingyu , Ren Meng , Yan Li , Yang Chuan
Published: April 2022

Background

Patients with type 2 diabetes mellitus (T2DM) are susceptible to developing symptomatic peripheral arterial disease (PAD). As a proven vasodilator and antiplatelet agent, the efficiency of Beraprost sodium (BPS) on the prevention of arteries occlusion and stiffness in T2DM patients with PAD has not yet been fully investigated.

Methods

From July 2010 to April 2012, 64 Patients enrolled were randomly assigned to the combined therapy group (n=32), which received combination therapy with BPS (60 μg/day) and aspirin (100 mg/day), or to the control group (n=32), which only received aspirin (100 mg/day). After randomization, the patients were followed up at years 0, 1, 2, 3, 4, and 5 with the evaluation of carotid intima-media thickness (CIMT), pulse wave velocity (PWV), inner artery diameter, stenosis rate, and medial arterial calcification (MAC) of lower limb arteries via high-resolution ultrasound measurement. Adverse events were also recorded in each visit.

Results

There was no significant change of the CIMT during the follow-up in both groups when compared to the baseline. Similar results were also observed in the PWV measurement. Significantly increases in the inner artery diameter of the dorsal pedal artery and posterior tibial artery were observed in patients with BPS and aspirin administration during the follow-up. Patients in the combined therapy group experienced marked improvement of MAC in the dorsal pedal artery and posterior tibial artery at the end of the follow-up. No significant difference in the adverse events was found between the combined therapy group and the aspirin group.

Conclusion

The combined therapy of BPS and aspirin showed a protective effect on arteries occlusion and stiffness in T2DM patients with PAD, along with a significant improvement of inner artery diameter and MAC in lower limbs.

Trial registration

http://www.chictr.org.cn, ChiCTR-TRC-10000919. Prospectively registered on 2010/06/29.
Support for lowering cervical cancer screening age to 25 for women living with HIV: retrospective cross-sectional programmatic data from Botswana
Authors: Ramogola-Masire Doreen , Grover Surbhi , Mathoma Anikie , Monare Barati , Gabaitiri Lesego , Bazzett-Matabele Lisa , Hofmeyr GJustus , Morroni Chelsea , Luckett Rebecca
Published: April 2022

Background

Women living with human immunodeficiency virus (HIV) tend to develop cervical cancer at a younger age than women without HIV. The World Health Organization’s (WHO) 2021 guidelines for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention include a conditional recommendation for initiating screening at age 25 for women living with HIV (WLWH). This recommendation is based on low-certainty evidence, and WHO calls for additional data. We describe the association of age and HIV status with visual inspection with acetic acid (VIA) positivity and cervical intraepithelial neoplasia grade two or higher (CIN2+) in Botswana.

Methods

This was a retrospective cross-sectional study of 5714 participants aged 25 to 49 years who underwent VIA screening in a clinic mainly serving WLWH. VIA-positive women received cryotherapy if eligible or were referred for colposcopy and excisional treatment. Known cervical cancer risk factors, screening outcome, and histological results were extracted from the program database. We compared the proportions and association of VIA positivity and CIN2+ by age and HIV status.

Results

The median age was 35 years [IQR 31–39], and 18% of the women were aged 25–29. Ninety percent were WLWH; median CD4 count was 250 cells/µL [IQR 150–428], and 34.2% were on anti-retroviral treatment (ART). VIA-positivity was associated with younger age (OR 1.48, CI 1.28, 1.72 for 25–29 years vs. 30–49 years), and HIV-positivity (OR 1.85, CI 1.51, 2.28). CIN2+ was only associated with HIV-positivity (OR 6.12, CI 3.39, 11.10), and proportions of CIN2+ were similar for both age groups in WLWH (69.1% vs. 68.3%).

