bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of online infographics for enhancing health literacy among patients with type 2 diabetes in primary care unit during the COVID-19 pandemic: a randomized controlled trial
Authors: Sutthiworapon Suchada , Vichitkunakorn Polathep , Choomalee Kittisakdi , Ngamchaliew Pitchayanont
Published: March 2024

Background

Health literacy (HL) in patients with type 2 diabetes mellitus (DM) can help control disease and prevent complications. However, most patients with type 2 DM have inadequate HL; therefore, their HL must be further improved. This study aimed to determine the effects of online infographics on improving HL among patients with type 2 DM.

Methods

This randomized controlled trial was conducted from July 2022 to September 2022, at the primary care unit of Songklanagarind Hospital, Thailand; 30 patients with type 2 DM were randomly assigned to the experimental (n = 15; three types of infographics) and control (n = 15; three types of pamphlets) groups. Infographics and pamphlets were distributed weekly via social media platforms. The S-TOFHLA Thai version and Thai-FCCHL were used to evaluate HL. Chi-square, Fisher’s exact, Wilcoxon rank-sum, t-test, paired t-test, and McNemar’s chi-square tests were used.

Results

The median age of 30 participants was 56 years. The mean duration of DM was 9.6 years, with a median HbA1c level of 7.5 mg%. Most participants (80%) had adequate HL in S-TOFHLA, whereas 63.3% had adequate HL in FCCHL. All participants in the infographic group who had inadequate HL in the S-TOFHLA pre-test achieved adequate HL. Meanwhile, only 50% of patients in the pamphlet group achieved adequate HL. Regarding FCCHL, 50% of patients in the infographic group and 60% in the pamphlet group who had inadequate HL in the pretest achieved adequate HL. However, no statistical significance in achieving adequate HL was found in either group. The mean differences (SD) in S-TOFHLA between before and after intervention were 12.53 (8.77; p = 0.0007) and 10.13 (9.88; p = 0.001) in the infographic and pamphlet groups, respectively. Regarding FCCHL, the mean differences (SD) were 3.47 (4.29) and 3.20 (2.91) in the infographic group (p = 0.003) and pamphlet (p = 0.002) groups, respectively. No statistical significance in the mean difference was found between both groups.

Conclusions

Novel online infographics and pamphlets did not significantly differ in achieving adequate HL among patients with type 2 DM who should receive health education about disease control and complication prevention. However, both interventions can increase and maintain HL levels. Online educational media can be appropriate during the COVID-19 pandemic. Nevertheless, further larger-scale studies should be performed to examine the impact of other DM educational media on HL promotion.

Trial registration

The Thai Clinical Trials Registry (TCTR) with registry ID TCTR20230425001 (date of registration 25/04/2023).
Prevalence of gestational diabetes in the United States and Canada: a systematic review and meta-analysis
Authors: Eades Claire E. , Burrows Katherine A. , Andreeva Roza , Stansfield Daniel R. , Evans Josie MM.
Published: March 2024

Background

An understanding of the prevalence of gestational diabetes mellitus among pregnant women is essential at local, national and international level so that appropriate health care interventions can be planned, financed and delivered.

Methods

A systematic review and meta-analysis of primary research reporting the prevalence of gestational diabetes mellitus in Canada or the United States were carried out according to Meta-analysis of Observational Studies in Epidemiology guidelines. Four electronic databases were systematically searched in June 2023 to identify articles that reported gestational diabetes mellitus prevalence using universal screening in pregnant women from eligible general population samples. Estimates were combined using a random effects model, and the effects of moderator variables analysed.

Results

There were 36 separate samples of women or deliveries (total sample size 1,550,917). Overall mean prevalence of gestational diabetes mellitus was 6.9% (95% CI: 5.7–8.3); 13.7% (95% CI: 10.7–17.3) in studies using a one-step screening strategy, and 5.2% (95% CI: 4.4–6.1) in those using a two-step strategy. Heterogeneity in technical methods between studies produced differences in estimates, as did different diagnostic thresholds used.

Conclusions

The meta-analysis suggests a slightly higher prevalence of gestational diabetes mellitus in Canada and the United States, compared to Europe, but highlights the need for standardised protocols for estimating gestational diabetes mellitus prevalence.
Cohort profile: China undergraduate cohort for environmental health study
Authors: Lu Peng , Miao Jiaming , Yang Liu , Dou Siqi , Yang Lei , Wang Chongjian , Xiang Hao , Chen Gongbo , Ye Tingting , Yan Lailai , Li Shanshan , Guo Yuming
Published: March 2024

The China Undergraduate Cohort (CUC) is an ambispective cohort study with its major purpose to better understand the effects of lifetime environmental exposures on health outcomes. We recruited 5322 college students with an average age of 18.3 ± 0.7 years in China from August 23, 2019 to October 28, 2019. Follow-up surveys were conducted annually. The dataset comprises individual demographic data (e.g. age, sex, height, weight, birth date, race, home address, annual family income, contact information), health-related behavior data (smoking status, smoking cessation, passive smoking exposure, drinking habit, physical activity, dietary status), lifestyle data (physical exercise, dietary habit, length of time spent outdoors), disease history (respiratory disease history, cardiovascular disease history, urinary system disease history, etc.), mental health status data (sleep quality, self-reported stress, anxiety and depression symptoms), lung function and blood samples data. Preliminary results from our cohort have found the association between air pollution, summer heat and mercury exposure and lung function among young adults in China.
The association between dietary total antioxidant capacity and hearing loss: results from the Tehran employees Cohort Study
Authors: Ghosn Batoul , Azadbakht Leila , Esmaeilpour Mohammad Reza Monazzam , Esmaillzadeh Ahmad
Published: March 2024

