bluuebunny/crossref_metadata_2025 huggingface dataset:
Respecting the free will, authenticity and autonomy of transgender youth
Authors: Crosse Leonie
Published: September 2023

Transgender and gender diverse (TGD) youth are currently being targeted by global anti-trans legislation that would prevent their access to gender-affirming care even by healthcare providers willing to deliver it and who understand the importance of this support. It has been suggested in some studies that transness in young people is a result of peer contagion. As such their free will, authenticity and autonomy could be brought into question when accessing gender-affirming care. It is important to explore the relevance of these concepts concerning the provision of gender-affirming care to TGD youth by nurses and other healthcare professionals. Nurses should challenge the notion held by some that these young people are not capable of knowing themselves or the level of treatment they require. They can do this by practising gender-affirming care determined by aspirational ethical values of beneficence, non-maleficence, autonomy and justice.
Honing the Craft of Qualitative Data Collection in Extreme Contexts
Authors: Sharma Payal , Toubiana Madeline , Lashley Kisha , Massa Felipe , Rogers Kristie , Ruebottom Trish
Published: September 2023

Over the past several years, there has been ongoing dialog within our academic journals and the profession regarding the value of examining extreme, unconventional, or unsettling contexts in management research. These conversations have highlighted that perhaps more than ever, we as a society are facing unprecedented grand and perplexing challenges, and conducting research in unconventional or extreme settings can reveal complex dynamics or relationships that we may not understand otherwise. Less discussed, however, are methodological considerations for conducting research in unique contexts. As such, we aim to extend the explicit discussion of effective strategies for scholars who consider the perspectives and workplace realities of unusual or unconventional populations. We bring together a collection of reflective essays rooted in the authors’ experiences of collecting data from extreme contexts or unusual samples. We highlight how these rich experiences in the field required the authors to modify or extend methodological conventions with the goal of guiding scholars pursuing research in similarly unconventional contexts.
How Much Collectivism Is There in Young Adults’ Collectivism? Vaccination Against COVID-19 in Serbia
Authors: Janicˇic´ Sonja , Ignjatovic´ Natalija , Vuletic´ Teodora
Published: September 2023

Collectivism is consistently correlated with a positive attitude toward COVID-19 vaccination. Nevertheless, qualitative evidence on how collectivism benefits vaccination is scarce. Serbia has been transitioning from a socialist to a neoliberal country for decades now, and its unique ideological context provokes different forms of collectivism. Young adults are usually the ones who represent radical political, non-neoliberal opposition, embracing collectivistic ideas. We selected a group of self-declared collectivists from Serbia and encouraged them to express their attitude toward vaccination. The final sample consisted of 16 narratives (four female), written by 13 vaccinated and three unvaccinated participants. We conducted two types of thematic analyses, resulting in 12 semantic (five collectivistic and seven individualistic) and two latent themes. The results unambiguously showed the presence of individualism in the argumentation of self-declared collectivists, especially those unvaccinated. We proposed the term Neoliberal collectivism to reach a better understanding of young people’s perspectives in the specific socio-political context.
Microstock images of artificial intelligence: How AI creates its own conditions of possibility
Authors: Romele Alberto , Severo Marta
Published: September 2023

The main goal of this paper is to account for the ‘algorithmization’ of microstock imagery. By this term, the authors refer to a material process implying the chronic use of graphic editors, semi-automatic keywording allowing complex and dynamic proto-classifications, and access to the images via search engines. The algorithmization of microstock imagery also goes along with the exploitation of producers’ labour, so that the authors recognize in it a form of digital labour. Moreover, the term ‘algorithmization’ is meant to underline that this material process has symbolic effects on the image contents as well as on people’s expectations and imaginaries of these contents. The paper analyses, in particular, the case study of microstock images depicting artificial intelligence (AI). By producing hundreds of thousands of visual representations of AI that spread via the Web and beyond it, algorithmized microstock imagery also produces its own symbolic conditions of possibility, that is, the expectations and imaginaries that contribute to the success of AI beyond its concrete effectiveness. The paper is structured into three sections. In the first section, the authors account for the existing literature on stock imagery. They contend that this literature focuses too much on the symbolic message, and too little on the material processes of production of these images. In the second section, the authors describe an empirical analysis they conducted on Shutterstock images depicting AI. In the third section, they distinguish three forms of digital labour and show that microstock imagery entertains resemblances to and differences from each form. They contend that despite its peculiarities, microstock image production is a paradigmatic form of digital labour due to its convergence towards algorithmization. In the conclusion, the authors show how, for microstock images depicting AI, the algorithmic loop of microstock imagery is complete.
Scandinavian design. The continuous closet and queer refugees in Denmark
Authors: Schröder Rieke
Published: September 2023