Conclusions

Younger WLWH in Botswana had a significant burden of CIN2+. This finding further supports lowering the screening age for WLWH from 30 to 25.
Complementary and alternative medicine modalities used to treat adverse effects of anti-cancer treatment among children and young adults: a systematic review and meta-analysis of randomized controlled trials
Authors: Mora Dana C. , Overvåg Grete , Jong Miek C. , Kristoffersen Agnete E. , Stavleu Debbie C. , Liu Jianping , Stub Trine
Published: April 2022

Background

Dealing with the symptom burden of cancer diagnosis and treatment has led parents to seek different self-management strategies including Alternative and Complementary Medicine (CAM). The aim of this study was to perform a systematic review and meta-analysis about the use and effect of CAM modalities to treat adverse effects of conventional cancer treatment among children and young adults.

Methods

Six scientific research databases were used to identify randomized controlled trials (RCTs) from 1990 to September 2020. Included studies investigated the use of CAM to treat cancer treatment related adverse effects in children and young adults compared to controls.

Results

Twenty RCTs comprising 1,069 participants were included in this review. The included studies investigated acupuncture, mind–body therapies, supplements, and vitamins for chemotherapy-induced nausea and vomiting (CINV), oral mucositis, and anxiety among children and young adults who underwent conventional cancer treatment. Seven studies (315 participants) were included in the meta-analysis. The overall effect of CAM (including acupuncture and hypnosis only) on chemotherapy-induced nausea and/or vomiting and controls was statistically significant with a standard mean difference of -0.54, 95% CI [-0.77, -0.31] I2 = 0% (p < 0.00001). There was a significant difference between acupuncture and controls (n = 5) for intensity and/or episodes of CINV with an SMD -0.59, 95% CI [-0.85, -0.33] (p < 0.00001). No significant difference was found between hypnosis and controls (n = 2) for severity or episodes of CINV with an SMD -0.41, 95% CI [-1.09, 0.27] I2 = 41% (p = 0.19).

Conclusion

Current evidence from this meta-analysis of randomized controlled trials shows that CAM, including acupuncture and hypnosis only, is effective in reducing chemotherapy-induced nausea and vomiting in children and young adults. More rigorous trials and long-term effects should be investigated if acupuncture and hypnosis are to be recommended for clinical use.
Parthenolide leads to proteomic differences in thyroid cancer cells and promotes apoptosis
Authors: Cui Meng , Wang Zhe , Huang Le-Tian , Wang Jia-He
Published: April 2022

Background

Parthenolide has anti-inflammatory, immunomodulatory and anti-cancer activities. But its effect on thyroid cancer cells is still largely unknown.

Methods

Label-free quantitative proteomics and bioinformatics analysis were used to investigate the differentially expressed proteins and their functions in thyroid cancer treated with parthenolide and control pair. Hoechst 33258 fluorescent staining and Annexin V-FITC/PI double staining flow cytometry were used to detected BCPAP cells apoptosis. Parallel reaction monitoring (PRM) and quantitative real-time PCR were used to verify the expression of apoptosis-related differential proteins and their mRNA.

Results

Sixty up-regulated and 96 down-regulated differentially expressed proteins were identified in parthenolide treated thyroid cancer cells BCPAP compared with control thyroid cancer cells. The proteins were mainly relevant to various biological processes that included metabolic processes, response to extracellular stimulus and interaction with host. The molecular functions of most differentially expressed proteins were associated with binding functions and nucleotidyltransferase activity. According to the Kyoto Encyclopedia of Genes and Genomes, the differentially expressed proteins identified are primarily related to various types of metabolic pathways and DNA replication. In cell experiments in vitro, with the increase of the dose of parthenolide, the number of cells gradually decreased, the apoptosis rate gradually increased. PRM verified that the apoptosis-related proteins HMOX1 and GCLM were up-regulated and IL1B was down-regulated in BCPAP cells treated with parthenolide. The mRNA expressions of HMOX1, GCLM, ITGA6 and CASP8 were up-regulated and HSPA1A was down-regulated by PCR.