Background

Despite numerous studies that have explored the association between individual antioxidants or specific combinations and the risk of hearing loss, there is lack of information regarding the relationship between dietary total antioxidant capacity (dTAC) and hearing loss. The conflicting results on this association further highlight the need for more research in this area. This study aims to investigate the association between overall dietary antioxidant intake and the risk of hearing loss among Iranian adults.

Methods

This cross-sectional study recruited 3443 adult participants aged between 19 and 67 years (with an average age of 41.4 years ± 8.8) who were employed at Tehran University of Medical Sciences in Iran. Participants underwent dietary assessment using a validated Food Frequency Questionnaire (FFQ). The hearing status of each participant was evaluated by a licensed audiologist in a soundproof room, using diagnostic audiometry that adhered to American National Standards specifications and followed standard audiometric clinical procedures. The dietary total antioxidant capacity (dTAC) was calculated using the Ferric Reducing-Antioxidant Power (FRAP) values.

Results

43.6% of male participants had hearing loss, while 26.8% among female participants. After accounting for various confounding factors, no significant association was observed between higher levels of dTAC and reduced odds of hearing loss in the overall population. However, among men under the age of 40, higher levels of dTAC were associated with decreased odds of hearing loss, even after adjusting for several covariates (OR: 0.56, 95% CI: 0.31–1.02, Ptrend = 0.02). This relationship was not evident in men over 40 years of age or among women.

Conclusion

The study found an inverse relationship between higher antioxidant intake in the diet and lower odds of hearing loss, specifically among men who were 40 years old or younger. However, this relationship was not observed in the overall population or among women. Additional prospective studies are necessary to validate these results.
Applying narrative medicine to prepare empathetic healthcare providers in undergraduate pharmacy education in Singapore: a mixed methods study
Authors: Han Zhe , Barton Keith C. , Ho Li-Ching , Yap Kai Zhen , Tan Doreen Su-Yin , Lee Shuh Shing , Neo Constance Xue Rui , Tan Amanda Han Lin , Boey Brian Ming Yao , Soon Charis Jia Yan , Gallagher Paul J.
Published: March 2024

Background

Narrative medicine demonstrated positive impact on empathy in medicine and nursing students. However, this pedagogical approach had not been evaluated in pharmacy education. This study sought to apply and evaluate the narrative medicine approach in extending empathy in Asian undergraduate pharmacy students.

Methods

Narrative medicine was applied through workshops which used narratives of people with different experiences and perspectives. First-year undergraduate pharmacy students who volunteered and attended these workshops formed the intervention group (N = 31) and the remaining first-year cohort formed the control group (N = 112). A sequential explanatory mixed methods approach was adopted in which quantitative methods were first used to measure impact on pharmacy students’ empathy using the Jefferson Scale of Empathy– Health Professions Student (JSE-HPS), and qualitative methods (i.e. group interviews) were then used to assess pharmacy students’ emotional responses to narratives, and the perspectives of pharmacy students and faculty of this pedagogical approach.

Results

There was no difference in JSE-HPS scores between intervention and control groups across baseline (i.e. upon matriculation), pre-intervention, and post-intervention timepoints. Pharmacy students in the intervention group had lower scores in Factor 3 (“Standing in People’s Shoes”) following the intervention. Five themes, guided by internal and external factors in cognition, emerged from the Group Interviews: (1) incongruence between students’ motivation and faculty’s perception, (2) learning context, (3) academic context, (4) cognitive system, and (5) affective system. Themes 1, 4 and 5 referred to internal factors such as students’ motivation, perceived learnings, and feelings. Themes 2 and 3 referred to external factors including workshop materials, activities, content, and facilitation.

Conclusion

This study is the first to demonstrate that pharmacy students engaged with the narrative medicine approach as narratives elicited emotional responses, exposed them to diverse perspectives, and deepened their appreciation of the importance of empathy and complexities of understanding patients’ perspectives. Scaffolded educational interventions using narratives and real-life patient encounters, alongside longitudinal measurements of empathy, are necessary to bring about meaningful and sustained improvements in empathy.
Adapting a health facility HIV stigma-reduction participatory training intervention to address drug use stigma in HIV care and treatment clinics in Dar es Salaam, Tanzania
Authors: Mlunde Linda B. , Saalim Khalida , Mbwambo Jessie K. , Kiwia Pfiriael , Fitch Elizabeth , Manyama Willbrord , Rugemalila Isack , Clay Sue , Lambdin Barrot H. , Stelmach Rachel D. , Bann Carla , Nyblade Laura
Published: March 2024

Background

HIV prevalence among people who use drugs (PWUD) in Tanzania is 4–7 times higher than in the general population, underscoring an urgent need to increase HIV testing and treatment among PWUD. Drug use stigma within HIV clinics is a barrier to HIV treatment for PWUD, yet few interventions to address HIV-clinic drug use stigma exist. Guided by the ADAPT-ITT model, we adapted the participatory training curriculum of the evidence-based Health Policy Plus Total Facility Approach to HIV stigma reduction, to address drug use stigma in HIV care and treatment clinics (CTCs).