This article explores how queer refugees’ navigation of ‘the closet’, centre of the coming out metaphor, is subverting its Scandinavian Design. While many queer people in Denmark conceptualize coming out of the closet as a desirable process, allowing queer subjects to become who they truly are, this understanding is challenged by the experiences of queer refugees who are strategically (not) coming out of the closet in different spaces and at different times. Through interviews with queer refugees and volunteers of a support group in Copenhagen, the article shows how these individuals negotiate the continuous closet – (re)appearing in different spaces and at different times. In being cautious about where to come out (on dating apps, in support groups, at home), to whom (friends, family, potential lovers) and at what time(s), queer refugees balance the refugee regimes’ expectations of normative LGBT(IQ)+ identities with their own complex lived realities.
Truth be told: How “true” and “false” labels influence user engagement with fact-checks
Authors: Aruguete Natalia , Bachmann Ingrid , Calvo Ernesto , Valenzuela Sebastián , Ventura Tiago
Published: September 2023

When do users share fact-checks on social media? We describe a survey experiment conducted during the 2019 election in Argentina measuring the propensity of voters to share corrections to political misinformation that randomly confirm or challenge their initial beliefs. We find evidence of selective sharing—the notion that individuals prefer to share pro-attitudinal rather than counter-attitudinal fact-checks. This effect, however, is conditioned by the type of adjudication made by fact-checkers. More specifically, in line with motivated reasoning processes, respondents report a higher intent to share confirmations (i.e. messages fact-checked with a “true” rating) compared with refutations (i.e. messages fact-checked with a “false” rating). Experimental results are partially confirmed with a regression discontinuity analysis of observational data of Twitter and replicated with additional experiments. Our findings suggest that fact-checkers could increase exposure to their verifications on social media by framing their corrections as confirmations of factually correct information.
The incidence and severity of diabetic hand infection presentations during the COVID-19 pandemic
Authors: Riyat Harjoat , Morris Holly , Gillott Elizabeth , Chris Bainbridge L , Johnson Nicholas
Published: September 2023

Diabetic hand infections are difficult to treat and can present with high morbidity. We set out to identify any changes in presentation and disease severity during the COVID-19 pandemic. A total of 61 pre-COVID and 32 during COVID patients with diabetes with a hand infection requiring intravenous antibiotics were included in the study. The pandemic caused a decrease in the number and proportion of presentations. Hospital admissions reduced as service provision was amended to enable increased outpatient treatment. However, there was a significant increase in surgical management (25 vs. 21, p = 0.02), total complications (5 vs. 8, p < 0.05) and incidence of amputations (2 vs. 4, p = 0.09). Mean haemoglobin A1C was also higher (48 mmol/L vs. 40 mmol/L, p < 0.05). While fewer patients attended the service during the pandemic, we witnessed an increased severity of hand infections in those we treated. There is a role for daily outpatient administration of intravenous antibiotics in selected patients to reduce the number of hospital admissions.

 

Level of evidence: IV
Do Minorities’ Friendships with Majority Culture Members and Their Emotional Fit with Majority Culture Influence Each Other Over Time?
Authors: Jasini Alba , De Leersnyder Jozefien , Ceulemans Eva , Gagliolo Matteo , Mesquita Batja
Published: September 2023

Immigrant-origin minorities who have majority friends have emotions that fit the majority norm. However, previous research on the link between minorities’ emotional fit and their friendships with majority culture members has been cross-sectional. Hence, little is known about the directionality of the association and whether emotional fit facilitates minority inclusion. In a longitudinal study of 3216 minority and 2283 majority youth, we tested bidirectional associations between emotional fit and majority friendships over time. Emotional fit was calculated by relating minorities’ emotional patterns to the average pattern of the majority sample in comparable situations. Majority friendships were measured as reciprocal friendship nominations in classrooms and self-report. Cross-lagged panel models offered partial support for the hypotheses using friendship nomination data, and full support using self-reported data. The findings suggest that minorities’ fit with the majority culture increases when they have majority friends and that emotional fit is a promising route for inclusion.
Audience Engagement Techniques in Oral Presentations
Authors: Usera Daniel
Published: September 2023

Public speaking is often conceptualized as a one-way monologue performed by a speaker for a listening audience. This monologic approach faces challenges and limited results as demonstrated by the education literature on active learning. In response to this research, this practitioner article explores the nature and effective execution of five universal Audience Engagement Techniques that provide opportunities for a speaker to turn their passively listening audience into active participants in a dialogue. Practical and theoretical implications of Audience Engagement Techniques generally are also discussed.
Clinicopathological Characteristics and Prognosis of Diffuse Large B-Cell Lymphoma in Relation to CA-125 and CA 19-9 Expression
Authors: Foda Abd AlRahman Mohammad , Atia Tarek , Sakr Hader I. , Abd Elaziz Ahmed Elnaghi Khaled , Abdelhay Wagih M. , Enan Eman T.
Published: September 2023