Conclusions

Parthenolide may influence the biological behavior of human thyroid cancer cells by affecting the expression of proteins related to cell metabolism and DNA replication. Parthenolide induced significant cellular morphological changes and apoptosis in human thyroid cancer cells, leading to an anti-proliferative effect.
Evaluation of Situational Judgment Tests in student selection in Indonesia and the impact on diversity issues
Authors: Soemantri Diantha , Findyartini Ardi , Yolanda Sophie , Morley Emma , Patterson Fiona
Published: April 2022

Background

Internationally, medical selection relies heavily on prior academic attainment which has an adverse impact on the diversity of selected students. Since non-academic attributes are also important, this study aims to evaluate the use of a Situational Judgment Test (SJT) for selection and the impact on student diversity relating to gender, ethnicity and socio-economic status. Previous SJT research has almost entirely originated from a Western context and this study focuses on new evidence in a South East Asian context with a different demographic profile.

Methods

Thirty faculty members developed 112 SJT scenarios assessing professionalism, communication and self-awareness domains. The scenarios underwent a concordance stage where stakeholder input was sought on the content appropriateness, to define the item scoring key, followed by an initial psychometric evaluation with first and second year medical students (N = 436). Based on these results, 30 scenarios, consisting of 128 nested items, were selected for pilot testing and evaluation regarding diversity issues with two cohorts of applicants in 2017 (N = 446) and 2018 (N = 508).

Results

The SJT demonstrated good internal consistency (Cronbach’s alpha of 0.80 and 0.81 respectively). There were significant differences in SJT scores based on gender in both years, where females consistently outperformed males (p = .0001). However, no significant differences were found based on high school origin, parental educational background or ethnicity.

Conclusions

This is the first study to evaluate the use of an SJT in Indonesia, which has a unique diversity profile compared to Western countries. Largely, the preliminary results replicate previous studies of the potential diversity benefits of using an SJT as a tool for medical student selection and has the potential to level the playing field regarding socio-economic status and ethnicity. Further studies exploring more variables representing diversity are warranted to confirm the early results in this study.
Privacy-preserving logistic regression with secret sharing
Authors: Ghavamipour Ali Reza , Turkmen Fatih , Jiang Xiaoqian
Published: April 2022

Background

Logistic regression (LR) is a widely used classification method for modeling binary outcomes in many medical data classification tasks. Researchers that collect and combine datasets from various data custodians and jurisdictions can greatly benefit from the increased statistical power to support their analysis goals. However, combining data from different sources creates serious privacy concerns that need to be addressed.

Methods

In this paper, we propose two privacy-preserving protocols for performing logistic regression with the Newton–Raphson method in the estimation of parameters. Our proposals are based on secure Multi-Party Computation (MPC) and tailored to the honest majority and dishonest majority security settings.

Results

The proposed protocols are evaluated against both synthetic and real-world datasets in terms of efficiency and accuracy, and a comparison is made with the ordinary logistic regression. The experimental results demonstrate that the proposed protocols are highly efficient and accurate.

Conclusions

Our work introduces two iterative algorithms to enable the distributed training of a logistic regression model in a privacy-preserving manner. The implementation results show that our algorithms can handle large datasets from multiple sources.
Optimising outcomes for complex trauma survivors: assessing the motivators, barriers and enablers for implementing trauma informed practice within a multidisciplinary health setting
Authors: Lovell Renee C. , Greenfield David , Johnson George , Eljiz Kathy , Amanatidis Sue
Published: April 2022

Background

Complex trauma is a significant public health issue with detrimental health, interpersonal and psychological impacts, which can impede client recovery and result in multiple representations. ‘Trauma Informed Practice’ (TIP) is an evidence-based model which ensures safe and effective services for clients and staff. This study examines health professional’s use of TIP, and the motivators, enablers and barriers to implementation in a multidisciplinary setting.

Methods

A mixed methods study with 24 front-line clinicians and managers within a community health setting in Australia. A purpose designed, expert validated TIP checklist was completed, followed by semi-structured focus groups. Survey data was reported using descriptive statistics. Focus group data was digitally recorded, transcribed and thematically analysed.