Methods

The first step in the training curriculum adaptation process was formative research. We conducted 32 in-depth interviews in Dar es Salaam, Tanzania: 18 (11 men and 7 women) with PWUD living with HIV, and 14 with a mix of clinical [7] and non-clinical [7] CTC staff (5 men and 9 women). Data were analyzed through rapid qualitative analysis to inform initial curriculum adaptation. This initial draft curriculum was then further adapted and refined through multiple iterative steps of review, feedback and revision including a 2-day stakeholder workshop and external expert review.

Results

Four CTC drug use stigma drivers emerged as key to address in the curriculum adaptation: (1) Lack of awareness of the manifestations and consequences of drug use stigma in CTCs (e.g., name calling, ignoring PWUD and denial of care); (2) Negative stereotypes (e.g., all PWUD are thieves, dangerous); (3) Fear of providing services to PWUD, and; (4) Lack of knowledge about drug use as a medical condition and absence of skills to care for PWUD. Five, 2.5-hour participatory training sessions were developed with topics focused on creating awareness of stigma and its consequences, understanding and addressing stereotypes and fears of interacting with PWUD; understanding drug use, addiction, and co-occurring conditions; deepening understanding of drug use stigma and creating empathy, including a panel session with people who had used drugs; and working to create actionable change.

Conclusion

Understanding context specific drivers and manifestations of drug use stigma from the perspective of PWUD and health workers allowed for ready adaptation of an existing evidence-based HIV-stigma reduction intervention to address drug use stigma in HIV care and treatment clinics. Future steps include a pilot test of the adapted intervention.
Cancer-associated fibroblast-secreted FGF7 as an ovarian cancer progression promoter
Authors: Feng Songwei , Ding Bo , Dai Zhu , Yin Han , Ding Yue , Liu Sicong , Zhang Ke , Lin Hao , Xiao Zhongdang , Shen Yang
Published: March 2024

Background

Ovarian cancer (OC) is distinguished by its aggressive nature and the limited efficacy of current treatment strategies. Recent studies have emphasized the significant role of cancer-associated fibroblasts (CAFs) in OC development and progression.

Methods

Employing sophisticated machine learning techniques on bulk transcriptomic datasets, we identified fibroblast growth factor 7 (FGF7), derived from CAFs, as a potential oncogenic factor. We investigated the relationship between FGF7 expression and various clinical parameters. A series of in vitro experiments were undertaken to evaluate the effect of CAFs-derived FGF7 on OC cell activities, such as proliferation, migration, and invasion. Single-cell transcriptomic analysis was also conducted to elucidate the interaction between FGF7 and its receptor. Detailed mechanistic investigations sought to clarify the pathways through which FGF7 fosters OC progression.

Results

Our findings indicate that higher FGF7 levels correlate with advanced tumor stages, increased vascular invasion, and poorer prognosis. CAFs-derived FGF7 significantly enhanced OC cell proliferation, migration, and invasion. Single-cell analysis and in vitro studies revealed that CAFs-derived FGF7 inhibits the ubiquitination and degradation of hypoxia-inducible factor 1 alpha (HIF-1α) via FGFR2 interaction. Activation of the FGF7/HIF-1α pathway resulted in the upregulation of mesenchymal markers and downregulation of epithelial markers. Importantly, in vivo treatment with neutralizing antibodies targeting CAFs-derived FGF7 substantially reduced tumor growth.

Conclusion

Neutralizing FGF7 in the medium or inhibiting HIF-1α signaling reversed the effects of FGF7-mediated EMT, emphasizing the dependence of FGF7-mediated EMT on HIF-1α activation. These findings suggest that targeting the FGF7/HIF-1α/EMT axis may offer new therapeutic opportunities to intervene in OC progression.
m6A methylation modification and immune infiltration analysis in osteonecrosis of the femoral head
Authors: Fang Weihua , Peng Peng , Lin Kun , Xiao Fangjun , He Wei , He Mincong , Wei Qiushi
Published: March 2024

Osteonecrosis of the femoral head (ONFH) is a elaborate hip disease characterized by collapse of femoral head and osteoarthritis. RNA N6-methyladenosine (m6A) plays a crucial role in a lot of biological processes within eukaryotic cells. However, the role of m6A in the regulation of ONFH remains unclear. In this study, we identified the m6A regulators in ONFH and performed subtype classification. We identified 7 significantly differentially expressed m6A regulators through the analysis of differences between ONFH and normal samples in the Gene Expression Omnibus (GEO) database. A random forest algorithm was employed to monitor these regulators to assess the risk of developing ONFH. We constructed a nomogram based on these 7 regulators. The decision curve analysis suggested that patients can benefit from the nomogram model. We classified the ONFH samples into two m6A models according to these 7 regulators through consensus clustering algorithm. After that, we evaluated those two m6A patterns using principal component analysis. We assessed the scores of those two m6A patterns and their relationship with immune infiltration. We observed a higher m6A score of type A than that of type B. Finally, we performed a cross-validation of crucial m6A regulatory factors in ONFH using external datasets and femoral head bone samples. In conclusion, we believed that the m6A pattern could provide a novel diagnostic strategy and offer new insights for molecularly targeted therapy of ONFH.
Expression level of neutrophil extracellular traps in peripheral blood of patients with chronic heart failure complicated with venous thrombosis and its clinical significance
Authors: Liu Fang , Zhai Qian
Published: March 2024

Objective

Previous studies have reported that neutrophil extracellular traps (NETs) have been identified to be involved in thrombosis, but the clinical value in chronic heart failure (CHF) patients with venous thrombosis is unclear. This study focused on the expression level of NETs in the peripheral blood of patients with CHF complicated with venous thrombosis and its clinical value.