Background: Some epithelial tumors express the carbohydrate antigen 125 (Cancer antigen-125, CA-125) and CA 19-9, especially ovarian and pancreatic tumors. Patients with non-Hodgkin lymphoma (NHL) were reported to have a close association between serum CA-125 levels and adverse prognostic factors with worse survival. We aimed to investigate CA-125 and 19-9 expression in nodal diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS) tissues using immunohistochemistry (IHC) and their relations to clinicopathological manifestations and patients' survival. Methods: 65 cases of DLBCL NOS were examined. A modified mechanical pencil tip was used to construct Manual Tissue Micro-array (TMA) blocks. Immunohistochemical staining for CA-125 and CA 19-9 was performed and scored semi-quantitatively. All relations were analyzed using established statistical methodologies. Results: Aberrant expression of CA 19-9 was detected in 12% of cases without any expression of CA-125. Moreover, 75% of the CA 19-9 positive cases were statistically significantly associated with anemia and performance status 1. Also, 75% of the CA 19-9 positive cases were females. Conclusions: CA 19-9 was aberrantly expressed in 12% of nodal DLBCL NOS cases and significantly related to anaemia and performance status but not to survival. In cases of DLBCL NOS, CA 19-9 expression cannot be considered an independent prognostic factor. CA-125 was not expressed in nodal DLBCL NOS tissues, necessitating re-evaluation studies. Therefore, it is advised to conduct more research to clarify the potential correlation between serum and tissue CA 19-9 levels and other clinic-pathological characteristics of nodal and extranodal DLBCL NOS patients.
Ribosome biogenesis disruption mediated chromatin structure changes revealed by SRAtac, a customizable end to end analysis pipeline for ATAC-seq
Authors: Freeman Trevor F. , Zhao Qiuxia , Surya Agustian , Rothe Reed , Cenik Elif Sarinay
Published: September 2023

The nucleolus is a large nuclear body that serves as the primary site for ribosome biogenesis. Recent studies have suggested that it also plays an important role in organizing chromatin architecture. However, to establish a causal relationship between nucleolar ribosome assembly and chromatin architecture, genetic tools are required to disrupt nucleolar ribosome biogenesis. In this study, we used ATAC-seq to investigate changes in chromatin accessibility upon specific depletion of two ribosome biogenesis components, RPOA-2 and GRWD-1, in the model organismCaenorhabditis elegans. To facilitate the analysis of ATAC-seq data, we introduced two tools: SRAlign, an extensible NGS data processing workflow, and SRAtac, a customizable end-to-end ATAC-seq analysis pipeline. Our results revealed highly comparable changes in chromatin accessibility following both RPOA-2 and GRWD-1 perturbations. However, we observed a weak correlation between changes in chromatin accessibility and gene expression. While our findings corroborate the idea ofa feedback mechanism between ribosomal RNA synthesis, nucleolar ribosome large subunit biogenesis, and chromatin structure during the L1 stage of C. elegans development, they also prompt questions regarding the functional impact of these alterations on gene expression.
Epigenetic regulation of functional candidate genes for milk production traits in dairy sheep subjected to protein restriction in the prepubertal stage
Authors: Fonseca P. A. S. , Suárez-Vega A. , Esteban-Blanco C. , Pelayo R. , Marina H. , Gutiérrez-Gil B. , Arranz J. J.
Published: September 2023

Background

As the prepubertal stage is a crucial point for the proper development of the mammary gland and milk production, this study aims to evaluate how protein restriction at this stage can affect methylation marks in milk somatic cells. Here, 28 Assaf ewes were subjected to 42.3% nutritional protein restriction (14 animals, NPR) or fed standard diets (14 animals, C) during the prepubertal stage. During the second lactation, the milk somatic cells of these ewes were sampled, and the extracted DNA was subjected to whole-genome bisulfite sequencing.

Results

A total of 1154 differentially methylated regions (DMRs) were identified between the NPR and C groups. Indeed, the results of functional enrichment analyses of the genes harboring these DMRs suggested their relevant effects on the development of the mammary gland and lipid metabolism in sheep. The additional analysis of the correlations of the mean methylation levels within these DMRs with fat, protein, and dry extract percentages in the milk and milk somatic cell counts suggested associations between several DMRs and milk production traits. However, there were no phenotypic differences in these traits between the NPR and C groups.

Conclusion

In light of the above, the results obtained in the current study might suggest potential candidate genes for the regulation of milk production traits in the sheep mammary gland. Further studies focusing on elucidating the genetic mechanisms affected by the identified DMRs may help to better understand the biological mechanisms modified in the mammary gland of dairy sheep as a response to nutritional challenges and their potential effects on milk production.
Efficacy and safety of immune checkpoint inhibitors in Proficient Mismatch Repair (pMMR)/ Non-Microsatellite Instability-High (non-MSI-H) metastatic colorectal cancer: a study based on 39 cohorts incorporating 1723 patients
Authors: Wu Qing , Wang Ziming , Luo Yang , Xie Xianhe
Published: September 2023

Purpose

This study was designed to investigate the efficacy and safety of immune checkpoint inhibitors (ICIs)-based therapy in proficient mismatch repair (pMMR)/non-microsatellite instability-high (non-MSI-H) metastatic colorectal cancer (mCRC).

Methods

Electronic databases were screened to identify relevant trials. The primary endpoints were pooled objective response rate (ORR) and disease control rate (DCR). Stratified analysis was accomplished on ICIs-based regimens, treatment lines and RAS status.