Results

Ten key factors were identified motivating, restricting or enabling TIP implementation. Seven were organisational factors including supportive and informed management, flexibility of service models, levels of service demands, resource availability, education opportunities, good client outcomes, and reporting requirements. Philosophical approach, team orientation, and vicarious trauma/stress management were three individual professional factors. Critically, alignment in two ways was necessary for successful implementation, that is: in knowledge and understanding across organisational role levels - clinician, manager and executive; and, in professional philosophy and team orientation of individual clinicians.

Conclusion

Providing TIP is essential for ensuring optimum client outcomes for trauma survivors and for maintaining workforce wellbeing. Although the increasing uptake to TIP is evident within the health setting, further attention is required to address the tension between service models focused on efficiently servicing whole populations and those attuned to effectively meeting the needs of high risk groups. A complex strategy to unite therapeutic and managerial goals is necessary if client, professional and organisational needs are to be effectively met.
Job satisfaction in midwives and its association with organisational and psychosocial factors at work: a nation-wide, cross-sectional study
Authors: Hansson Malin , Dencker Anna , Lundgren Ingela , Carlsson Ing-Marie , Eriksson Monica , Hensing Gunnel
Published: April 2022

Background

Midwives report a challenging work environment globally, with high levels of burnout, insufficient work resources and low job satisfaction. The primary objective of this study was to identify factors in the organisational and psychosocial work environment associated with midwives’ job satisfaction. A secondary objective was to identify differences in how midwives assess the organisational and psychosocial work environment compared to Swedish benchmarks.

Methods

This nation-wide, cross-sectional web survey study analysed midwives’ assessment of their organisational and psychosocial work environment using the COPSOQ III instrument. A multivariable, bi-directional, stepwise linear regression was used to identify association with job satisfaction (N = 1747, 99.6% women). A conventional minimal important score difference (MID ± 5 as a noticeable difference with clinical importance) were used to compare midwives’ results with Swedish benchmarks.

Results

A multivariable regression model with 13 scales explained the variance in job satisfaction (R2 = .65). Five scales, possibilities for development, quality of work, role conflict, burnout and recognition, explained most of the variance in midwives’ job satisfaction (R2 = .63) and had β values ranging from .23 to .10. Midwives had adverse MID compared to Swedish benchmarks with higher difference in mean values regarding quantitative demands (8.3), work pace (6.0) emotional demand (20.6), role conflicts (7.9) and burnout (8.3). In addition, lower organisational justice (-6.4), self-rated health (-8.8), influence (-13.2) and recognition at work (-5.8). However, variation and meaning of work showed a beneficial difference in mean values with 7.9 and 13.7 respectively.

Conclusions

Midwives reported high levels of meaningfulness in their work, and meaningfulness was associated with job satisfaction. However, midwives also reported adversely high demands and a lack of influence and recognition at work and in addition, high role conflict and burnout compared to Swedish benchmarks. The lack of organisational resources are modifiable factors that can be taken into account when structural changes are made regarding organisation of care, management and resource allocation. Midwives are necessary to a high quality sexual, reproductive and perinatal health care. Future studies are needed to investigate if job satisfaction can be improved through professional recognition and development, and if this can reduce turnover in midwives.
Evaluating the comparative efficiency of medical centers in Taiwan: a dynamic data envelopment analysis application
Authors: Chiu Cheng-Ming , Chen Ming-Shu , Lin Chung-Shun , Lin Wei-Yu , Lang Hui-Chu
Published: April 2022

Background

People in Taiwan enjoy comprehensive National Health Insurance coverage. However, under the global budget constraint, hospitals encounter enormous challenges. This study was designed to examine Taiwan medical centers' efficiency and factors that influence it.

Methods

We obtained data from open sources of government routine publications and hospitals disclosed by law to the National Health Insurance Administration, Ministry of Health and Welfare, Taiwan. The dynamic data envelopment analysis(DDEA) model was adopted to estimate all medical centers' efficiencies during 2015–2018. Beta regression models were used to model the efficiency level obtained from the DDEA model. We applied an input-oriented approach under both the constant returns-to-scale (CRS) and variable returns-to-scale (VRS) assumptions to estimate efficiency.