Methods

80 patients with CHF were included and divided into 2 groups according to the occurrence of venous thrombosis, and the expression levels of NETs in peripheral venous blood and lesion veins of the patients were detected through fluorescent staining. Myeloperoxidase-DNA (MPO-DNA) and citrullinated histone H3 (CitH3), markers of NETs, were detected by enzyme linked immunosorbent assay kit. The receiver operating characteristic (ROC) curve was used to analyze the value of peripheral venous blood NETs in the diagnosis of venous thrombosis in CHF patients, while the relationship between NETs in peripheral and lesion veins was analyzed by a unitary linear regression model.

Results

The results showed that the concentration of NETs, MPO-DNA, and CitH3 in CHF patients combined with venous thrombosis was markedly higher than that in patients without venous thrombosis, and the concentration of NETs, MPO-DNA, and CitH3 in lesion venous blood was notably higher than that in peripheral venous blood. Binary logistics regression analysis showed that NETs in peripheral venous blood were an independent risk factor for venous thrombosis in patients with heart failure. The unitary linear regression model fitted well, indicating a notable positive correlation between NETs concentrations in peripheral and lesion veins. The area under the ROC curve for diagnosing venous thrombosis was 0.85, indicating that peripheral blood NETs concentration levels could effectively predict venous thrombosis in CHF patients.

Conclusion

The expression level of NETs was high in the peripheral blood of CHF patients combined with venous thrombosis and was the highest in lesion venous blood. NETs levels in peripheral blood had the value of diagnosing venous thrombosis in CHF patients, and the concentrations of NETs in peripheral and lesion veins are markedly positively correlated.
Evaluation of intramural hematoma: a novel use of 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging
Authors: Yang Fan , Chen Yuanwei , Zhou Yongrong , Shao Dan , Luo Jianfang
Published: March 2024

Background

Aortic intramural hematoma (IMH) is one of the typical entities of acute aortic syndrome and probably accounts for 5–25% of all cases. The ulcer-like projections (ULP), which are described as a focal, blood-filled pouch protruding into the hematoma of the aortic wall, are regarded as one of the high-risk imaging features of IMH and may cause initial medical treatment failure and death.

Case presentation

We present a case report of an acute type B IMH patient with impaired renal function and newly developed ULP in the acute phase. The 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MR) was performed to evaluate the condition of aortic hematoma. The 18F-FDG focal uptake along the aortic wall of the hematoma was normal compared to the background (SUVmax 2.17; SUVSVC 1.6; TBR 1.35). We considered the IMH stable in such cases and opted for medical treatment and watchful observation. Six months after discharge, the patient’s recovery was satisfactory, and aortic remodeling was ideal.

Conclusions

The 18F-FDG PET/MR is a novel tool to evaluate the risk of IMH patients and thus provides information for therapy selection.
Low diagnostic performance of thick blood smears of 50 µl in comparison with direct examination of 10 µl blood and the leukoconcentration technique of 5ml blood among loiasis-suspected patients with low microfilaremia in Gabon, Central Africa, using the STARD-BLCM guidelines
Authors: M’Bondoukwé Noé Patrick , Owono-Medang Matthieu , Moussavou-Boussougou Marie Noëlle , Akoue Yvan , Migueba Valentin , Bulaev Dmitry , Neven Anouk , James Luice Aurtin Joel , Ntsame Ella Sylvie Alberte , Mawili-Mboumba Denise Patricia , Atsame Julienne , Vaillant Michel , Bouyou Akotet Marielle Karine
Published: March 2024

Background

The aim of this study was to determine performance indicators of thick blood smears of 50 µl (TBS-50), following the Standards for the Reporting of Diagnostic Accuracy Studies–Bayesian Latent Class Model (STARD-BLCM) guidelines. TBS-50 was compared with two common parasitological techniques—direct examination of 10 µl blood and a leukoconcentration of 5 ml—for the diagnosis of microfilaremic loiasis.

Methods

The study population was recruited among patients of the Department of Parasitology-Mycology-Tropical Medicine over a period of 1 year. Age, sex, symptoms, and eosinophilia variables were recorded from laboratory registers and medical files. Direct examination of 10 µl of blood, TBS-50, and the leukoconcentration technique with 5 ml of blood were performed for each patient. The classical formula and BLCM were used to determine the diagnostic accuracy of the three techniques as well as the prevalence of microfilaremic loiasis. Three models were built within the framework of BLCM—the BLCM model I and alternative models II and III—for sensitivity analysis.