Results

Totally, 1723 mCRC patients from 39 cohorts were included. The pooled ORR, DCR, 12-month overall survival (OS) rate and 6-month progression-free survival (PFS) rate of ICIs-based therapy in pMMR/non-MSI-H mCRC were 8.5% (95% CI: 4.4%-13.5%), 48.2% (95% CI: 37.8%-58.6%), 52.3% (95% CI: 46.4%-58.1%) and 32.8% (95% CI: 23.5%-42.7%) respectively. As a whole, no significantly differences were shown between ICIs-based and non-ICIs-based therapy for pMMR/non-MSI-H mCRC in terms of both PFS (HR = 1.0, 95% CI: 0.9–1.1, P = 0.91) and OS (HR = 1.0, 95% CI: 0.9–1.2, P = 0.51). It was worth noting that the addition of ICIs to anti-vascular endothelial growth factor (VEGF) agent plus chemotherapy displayed excellent efficacy in pMMR/non-MSI-H mCRC (ORR = 42.4%, 95% CI: 10.0%-78.6%; DCR = 92.0%, 95% CI: 68.3%-100.0%; 12-month OS rate = 71.4%, 95% CI: 50.0%-89.1%; 6-month PFS rate = 55.2%, 95% CI: 24.8%-83.8%; and PFS (compared with non-ICIs-based therapy): HR = 0.9, 95% CI: 0.8–1.0, P = 0.02), especially served as first-line therapy (ORR = 74.2%, 95% CI: 61.4%-85.4%; DCR = 98.7%, 95% CI: 92.0%-100.0%); and without additional treatment related adverse events (TRAEs) were observed.

Conclusions

ICIs-based combination therapy, especially the addition of ICIs to first-line anti-VEGF agent plus chemotherapy, is promising in pMMR/non-MSI-H mCRC with good efficacy and controllable toxicity.
Association between weight-adjusted-waist index and risk of cardiovascular diseases in United States adults: a cross-sectional study
Authors: Fang Haiyang , Xie Feng , Li Kai , Li Meng , Wu Yanqing
Published: September 2023

Background

As a new obesity-related index, the weight-adjusted-waist index (WWI) appears to be a good predictor of cardiovascular disease (CVD) in East Asian populations. This study aimed to validate the association between WWI and CVD in United States (US) adults and also evaluate its relationships with the prevalence of specific CVDs.

Methods

The data were obtained from the 2009–2016 National Health and Nutrition Examination Survey. WWI was calculated as waist circumference divided by the square root of weight, and CVD was ascertained based on self-reported physician diagnoses. Multivariable logistic regression models and subgroup analyses were performed to evaluate the association between WWI and CVD.

Results

A total of 21,040 participants were included. There was a positive linear relationship between WWI and the odds of CVD (P = 0.310). After adjusting for all covariates, each unit of increased WWI was associated with 48% increased risk of CVD (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.25–1.74). Moreover, compared with the lowest quintile (< 10.3 cm/√kg), the multivariable-adjusted OR was 3.18 (95% CI: 1.80–5.59) in the highest quintile (≥ 11.8 cm/√kg). Besides, positive associations were also found between WWI and increased prevalence of congestive heart failure (OR: 1.47, 95% CI: 1.11–1.96), coronary heart disease (OR: 1.27, 95% CI: 1.01–1.60), angina (OR: 1.44, 95% CI: 1.06–1.96), heart attack (OR: 1.66, 95% CI: 1.29–2.12), and stroke (OR: 1.32, 95% CI: 1.02–1.70). Subgroup analyses showed that stronger associations between WWI and CVD were detected in participants younger than 50 years of age (P < 0.001).

Conclusions

High levels of WWI were significantly associated with an increased risk of CVD in US adults, particularly in people under 50 years of age. These findings indicate that WWI may be an intervention indicator to reduce the risk of CVD in the general adult population.
Prevalence of social frailty and its associated factors in the older Chinese population: a national cross-sectional study
Authors: Qi Xin , Li Yingying , Hu Jiabin , Meng Lingbing , Zeng Ping , Shi Jing , Jia Na , Zeng Xuezhai , Li Hui , Zhang Qiuxia , Li Juan , Liu Deping
Published: September 2023

Background

Social frailty has not been comprehensively studied in China. Our objective is to investigate the prevalence of social frailty among the older population in China, as well as identify relevant factors and urban-rural differences.

Methods

We obtained data from the Fourth Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) database. The study employed a multistage, stratified, cluster-sampling method, recruiting a total of 224,142 adults aged 60 years or older. Participants were interviewed to gather demographic data and information on family, health and medical conditions, health care service status, living environment conditions, social participation, protected rights status, spiritual and cultural life, and health. Social frailty was assessed using the HALFE Social Frailty Index. A score of three or above indicated social frailty.