Results

The findings indicated that 68.4% (13 of 19) of medical centers were inefficient according to scale efficiency. The mean efficiency scores of all medical centers during 2015–2018 under the CRS, VRS, and Scale were 0.85, 0.930, and 0.95,respectively. Regression results showed that an increase in the population less than 14 years of age, assets, nurse-patient ratio and bed occupancy rate could increase medical centers' efficiency. The rate of emergency return within 3-day and patient self-pay revenues were associated significantly with reduced hospital efficiency (p < 0.05). The result also showed that the foundation owns medical center has the highest efficiency than other ownership hospitals.

Conclusions

The study results provide information for hospital managers to consider ways they could adjust available resources to achieve high efficiency.
Stiffness optimization and reliable design of a hip implant by using the potential of additive manufacturing processes
Authors: Risse Lena , Woodcock Steven , Brüggemann Jan-Peter , Kullmer Gunter , Richard Hans Albert
Published: April 2022

Background

Due to the steadily increasing life expectancy of the population, the need for medical aids to maintain the previous quality of life is growing. The basis for independent mobility is a functional locomotor system. The hip joint can be so badly damaged by everyday wear or accelerated by illness that reconstruction by means of endoprostheses is necessary.

Results

In order to ensure a high quality of life for the patient after this procedure as well as a long service life of the prosthesis, a high-quality design is required, so that many different aspects have to be taken into account when developing prostheses. Long-term medical studies show that the service life and operational safety of a hip prosthesis by best possible adaptation of the stiffness to that of the bone can be increased. The use of additive manufacturing processes enables to specifically change the stiffness of implant structures.

Conclusions

Reduced implant stiffness leads to an increase in stress in the surrounding bone and thus to a reduction in bone resorption. Numerical methods are used to demonstrate this fact in the hip implant developed. The safety of use is nevertheless ensured by evaluating and taking into account the stresses that occur for critical load cases. These results are a promising basis to enable longer service life of prostheses in the future.
Graphene quantum dots rescue angiogenic retinopathy via blocking STAT3/Periostin/ERK signaling
Authors: Zhao Na , Gui Xiao , Fang Qian , Zhang Rui , Zhu Weiye , Zhang Haorui , Li Qing , Zhou Yukun , Zhao Jiawei , Cui Xiao , Gao Guangping , Tang Huipeng , Shen Ni , Chen Taoyong , Song Hongyuan , Shen Wei
Published: April 2022

Background

Pathological retinal angiogenesis resulting from a variety of ocular diseases including oxygen induced retinopathy, diabetic retinopathy and ocular vein occlusion, is one of the major reasons for vision loss, yet the therapeutic option is limited. Multiple nanoparticles have been reported to alleviate angiogenic retinopathy. However, the adverse effect cannot be ignored due to the relatively large scale. Graphene quantum dots (GQDs) have shown potential in drug delivery and have been proved biocompatible. In this study, Graphene quantum dots are extensively investigated for their application in angiogenic retinopathy therapy.

Results

We showed that GQDs were biocompatible nanomaterials in vitro and in vivo. The nanoparticles have a dose-dependent inhibitory effect on proliferation, migration, tube formation and sprouting of human umbilical vein endothelial cells (HUVECs). Further data show that GQDs could inhibit pathological retinal neovascularization in an oxygen-induced retinopathy (OIR) model. The data of RNA sequencing suggested that periostin is involved in this process. GQDs inhibit the expression of periostin via STAT3, and further regulated cell cycle-related protein levels through ERK pathway. The signaling pathway was conformed in vivo using OIR mouse model.

Conclusions

The present study indicated that GQDs could be a biocompatible anti-angiogenic nanomedicine in the treatment of pathological retinal neovascularization via disrupting periostin/ERK pathway and subsequent cell cycle.