Results

In total, 191 patients consented to be included. The direct blood examination and TBS-50 yielded comparable qualitative and quantitative results. Hence, they are reported together. The prevalence of Loa loa microfilaremia was 9.4% (95% CI 5.7–14.5; n = 18/191) with direct blood examination/TBS-50 and 12.6% [8.2–18.1] (n = 24/191) for leukoconcentration. Comparing TBS-50 with the leukoconcentration method using the classical formula, the sensitivity was 75.0% [53.3–90.2], specificity was 100.0% [97.8–100.0], the positive predictive value was 100.0% [81.5–100.0], and the negative predictive value was 96.5% [92.6–98.7]. The prevalence of microfilaremic loiasis was estimated at 9.7% [6.2–13.7] using BLCM model I. The outputs of BLCM model I showed sensitivity of 78.9% [65.3–90.3], specificity of 100.0% [99.3–100.0], a positive predictive value of 99.1% [87.2–100.0], and a negative predictive value of 93.0% [87.3–97.7] for direct blood examination/TBS-50.

Conclusions

TBS-50 demonstrates low sensitivity relative to two other techniques. In one in five cases, the result will be falsely declared negative using these methods. However, this method can be deployed with limited funds.

Graphical Abstract
TCP Stratos for stratosphere based computing platforms
Authors: Periola A. A.
Published: March 2024

Stratosphere computing platforms (SCPs) benefit from free cooling but face challenges necessitating transmission control protocol (TCP) re-design. The redesign should be considered due to stratospheric gravity waves (SGWs), and sudden stratospheric warming (SSWs). SGWs, and SSWs disturb the wireless channel during SCPs packet communications. SCP packet transmission can be done using existing TCP variants at the expense of high packet loss as existing TCP variants do not consider SGWs, and SSWs. TCP variants designed for satellite links are not suitable as they do not explicitly consider the SSW, and SGW. Moreover, the use of SCPs in future internet is at a nascent stage. The presented research proposes a new TCP variant i.e., TCP Stratos. TCP Stratos incorporates a parameter transfer mechanism and comprises loss-based; and delay-based components. However, its window evolution considers the occurrence of SSWs, and SGWs. The performance benefit of the proposed approach is evaluated via MATLAB numerical simulation. MATLAB simulation has been used because of the consideration of the stratosphere. The modelling of the stratosphere in this case is challenging for conventional tools and frameworks. Performance evaluation shows that using TCP Stratos instead of existing TCP variants and improved TCP variants reduces the packet loss rate by an average of (7.1–23.1) % and (3.8–12.8) %, respectively. The throughput is enhanced by an average of (20.5–53)%, and (40.9–70)% when TCP Stratos is used instead of existing TCP variant and modified TCP variant, respectively.
Feasibility of precision smoking treatment in a low-income community setting: results of a pilot randomized controlled trial in The Southern Community Cohort Study
Authors: Lee Scott S. , Senft Everson Nicole , Sanderson Maureen , Selove Rebecca , Blot William J. , King Stephen , Gilliam Karen , Kundu Suman , Steinwandel Mark , Sternlieb Sarah J. , Cai Qiuyin , Warren Andersen Shaneda , Friedman Debra L. , Connors Kelly Erin , Fadden Mary Kay , Freiberg Matthew S. , Wells Quinn S. , Canedo Juan , Tyndale Rachel F. , Young Robert P. , Hopkins Raewyn J. , Tindle Hilary A.
Published: March 2024

Background

The feasibility of precision smoking treatment in socioeconomically disadvantaged communities has not been studied.

Methods

Participants in the Southern Community Cohort Study who smoked daily were invited to join a pilot randomized controlled trial of three smoking cessation interventions: guideline-based care (GBC), GBC plus nicotine metabolism-informed care (MIC), and GBC plus counseling guided by a polygenic risk score (PRS) for lung cancer. Feasibility was assessed by rates of study enrollment, engagement, and retention, targeting > 70% for each. Using logistic regression, we also assessed whether feasibility varied by age, sex, race, income, education, and attitudes toward precision smoking treatment.

Results

Of 92 eligible individuals (79.3% Black; 68.2% with household income < $15,000), 67 (72.8%; 95% CI 63.0–80.9%) enrolled and were randomized. Of these, 58 (86.6%; 95% CI 76.4–92.8%) engaged with the intervention, and of these engaged participants, 43 (74.1%; 95% CI 61.6–83.7%) were retained at 6-month follow-up. Conditional on enrollment, older age was associated with lower engagement (OR 0.83, 95% CI 0.73–0.95, p = 0.008). Conditional on engagement, retention was significantly lower in the PRS arm than in the GBC arm (OR 0.18, 95% CI 0.03–1.00, p = 0.050). No other selection effects were observed.

Conclusions

Genetically informed precision smoking cessation interventions are feasible in socioeconomically disadvantaged communities, exhibiting high enrollment, engagement, and retention irrespective of race, sex, income, education, or attitudes toward precision smoking treatment. Future smoking cessation interventions in this population should take steps to engage older people and to sustain participation in interventions that include genetic risk counseling.