Results

We analyzed a total of 222,179 cases, and the overall prevalence of social frailty was found to be 15.2%. The highest prevalence was observed among participants aged 75–79 years (18.0%). The prevalence of social frailty was higher in rural older populations compared to urban older populations (19.9% in rural vs. 10.9% in urban, P < 0.0001). In urban areas, women had a higher prevalence than men (11.7% in women vs. 9.9% in men, P < 0.0001), while in rural areas, men had a higher prevalence than women (20.6% in men vs. 19.2% in women, P < 0.0001). Multivariate regression analysis revealed that living in a rural/urban environment (OR 1.789, 95% CI 1.742–1.837), absence of a spouse/spousal presence (OR 4.874, 95% CI 4.743–5.009), self-assessed unhealthy/health status (OR 1.696, 95% CI 1.633–1.761), and housing dissatisfaction/satisfaction (OR 2.303, 95% CI 2.233–2.376) were all significantly associated with social frailty.

Conclusions

Using the HALFE social frailty index, we found a prevalence of 15.2% among older people in China, with the highest prevalence observed in the 75–79 age group. Social frailty was more prevalent in rural areas than in urban areas. Various factors, including spousal presence, housing satisfaction, health status, and urban-rural residential differences, were significantly associated with social frailty. These findings highlight the modifiable and non-modifiable factors that contribute to social frailty among older individuals in China.
Suspected medullary washout leading to severe polyuria following delayed cerebral ischemia: a case report
Authors: Sene Pape-Mamadou , Gebai Ahmad , Kopel Tal , Cailhier Jean-François , Lafrance Dominique , Côté Jean-Maxime
Published: September 2023

Background

Delayed cerebral ischemia is a clinical entity commonly encountered in patients presenting with acute neurological injury and is often complicated by dysnatremias, such as the cerebral salt wasting syndrome. In this case report, we described an exceptional case of polyuria attributed to an initial cerebral salt wasting phenomenon and iatrogenic-induced medullary washout.

Case presentation

A 53-year-old woman was admitted to our hospital for the management of a Modified Fisher scale grade 4 subarachnoid hemorrhage due to a ruptured posterior communicating aneurysm. She was initially managed with coil embolization and external ventricular drain due to secondary hydrocephalus. Throughout the course of her hospitalization, she developed severe polyuria reaching up to 40L per day. To keep up with the excessive urinary losses and maintain appropriate cerebral perfusion, fluid replacement therapy was adjusted every hour, reaching up to 1.3 L of crystalloid per hour in addition to aminergic support. An initial diagnosis of partial diabetes insipidus, followed by a cerebral salt wasting syndrome was suspected. While the urine output continued to increase, her serum urea concentration progressively decreased to a point of almost being undetectable on day 9. At that time, the presence of an interstitial medulla washout was hypothesized. Various pharmacological and non-pharmacological interventions were progressively introduced to regain normal renal homeostasis, including non-steroidal anti-inflammatory drugs, fludrocortisone, oral urea and high-protein intake. Medications were progressively weaned, and the patient was successfully discharged from the ICU.

Conclusions

Cerebral salt wasting should be considered in the initial differential diagnosis of a patient presenting with polyuria in the context of acute neurological injury. Early recognition of this entity is critical to quickly implement proper management. However, as shown in this case report, the concomitance of delayed cerebral ischemia may complexify that management.
Effects of the online and offline hybrid continuous group care on maternal and infant health: a randomized controlled trial
Authors: Yang Xiaoli , Li Linwei , Zhou Rong , Xia Jieqiong , Li Minxiang , Zhang Caihong , Guo Honghua
Published: September 2023

Background

The group care is a well-established maternal care model that has been widely used in many developed countries, but in China, it is confined to prenatal care services. In addition, affected by traditional birth culture, Chinese women tend to focus more on their fetuses and newborns but lack attention to their own intrapartum and postpartum care. The aim of this study was to construct and implement a prenatal, intrapartum, and the postpartum continuous group care model that combines online and offline service in Hainan Province, China, and to evaluate the effect on maternal women and newborns.

Methods

This study was a randomized controlled trial involving 144 pregnant women in a first-class tertiary general hospital in Hainan Province, China. Women were divided into an intervention group and a control group using the random number table, with 72 women in each group. The control group received routine maternal care services, and the intervention group received the continuous group care based on the routine maternal care services. Count data such as rate of cesarean section and incidence rate of fetal macrosomia were analyzed with the chi-square test or Fisher’s exact test, and the General Self-efficacy Scale scores were analyzed by repeated measures ANOVA. P < 0.05 was considered statistically significant, with two-sided probability values.

Results

Compared with the control group, the rate of excessive prenatal weight gain, cesarean section, and 42-day postpartum depression were significantly lower in the intervention group (P < 0.05), and higher General Self-efficacy Scale scores (in the expectant period and 42 days postpartum) and exclusive breastfeeding rate (42 days postpartum) (P < 0.05). The incidence of fetal macrosomia was significantly lower in the intervention group (P < 0.05). But there was no significant difference in birth weight, preterm birth, the incidence of low-birth-weight infants and 1-min Apgar score (P > 0.05).

Conclusion

The continuous group care with online and offline service can effectively control the gestational weight gain, reduce the rate of cesarean section, macrosomia, and postpartum depression. It can improve the self-efficacy of women and the rate of exclusive breastfeeding effectively.