Graphical Abstract
Homogenous multifunctional microspheres induce ferroptosis to promote the anti-hepatocarcinoma effect of chemoembolization
Authors: Chen Minjiang , Li Jie , Shu Gaofeng , Shen Lin , Qiao Enqi , Zhang Nannan , Fang Shiji , Chen Xiaoxiao , Zhao Zhongwei , Tu Jianfei , Song Jingjing , Du Yongzhong , Ji Jiansong
Published: April 2022

Transcatheter arterial chemoembolization (TACE) is one of the main palliative therapies for advanced hepatocellular carcinoma (HCC), which is also regarded as a promising therapeutic strategy for cancer treatment. However, drug-loaded microspheres (DLMs), as commonly used clinical chemoembolization drugs, still have the problems of uneven particle size and unstable therapeutic efficacy. Herein, gelatin was used as the wall material of the microspheres, and homogenous gelatin microspheres co-loaded with adriamycin and Fe3O4 nanoparticles (ADM/Fe3O4-MS) were further prepared by a high-voltage electrospray technology. The introduction of Fe3O4 nanoparticles into DLMs not only provided excellent T2-weighted magnetic resonance imaging (MRI) properties, but also improved the anti-tumor effectiveness under microwave-induced hyperthermia. The results showed that ADM/Fe3O4-MS plus microwave irradiation had significantly better antitumor efficacy than the other types of microspheres at both cell and animal levels. Our study further confirmed that ferroptosis was involved in the anti-tumor process of ADM/Fe3O4-MS plus microwave irradiation, and ferroptosis marker GPX4 was significantly decreased and ACSL4 was significantly increased, and ferroptosis inhibitors could reverse the tumor cell killing effect caused by ADM/Fe3O4-MS to a certain extent. Our results confirmed that microwave mediated hyperthermia could amplify the antitumor efficacy of ADM/Fe3O4-MS by activating ferroptosis and the introduction of Fe3O4 nanoparticles can significantly improve TACE for HCC. This study confirmed that it was feasible to use uniform-sized gelatin microspheres co-loaded with Fe3O4 nanoparticles and adriamycin to enhance the efficacy of TACE for HCC.

Graphical Abstract
Hydrogel supplemented with human platelet lysate enhances multi-lineage differentiation of mesenchymal stem cells
Authors: Lei Tong , Liu Yanyan , Deng Shiwen , Xiao Zhuangzhuang , Yang Yanjie , Zhang Xiaoshuang , Bi Wangyu , Du Hongwu
Published: April 2022

Stem cells from human exfoliated deciduous teeth (SHED) can be used as a potential clinical material. But the use of xenogeneic ingredients will increase the risk of zoonotic disease transmission. Human platelet lysate (HPL) is a potential surrogate and used in human cell expansion with reliability in clinical applications. In this study, we synthesized chitosan/gelatin/gellan gum hydrogel supplemented with HPL and investigated the effect of 3D culture for SHED. TMT-tagged proteomics was used to decipher the secretome protein profiles of SHEDs and a total of 3209 proteins were identified, of which 23 were up-regulated and 192 were down-regulated. The results showed that hydrogel supplemented with HPL promoted SHED proliferation. After induction, the hydrogel coating contributed to osteogenic differentiation, adipogenic differentiation and differentiation into neural-like cells of SHED. SHED encapsulated in a hydrogel promotes migration and angiogenesis of HUVEC. In conclusion, our research found that hydrogel supplemented with HPL can be used as a method for SHED in standardized production and can contribute to the clinical application of SHED in cell therapy.
Socio-economic correlates of quality of life in single and married urban individuals: a Polish case study
Authors: Puciato Daniel , Rozpara Michał , Bugdol Marek , Mróz-Gorgoń Barbara
Published: April 2022

Background

One of key current social trends is the increasing number of single people. It has multiple implications as single individuals often live and behave differently than those living in relationships. Marital status and socioeconomic status may also be significant quality of life factors for single persons. The aim of this study is to identify relationships between quality of life and selected indicators of socioeconomic status in single and married respondents from the Wrocław metropolitan area in Poland.

Methods

4460 respondents took part in the study (1828 single, 2632 married). The study was cross-sectional based on a diagnostic survey. Data was gathered on respondents’ sex, age, education, marital status, occupational status and financial situation as well as their quality of life and perceived health condition. Frequencies (f) and relative frequencies (rf) of categories of dependent and independent variables were determined. The chi-squared test (χ2) and odds ratio (OR) statistics were applied. The level of statistical significance was set at α = .05.