Trial registration: ClinicalTrials.gov No. NCT03521141, Registered 27 April 2018, https://www.clinicaltrials.gov/study/NCT03521141
The relationship between internalised weight bias and biopsychosocial outcomes in children and youth: a systematic review
Authors: Foster Tiarna , Eaton Melissa , Probst Yasmine
Published: March 2024

Objective

To synthesise the evidence on the relationships between internalised weight bias (IWB) and biopsychosocial health outcomes in individuals ≤ 25 years.

Methods

A systematic review was conducted by searching five scientific databases up to May 2022 to retrieve studies that investigated associations between IWB and biopsychosocial outcomes. Articles with participants ≤ 25 years, at least one validated measure of IWB, one measure of a biopsychosocial outcome, and were observational were included. Excluded articles involved systematic literature reviews, case study reports, intervention studies, meta-analyses, grey literature, pilot, and feasibility studies. Quality assessment was carried out using the American Dietetic Association Quality Criteria Checklist. The protocol was registered with PROSPERO, ID number CRD42022323876.

Results

Two hundred and sixty-six articles were identified. Nineteen were eligible for inclusion, (15 cross-sectional and 4 prospective). The Weight Bias Internalization Scale and the Weight Self-Stigma Questionnaire were the most used tools to assess IWB with large heterogeneity in tool types used to assess biopsychosocial measures. IWB had positive associations with psychopathology, eating disorder symptomology, higher BMI, being female, and experiences of weight stigma. It was negatively associated with quality of life, body image, physical activity, social ability, self-esteem, and socioeconomic status.

Discussion

IWB associated with adverse biopsychosocial outcomes in children and youth populations. IWB may be more clinically relevant in assessing at-risk children and youth than physical weight due to its psychosocial aspects and ability to expand beyond the scope of BMI. Research would benefit from better assessment tools designed for children and youth that accurately measure IWB. Future research should focus on increased diversity and longitudinal study designs with children and youth-specific populations.
Intervening factors between risk of violence and aggressive behaviours among forensic inpatients: a scoping review
Authors: Ahmad Badruddin Norhameza , Roseliza-Murni AbRahman , Kamaluddin Mohammad Rahim , Ahmad Badayai Abdul Rahman , Munusamy Shalini
Published: March 2024

Background

Risk of violence is closely associated with aggression propensity. However, there is a lack of research to explain the mechanisms behind this association, especially among the patients of forensic secure facilities. This review aimed to identify and synthesize the available literature concerning the intervening factors (mediating or moderating factors) in the relationship between the risk of violence and aggressive behavior in forensic secure facilities.

Methods

Two electronic academic databases were searched: Scopus and Web of Science (WoS) using specific keywords as search terms derived from the PCC framework with no specific time limit. The search strategy was developed based on the JBI Manual for Evidence Synthesis and utilised the PRISMA-ScR guidelines. Data on the risk of violence, intervening factors, and aggressive behavior were extracted from the included studies. Further analysis was performed whereby similar data were grouped and synthesised together.

Results

The initial search produced 342 studies. However, only nine studies fulfilled the inclusion criteria. The nine studies included 1,068 adult forensic inpatients from various psychiatric hospitals. Only mediation studies reported significant mechanisms of influence between the risk of violence and aggressive behavior. It is postulated that the human agency factor may be the underlying factor that influences a person’s functioning and the subsequent series of events between the risk of violence and aggression.

Conclusions

In light of the paucity of evidence in this area, a generalised conclusion cannot be established. More studies are warranted to address the gaps before conclusive recommendations can be proposed to the relevant stakeholders.
Integration of transcriptomic analysis and multiple machine learning approaches identifies NAFLD progression-specific hub genes to reveal distinct genomic patterns and actionable targets
Authors: Sun Jing , Shi Run , Wu Yang , Lou Yan , Nie Lijuan , Zhang Chun , Cao Yutian , Yan Qianhua , Ye Lifang , Zhang Shu , Wang Xuanbin , Wu Qibiao , Jiao Xuehua , Yu Jiangyi , Fang Zhuyuan , Zhou Xiqiao
Published: March 2024

Background

Nonalcoholic fatty liver disease (NAFLD) is a leading public health problem worldwide. Approximately one fourth of patients with nonalcoholic fatty liver (NAFL) progress to nonalcoholic steatohepatitis (NASH), an advanced stage of NAFLD. Hence, there is an urgent need to make a better understanding of NAFLD heterogeneity and facilitate personalized management of high-risk NAFLD patients who may benefit from more intensive surveillance and preventive intervene.

Methods

In this study, a series of bioinformatic methods were performed to identify NAFLD progression-specific pathways and genes, and three machine learning approaches were combined to construct a risk-stratification gene signature to quantify risk assessment. In addition, bulk RNA-seq, single-cell RNA-seq (scRNA-seq) transcriptome profiling data and whole-exome sequencing (WES) data were comprehensively analyzed to reveal the genomic alterations and altered pathways between distinct molecular subtypes.

Results

Two distinct subtypes of NAFL were identified with the NAFLD progression-specific genes, and one subtype has a high similarity of the inflammatory pattern and fibrotic potential with NASH. The established risk-stratification gene signature could discriminate advanced samples from overall NAFLD. COL1A2, one key gene closely related to NAFLD progression, is specifically expressed in fibroblasts involved in hepatocellular carcinoma (HCC), and significantly correlated with EMT and angiogenesis in pan-cancer. Moreover, the β-catenin/COL1A2 axis might play a critical role in fibrosis severity and inflammatory response during NAFLD-HCC progression.