Trial registration

Chinese Clinical Trial Regestry (ChiCTR2200065765, 04/11/2022, Retrospectively registered).
PD-L1 protein expression by Combined Positive Score (CPS) in patients with muscle invasive or advanced urothelial carcinoma: a single institution experience
Authors: Nasr Sarah , Haddad Fadi G. , Khazen Joseph , Kattan Joseph , Trak-Smayra Viviane
Published: September 2023

Introduction

Immune checkpoint inhibitors have revolutionized the treatment of patients with advanced urothelial carcinoma (UC) in the frontline and relapsed settings. Lebanon has one of the highest incidence of UC worldwide, yet no data exists regarding the expression of PD-L1 by Combined Positive Score (CPS) in advanced disease.

Methods

We reviewed all patients treated at our institution for high grade UC, stage pT2 and above, between January 2017 and March 2021. We assessed the expression of PD-L1 by immunohistochemistry using 22C3 clone, and analyzed the association between PD-L1 expression and clinicopathological characteristics. PD-L1 positivity was defined as CPS score ≥ 10.

Results

A total of 101 patients with advanced UC were included, with a median age of 71 years (range, 38 to 96 years); 78% were ever-smokers. Ninety-three of 101 patients (92%) had conventional UC and 43 patients (43%) had positive PD-L1 expression, with 12 patients having CPS of 100. The analysis by molecular subtype showed that patients with maximal CPS of 100 were enriched in “basal” molecular subtype. However, no association was found between PD-L1 expression (positive versus negative) and clinicopathological characteristics.

Conclusion

The positivity of PD-L1 expression as assessed by CPS using the 22C3 clone in our population was almost comparable to the results reported in the occidental literature. Therefore, PD-L1 expression, as a potential predictor of response to immunotherapy, concerns the same percentage of the Lebanese UC patients.
Knowledge, attitude and preventative practice of tuberculosis in rural communities of Dikgale, Mamabolo and Mothiba health and demographic surveillance system in Limpopo province, South Africa
Authors: Seloma Ngwanamohuba Mologadi , Makgatho Marema Ephraim , Maimela Eric
Published: September 2023

Background

Tuberculosis continues to be a serious public health issue. To reduce the transmission of the disease, it is imperative to address the major obstacle of inadequate understanding regarding the causes, risk factors, treatments, and prevention of pulmonary TB. The study assessed knowledge, attitude, and preventative practices of tuberculosis among community members in Dikgale, Mamabolo and Mothiba (DIMAMO) Health Demographic Surveillance system, Limpopo Province South Africa.

Methods

A cross-sectional clinic-based survey involving 360 participants was conducted at clinics at Dikgale, Mamabolo and Mothiba (DIMAMO) Health and Demographic Surveillance System. A standardised questionnaire on socio-demographic, knowledge, attitude and preventative practices towards tuberculosis based on (WHO) KAP-TB template guidelines was used to collect data. Descriptive statistics on Statistical Package for Social Sciences (SPSS) version 27.0 was used to analyse data.

Results

The results of the cross-sectional survey on KAP-TB illustrated that the participants have good knowledge, attitude, and perception of TB. Majority of the participants (n = 270, 75%) had good general knowledge, while (n = 90, 25%) had poor knowledge about TB. However, the study reports (n = 57, 15.6%) having knowledge of causative agents of TB. Participants showed a favourable attitude toward people who are infected with TB. 87% showed a favourable attitude while only 12.46% showed an unfavourable attitude towards TB. Participants showed a good practice of (71.7%) while (28.3%) of participants had poor practice towards TB.

Conclusion

Health education interventions programme on TB needs to be intensified among the community members to improve TB awareness and reduce transmission. Focused educational interventions on TB aetiology and mode of transmission are required to increase TB preventative practices and improve health-seeking behaviour among community members.
Cervical cancer screening outcomes in public health facilities in three states in Nigeria
Authors: Lawson Olufunmilayo , Ameyan Lola , Tukur Zainab , Dunu Sophia , Kerry Matilda , Okuyemi Oluwapelumi Ololade , Yusuf Zainab , Fasawe Olufunke , Wiwa Owens , Hebert Katharine Schilling , Joseph Jessica Trenc , Nwokwu Uchechukwu Emmanuel , Okpako Okpikpi , Chime Christopher Ifeanyi
Published: September 2023

Background

Cervical cancer continues to generate a significant burden of disease and death in low- and middle-income countries (LMICs). Lack of awareness and poor access to early screening and pre-cancer treatment contribute to the high mortality. We describe here cervical cancer screening outcomes in public health facilities in three states in Nigeria.

Methods

We conducted an observational study in 177 government health facilities in Lagos, Kaduna, and Rivers State, Nigeria from January to December 2021, in which we reviewed programmatic data collected through the newly introduced Cervical Cancer Prevention Program. Women who received screening and provided consent were enrolled into the study. Data were extracted from registers in the health facilities using SurveyCTO and descriptive statistical analysis was conducted using StataSE 15 (StataCorp, College Station, TX, USA).