Results

A stochastic dependence (p ≤ .05) between marital status and perceived health condition and quality of life in the social domain was found among the respondents. Male sex, higher education, being an entrepreneur, college student or white-collar worker, and good financial status were associated with the highest assessments of quality of life and perceived health condition. The directions of quality of life modifications determined by socioeconomic status were similar in single and married urban respondents; however, the strength of these modifications was greater in the latter.

Conclusions

It is recommended to target respondents with public health programs aimed at lifestyle improvement, tailored to the needs of single and married individuals. Public policies directed at improving education and material situation of respondents are also worth considering, as they may be essential for modeling their quality of life. In addition, research on quality of life should be continued, which is particularly relevant in a pandemic situation.
Post-intensive care screening: French translation and validation of the Healthy Aging Brain Care-Monitor, hybrid version
Authors: Horlait Geoffrey , Beaudart Charlotte , Bougard Laurine , Bornheim Stephen , Colson Camille , Misset Benoit , Bruyère Olivier , Boustani Malaz , Rousseau Anne-Françoise
Published: April 2022

Background

The Healthy Aging Brain Care-Monitor (HABC-M) questionnaires (self-reported version and caregiver version) have been validated for post-intensive care syndrome (PICS) detection in patients surviving a stay in the intensive care unit (ICU). Their authors have also developed a hybrid version (HABC-M-HV) suited to the daily needs of their post-ICU follow-up clinic. The objectives of the present cross-sectional observational study were to translate the HABC-M-HV questionnaire into French (HABC-M-HV-F) according to international guidelines and to test its measurement properties.

Methods

The HABC-M-HV was translated according to international guidelines. The measurement performances of the questionnaire were tested using internal consistency, test–retest reliability, Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC) calculation, floor and ceiling effect measurement and construct validity.

Results

The validation study included 51 ICU survivors (27.5% women, 63 [55–71] years old). The questionnaire was administered by phone. The internal consistency was very good (Cronbach’s alpha coefficient 0.79). The intra- and inter-examinator reliabilities were excellent (Intraclass Coefficient Correlation = 0.99 and 0.97, respectively). The SEM was 0.62 and the SDC was 1.72. No floor or ceiling effects were observed. The convergent validity was almost entirely confirmed with 71.4% of our hypothesis confirmed.

Conclusion

The HABC-M-HV-F has been shown to be a valid and reliable tool for PICS screening and follow-up in French-speaking ICU survivors. A remote administration by phone was feasible.

Trial registration: Not applicable.
Circ_0047921 acts as the sponge of miR-1287-5p to stimulate lung cancer progression by regulating proliferation, migration, invasion, and glycolysis of lung cancer cells
Authors: Xiao Yuehua , Gu Shequn , Yao Wenxiu , Qin Ling , Luo Jihui
Published: April 2022

Background

Lung cancer is a common respiratory system disease caused by multiple factors. Circular RNAs (circRNAs) play vital roles in tumorigenesis, including lung cancer. This study aimed to clarify the role and underlying molecular mechanisms of circ_0047921 in lung cancer.

Methods

Real-time quantitative polymerase chain reaction (RT-qPCR) was used to assess the expression levels of circ_0047921, La-related protein 1 (LARP1), and miR-1287-5p. Cell proliferation was analyzed by CCK-8 and EdU assays. Transwell assay was used to assess migration and invasion. Western blot assay was employed to quantify protein expression. Glycolysis ability of cell was determined by measuring glucose consumption and lactate production with matched kits. The relationship between miR-1287-5p and circ_0047921 or LARP1 was confirmed by dual-luciferase reporter assay. In addition, a xenograft model was established to clarify the functional role of circ_0047921 in vivo.