Conclusion

In summary, our study provided evidence for the necessity of molecular classification and established a risk-stratification gene signature to quantify risk assessment of NAFLD, aiming to identify different risk subsets and to guide personalized treatment.
Extreme precipitation trends in Northeast China based on a non-stationary generalized extreme value model
Authors: Meng Fangxiu , Xie Kang , Liu Peng , Chen Huazhou , Wang Yao , Shi Haiyun
Published: March 2024

Northeast China is the main food production base of China. Extreme precipitation (EP) events can seriously impact agricultural production and socioeconomics, but the understanding of EP in Northeast China is still limited. In this study, using the non-stationary generalized extreme value (GEV) model, we investigate the trend and potential risk of EP in Northeast China during 1959–2017, especially in early and mid-summer (periods of high frequency of EP). Then, the relationships between EP and large-scale circulation over Northeast China in early and mid-summer are analyzed separately. The EP in Northeast China mainly presents positive trends in early summer but negative trends in mid-summer. Meanwhile, the EP with all the return periods presents apparently increasing trends in early summer, corresponding to more frequent EP events. Nevertheless, in mid-summer, the EP with 2-year return period decreases with location parameter, and the EP with 20-year, 50-year, and 100-year return periods slightly increases with scale parameter. The EP with 2-year return period occurs frequently in Liaoning Province, while the EP with 100-year return period is more likely to occur in Jilin Province and Heilongjiang Province. Moreover, the increase of the EP in early summer is mainly influenced by the northeast cold vortex; the effect of cold air on the EP is stronger in mid-summer, giving a clear explanation why the EP in mid-summer does not increase significantly. Overall, the outcomes of this study would be beneficial for the disaster prevention and mitigation in Northeast China.
Fake human but real influencer: the interplay of authenticity and humanlikeness in Virtual Influencer communication?
Authors: Ju Naan , Kim Terry , Im Hyunjoo
Published: March 2024

Recently, there has been a lot of interest in industry and academia in virtual influencers (VIs). This study aimed to augment the understanding of VI marketing by exploring the relationship between VI’s characteristics (i.e., their humanlikeness level and operator type), their social media post characteristics (i.e., emotional expression, use of pronouns, use of punctuation marks), and consumer engagement. The analysis of three popular VIs’ Instagram profiles and posts revealed that VIs with less humanlike appearances tend to exhibit stronger positive emotional expressions. Interestingly, the level of humanlikeness in appearance was not associated with VI's other post characteristics, suggesting other intrinsic factors (e.g., the VI’s character and virtual universe) may play a pivotal role. Whether a brand operates the VI or not made a statistically significant difference in the VI’s post characteristics. Assessment of user engagement metrics (i.e., number of likes and comments) showed that users prefer hyper-realistic VIs and VIs operated by non-brand agencies, underscoring the importance of perceived authenticity in the digital realm. The emotions expressed by VIs, along with their use of punctuation, were positively related to user engagement.
Successful management of splenic artery dissection after sigmoid colon perforation in vascular Ehlers–Danlos syndrome
Authors: Yoshizaki Moegi , Matsuo Yasuko , Yasuda Satoshi , Doi Shunsuke , Sakata Takeshi , Nagai Minako , Nakamura Kota , Kohara Yuichiro , Toyoda Shohei , Tanaka Toshihiro , Sho Masayuki
Published: March 2024

Background

Ehlers–Danlos syndrome (EDS) is a genetic disorder that causes fragility of the systemic connective tissues. Of the 13 subtypes, vascular EDS (vEDS) is associated with abnormalities in collagen production, resulting in arterial rupture and intestinal perforation. Herein, we report the case of a man with confirmed vEDS who survived a ruptured dissected splenic artery aneurysm triggered by perforation of the sigmoid colon.

Case presentation

A 48-year-old man presented to our hospital with sudden severe lower abdominal pain. The patient was genetically diagnosed with vEDS at the age of 43 years. Abdominal computed tomography (CT) showed fluid and free air surrounding the sigmoid colon. These findings suggested sigmoid colon perforation, and emergency surgery was needed. Hartmann’s procedure was performed. The resected specimen showed a 2-cm-sized depression around the perforation. Histopathological findings showed an abscess and exudate in the serosa of the perforation and thinning of the intrinsic muscular layer in the depressed area. The patient was doing well postoperatively; however, on the ninth postoperative day, sudden upper abdominal pain developed. CT revealed an intra-abdominal hemorrhage due to rupture of a dissecting splenic artery aneurysm. The aneurysm was not observed on preoperative CT and was distant from the surgical site. Urgent transcatheter arterial embolization was performed. Although embolization of the splenic artery was attempted during the procedure, the arterial dissection spread to the common hepatic artery. Moreover, the proper hepatic and gastroduodenal arteries were poorly visualized, probably due to vasospasm. Although complications associated with extensive embolization were a concern, embolization of the splenic and common hepatic arteries was necessary to save the patient’s life. After embolization, angiography showed that the left hepatic blood flow was maintained from the inferior phrenic artery, and the right hepatic inflow was maintained from the superior mesenteric artery via the peribiliary vascular plexus in the hilar area. The patient recovered well and was discharged on the 19th postoperative day.