Results

Eighty-three thousand, five hundred ninety-three women were included in the analysis including 6,043 (7%) WLHIV. 67,371 (81%) received VIA as their primary screening while 16,173 (19%) received HPV DNA testing, with 49 (< 1%) receiving both at the same time. VIA positivity was 7% for WLHIV and 3% for general population, while HPV prevalence was 16% for WLHIV and 8% for general population. Following a positive HPV result, 21% of women referred, completed triage examination. 96% of women identified with precancerous lesions, received treatment. 44% of women with suspected cancer were successfully referred to an oncology center for advanced treatment. Following treatment with thermal ablation, seven adverse events were reported.

Conclusions

The Program has successfully increased women’s access to screening and treatment of precancerous lesions. Almost all women who were eligible for pre-cancerous lesion treatment received it, often on the same day when screened using VIA. However, for women referred for a triage exam or due to suspected cancer, many did not complete their referral visits. More effort is required to ensure HPV positive women and women with suspected cancer are adequately linked to care to further reduce morbidity and mortality associated with cervical cancer in Nigeria. Implementation studies should be conducted to provide insights to improve the utilization of the existing centralized and point of care (POC) platforms to facilitate same day results, and to improve triage and treatment rates.
An examination of the relationships between the neighborhood social environment, adiposity, and cardiometabolic disease risk in adolescence: a cross-sectional study
Authors: Denstel Kara D. , Beyl Robbie A. , Danos Denise M. , Kepper Maura M. , Staiano Amanda E. , Theall Katherine T. , Tseng Tung-Sung , Broyles Stephanie T.
Published: September 2023

Background

Disadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 years.

Methods

This cross-sectional study utilized baseline data from the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) study. Adolescent data were obtained using self-reported questionnaires (demographics and perceived neighborhood disorder), anthropometry, body imaging, and a blood draw while objective neighborhood data for the concentrated disadvantage index were acquired from the 2016 American Community Survey five-year block group estimates, 2012–2016. Multilevel linear regression models were used to examine whether neighborhood concentrated disadvantage index and perceived neighborhood disorder were associated with body mass index, waist circumference, body fat, adipose tissue, blood pressure, and lipids. We performed multilevel logistic regression to determine the odds of elevated adiposity and cardiometabolic disease risk for adolescents living in neighborhoods with varying levels of neighborhood concentrated disadvantage and disorder.

Results

Adolescents living in neighborhoods with higher disadvantage or disorder had greater waist circumference and total percent body fat compared to those in less disadvantaged and disordered neighborhoods (p for trend < 0.05). Neighborhood disadvantage was also positively associated with percentage of the 95th Body Mass Index percentile and visceral abdominal adipose tissue mass while greater perceived neighborhood disorder was related to higher trunk fat mass and diastolic blood pressure (p for trend < 0.05). Living in the most disadvantaged was associated with greater odds of obesity (OR: 2.9, 95% CI:1.3, 6.5) and being in the top tertile of body fat mass (OR: 3.0, 95% CI: 1.4, 6.6). Similar results were found with neighborhood disorder for odds of obesity (OR: 2.1, 95% CI:1.1, 4.2) and top tertile of body fat mass (OR: 2.1, 95% CI:1.04, 4.1).

Conclusions

Neighborhood social environment measures of chronic stress exposure were associated with excess adiposity during adolescence, and relationships were most consistently identified among adolescents living in the most disadvantaged and disordered neighborhoods. Future studies should account for the influences of the neighborhood environment to stimulate equitable improvements in adolescent health.

Clinical Trials Registration

# NCT02784509.
Factors associated with full vaccination and zero vaccine dose in children aged 12–59 months in 6 health districts of Cameroon
Authors: Yakum Martin Ndinakie , Atanga Funwie Desmond , Ajong Atem Bethel , Eba Ze Linda Evans , Shah Zahir
Published: September 2023

Background

Routine immunisation coverage in Cameroon is still below the target of the national Expanded Programme on Immunisation (EPI), with only 42% of children fully immunised according to Demographic and Health Survey (DHS) report in 2018. The objective of this study was to evaluate factors associated with full immunisation and zero-dose in Cameroonian children.

Methods

A two-stage cross-sectional cluster survey was conducted in Yaoundé in November 2021, targeting children aged 12–59 months. The clusters were chosen with probability proportionate to population size (PPS), and households selected by restricted sampling technique. Data were collected from the vaccination card of the child or from parents’ recall, if the card was not available, using electronic forms with tablets. Using R (version 4.1.0.), the proportion of fully immunised children was calculated. The household wealth index was described using principal component analysis, and factors associated with full immunisation assessed with multiple logistics regression. The threshold of statistical significance was set at 5%.

Findings

A total, 273 children aged 12–59 months enrolled; 37% of participants were fully immunised, and 16% had never received any vaccine. Mother’s level of education: Primary (OR = 3.59,p = 0.0200), high school (OR = 3.68,p = 0.0400*), and higher education (OR = 8.25,p = 0.0018), and sharing household with biological father (OR = 2.11,p = 0.0305) were significantly associated with full vaccination. Living in a richer (3rd-5thwealth quintiles) household (OR = 0.25,p = 0.0053); mother’s education: Primary (OR = 0.07,p = 0.0271) and Higher education (OR = 0.10,p = 0.0419), living with the mother (OR = 0.05,p =  < 0.0001) and living with the father (OR = 0.22,p = 0.0253) had significant negative association with zero-dose in children.