Results

Circ_0047921 was highly expressed in lung cancer tissues and cells. Circ_0047921 downregulation repressed proliferation, migration, invasion, epithelial-mesenchymal transition (EMT) and glycolysis in lung cancer cells. Circ_0047921 targeted miR-1287-5p to deplete miR-1287-5p expression. The effects caused by circ_0047921 downregulation were reversed by miR-1287-5p inhibition. In addition, LARP1 was a target of miR-1287-5p, and circ_0047921 could directly interact with miR-1287-5p to increase the expression of LARP1. The effects caused by circ_0047921 downregulation were also reversed by LARP1 overexpression. Circ_0047921 silencing impeded the growth of tumor in vivo.

Conclusion

Circ_0047921 was overexpressed in lung cancer, and circ_0047921 targeted miR-1287-5p to modulate LARP1 expression, thereby facilitating the development of lung cancer.

Trial registration

The present study was approved by the ethical review committee of The First People’s Hospital of Chenzhou, Southern Medical University with reference no. 20210106.
Identification of deleterious variants in patients with male infertility due to idiopathic non-obstructive azoospermia
Authors: Tang Dongdong , Li Kuokuo , Geng Hao , Xu Chuan , Lv Mingrong , Gao Yang , Wang Guanxiong , Yu Hui , Shao Zhongmei , Shen Qunshan , Jiang Hui , Zhang Xiansheng , He Xiaojin , Cao Yunxia
Published: April 2022

Background

Non-obstructive azoospermia (NOA) is the most severe type of male infertility, affecting 1% of men worldwide. Most of its etiologies remain idiopathic. Although genetic studies have identified dozens of NOA genes, monogenic mutations can also account for a small proportion of idiopathic NOA cases. Hence, this genetic study was conducted to explore the causes of monogenic variants of NOA in a cohort of Chinese patients.

Methods

Following the screening using chromosomal karyotyping, Y chromosome microdeletion analyses, and sex hormone assessments, subsequent whole-exome sequencing analysis was performed in 55 unrelated idiopathic NOA patients with male infertility to explore potential deleterious variants associated with spermatogenesis. We also performed Sanger sequencing to demonstrate the variants. Testicular biopsy or microsurgical testicular sperm extraction was also performed to confirm the diagnosis of NOA and identify spermatozoa. Hematoxylin and eosin staining was performed to assess the histopathology of spermatogenesis.

Results

Abnormal testicular pathological phenotypes included Sertoli cell-only syndrome, maturation arrest, and hypospermatogenesis. Using bioinformatics analysis, we detected novel variants in two recessive genes, FANCA (NM_000135, c.3263C > T, c.1729C > G) and SYCE1 (NM_001143763, c.689_690del); one X-linked gene, TEX11 (NM_031276, c.466A > G, c.559_560del); and two dominant genes, DMRT1 (NM_021951, c.425C > T, c.340G > A) and PLK4 (NM_001190799, c.2785A > G), in eight patients, which corresponded to 14.55% (8/55) of the patients.

Conclusion

This study presented some novel variants of known pathogenic genes for NOA. Further, it expanded the variant spectrum of NOA patients, which might advance clinical genetic counseling in the future.
STRIVE PNG: using a partnership-based approach in implementation research to strengthen surveillance and health systems in Papua New Guinea
Authors: Farquhar Rachael , Dori Annie , MacCana Sarah , Tefuarani Nakapi , Lavu Evelyn , Barry Alyssa , Karl Stephan , Makita Leo , Robinson Leanne , Laman Moses
Published: April 2022

Successful implementation research requires effective and equitable relationships between policy-makers, researchers and implementers to effect evidence-based systems change. However, mainstream research grant models between Global North and Global South institutions often (unintentionally) reinforce power imbalances between partners, which result in missed opportunities for knowledge and learning exchange between policy-makers, researchers and implementers.

This case study, centred on the STRIVE PNG project, describes how a partnership-based approach has been used to establish, maintain and review effective and equitable relationships between 13 partner organizations (independent research institutes, government health agencies and public health laboratories) to strengthen surveillance and health systems in Papua New Guinea (PNG). We provide an overview of key terms (with supporting conceptual frameworks), describe selected partnership processes and tools used within the project, and share observations regarding early outcomes achieved through this approach.