Conclusions

vEDS can cause arterial rupture after intestinal surgery. Therefore, careful post-operative management is necessary. Moreover, cooperation with interventional radiologists is important for prompt treatment of vascular complications.
A systematic review of the effects of hepatitis B and C virus on the progression of liver fluke infection to liver cancer
Authors: O’Rourke Allison
Published: March 2024

Hepatitis B and C virus, Opisthorchis viverrini and Clonorchis sinensis, are all individually known to put a person at increased risk for cholangiocarcinoma and hepatocellular carcinoma. This paper seeks to determine if there is any interaction between liver flukes and hepatitis virus infection that are known to put a person at an increased risk for cholangiocarcinoma and hepatocellular carcinoma collectively. This paper seeks to determine whether there is any publicly available articles in English that determine if having a hepatitis viral co-infection along with liver flukes would influence the risk of developing liver cancer. We followed PRISMA systematic review guidelines to conduct a literature review. Three manuscripts fit the search criteria. Two presented evidence in support of a synergistic relationship between liver fluke and viral hepatitis infection while the other found no relationship. One manuscript determined that the interaction between hepatitis B and C. sinensis did not have any significant risk of liver cancer. Studies found that HBV affected progression of co-infection to liver cancer but may have its own disease state worsened by presence of liver flukes. Only one paper was found that presented data on HCV, therefore no conclusion can be drawn due to the lack of evidence discovered. Of the studies, the conclusions and strength of the data were mixed. However, the stronger studies suggested a synergistic relationship between liver flukes and HBV to increase the risk of progressing to liver cancer.
Social learning-based health literacy promotion on the self efficacy and social anxiety of adolescents with type 1 diabetes
Authors: Begjani Jamalodin , Hosseini Akram Sadat Sadat , Saneifard Hedieh , Hasanabad Vida Rahimi
Published: March 2024

Background and objective

Type 1 diabetes mellitus one of the biggest health concerns around the world, is difficult to manage during adolescence. Among the non-medical methods of controlling this disease is empowerment through self-efficacy. Poor self-efficacy leads to social anxiety and ultimately deficiencies in diabetes. There is also a correlation among health literacy, self-efficacy, and social anxiety. Thus, the present study aimed to evaluate the impact of a literacy promotion training program based on social learning theory on the self-efficacy and social anxiety of adolescents with T1DM.

Methods

The current research is a semi-experimental type that was carried out with the cooperation of 66 adolescents aged 15–18 years with type 1 diabetes in Iran (Tehran, 2022). It has control and intervention groups. The endocrinology and diabetes clinics of the intervention and control groups were randomly selected in a multi-stage manner (endocrine and diabetes clinic of children’s medical center hospital for the control group and endocrine and diabetes clinic of Mofid hospital for the intervention group) and the participants were selected by Simple Random Sampling method (draw). The training program designed based on Bandura’s social learning theory was used to teach adolescents during seven consecutive sessions of 30–45 min during one week. Questionnaires were completed before and one month after the intervention. Data were analysed in SPSS-25 software.

Findings

The intervention for adolescents with T1DM in intervention group compared to the control group had a significant effect on improve health literacy (P<0.001), self-efficacy (P<0.001), and social anxiety (P<0.05).

Conclusions

The results can also be used to improve the capabilities of adolescents with T1DM, reduce and prevent disease complications, and develop operational-educational programs in the centers from which these adolescents receive various services.

Trial registration

IRCT20210422051045N1.
Diagnostic utility of renal shear wave elastography and renal Doppler findings in diabetic nephropathy: a case–control study
Authors: Baz Ahmed Abdelrahman , Abdeen Eman Muhammad , Helmy Mona Yousry , Al-Bohy Abo El-Magd
Published: March 2024

Background

Diabetes mellitus is a common systemic disease that affects the kidneys and could eventually develop an end-stage renal failure. Renal biopsy is considered a gold standard for histological characterization of diabetic nephropathy, of which renal fibrosis is a dominant component, affecting its stiffness. The objective of this study is to investigate a correlation between renal stiffness obtained by shear wave elastography, renal Doppler resistivity indices, laboratory findings, and the histological characterization depicted by renal biopsies (if feasible) in diabetic nephropathy patients and to compare their results with those obtained from normal population to explore the diagnostic efficacy of shear wave elastography. Shear wave elastography and color duplex US were performed in twenty-six diabetic nephropathy patients and twenty-six healthy (age and sex-matched) control subjects. The shear wave elastography-derived mean value of the renal tissue stiffness was measured (in kilopascals) as well as the resistivity indices of segmental renal arteries, and then the mean values were correlated to patients' clinical-laboratory data (serum creatinine and albumin/ creatinine ratio) and the biopsy results, if feasible.

Results

A significant positive correlation was found between the mean resistivity indices and the mean renal cortical stiffness at one hand and the patients' clinical-laboratory data with statistically significant differences found between the control, early, and late stages of diabetic nephropathy.

Conclusions

Shear wave elastography is a promising, non-invasive, and accurate diagnostic tool for assessment and differentiation between early and late stages of diabetic nephropathy with a significant positive correlation to the clinical-laboratory and renal Doppler findings.