Conclusion

The proportion of fully vaccinated children in Yaounde is lower than the national average. Children from poor homes and those borne by uneducated mother have higher odds of not being vaccinated. Immunisation programmes in Yaounde need to be stepped up to improve coverage. Equally, there is a need to reconsider how the poor can the better reached with immunisation services.
Spatio-temporal evolution patterns of influenza incidence and its nonlinear spatial correlation with environmental pollutants in China
Authors: Li Hao , Ge Miao , Wang Congxia
Published: September 2023

Background

Currently, the influenza epidemic in China is at a high level and mixed with other respiratory diseases. Current studies focus on regional influenza and the impact of environmental pollutants on time series, and lack of overall studies on the national influenza epidemic and the nonlinear correlation between environmental pollutants and influenza. The unclear spatial and temporal evolution patterns of influenza as well as the unclear correlation effect between environmental pollutants and influenza epidemic have greatly hindered the prevention and treatment of influenza epidemic by relevant departments, resulting in unnecessary economic and human losses.

Method

This study used Chinese influenza incidence data for 2007–2017 released by the China CDC and air pollutant site monitoring data. Seasonal as well as inter monthly differences in influenza incidence across 31 provinces of China have been clarified through time series. Space-Time Cube model (STC) was used to investigate the spatio-temporal evolution of influenza incidence in 315 Chinese cities during 2007–2017. Then, based on the spatial heterogeneity of influenza incidence in China, Generalized additive model (GAM) was used to identify the correlation effect of environmental pollutants (PM2.5, PM10, CO, SO2, NO2, O3) and influenza incidence.

Result

The influenza incidence in China had obvious seasonal changes, with frequent outbreaks in winter and spring. The influenza incidence decreased significantly after March, with only sporadic outbreaks occurring in some areas. In the past 11 years, the influenza epidemic had gradually worsened, and the clustering of influenza had gradually expanded, which had become a serious public health problem. The correlation between environmental pollutants and influenza incidence was nonlinear. Generally, PM2.5, CO and NO2 were positively correlated at high concentrations, while PM10 and SO2 were negatively correlated. O3 was not strongly correlated with the influenza incidence.

Conclusion

The study found that the influenza epidemic in China was in a rapidly rising stage, and several regions had a multi-year outbreak trend and the hot spots continue to expand outward. The association between environmental pollutants and influenza incidence was nonlinear and spatially heterogeneous. Relevant departments should improve the monitoring of influenza epidemic, optimize the allocation of resources, reduce environmental pollution, and strengthen vaccination to effectively prevent the aggravation and spread of influenza epidemic in the high incidence season and areas.
Assessing the role of anastomotic level in low anterior resection (LAR) surgery among rectal cancer patients in the development of LAR syndrome: a systematic review study
Authors: Hashempour Mohammad Reza , Moradi Muhammadhosein , oroomi Reza Ghasemian , Daneshvar Siamak , Meysamie Alipasha , Nikshoar Mohammadreza , Anaraki Fakhrosadat
Published: September 2023

Background

The etiology of LARS has not been elaborated on clearly. Studies have reported neoadjuvant therapy, low-lying rectal cancers, adjuvant therapy and anastomotic leakage as risk factors for the development of LARS. Anastomotic level has also been proposed as a possible risk factor; However, there have been conflicting results. This study aims to evaluate the role of the level of anastomosis as a potential risk factor for the development of LARS.

Method

A systematic literature search was conducted on Pubmed, Scopus, Embase, and Web of Science databases using Mesh terms and non-Mesh terms from 2012 to 2023. Original English studies conducted on rectal cancer patients reporting of anastomotic level and LARS status were included in this study. Eligible studies were assessed regarding quality control with Joanna-Briggs Institute (JBI) questionnaires.

Results

A total of 396 articles were found using the research queries, and after applying selection criteria 4 articles were selected. A sample population of 808 patients were included in this study with a mean age of 61.51 years with male patients consisting 59.28% of the cases. The Mean assessment time was 15.6 months which revealed a mean prevalence of 48.89% for LAR syndrome. Regression analysis revealed significantly increased risk of LAR syndrome development due to low anastomosis level in all 4 studies with odds ratios of 5.336 (95% CI:3.197–8.907), 3.76 (95% CI: 1.34–10.61), 1.145 (95% CI: 1.141–2.149) and 2.11 (95% CI: 1.05–4.27) for low anastomoses and 4.34 (95% CI: 1.05–18.04) for ultralow anastomoses.

Conclusions

LARS is a long-term complication following surgery, leading to reduced quality of life. Low anastomosis level has been reported as a possible risk factor. All of the studies in this systematic review were associated with an increased risk of LARS development among patients with low anastomosis.