bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and enablers to emergency obstetric and newborn care services use in Wolaita Zone, Southern Ethiopia: a qualitative case study
Authors: Alemayehu Mihiretu , Yakob Bereket , Khuzwayo Nelisiwe
Published: November 2022

Background

Globally, 11.4 million untreated obstetric complications did not receive Emergency Obstetric and Newborn Care (EmONC) services yearly, with the highest burden in low and middle-income countries. Half of the Ethiopian women with obstetric complications did not receive EmONC services. However, essential aspects of the problem have not been assessed in depth. This study, therefore, explored the various aspects of barriers and enablers to women’s EmONC services utilization in southern Ethiopia.

Methodology

A qualitative case study research design was used in nine districts of the Wolaita Zone. A total of 37 study participants were selected using a purposive stratified sampling technique and interviewed till data saturation. Twenty-two key informant interviews were conducted among front-line EmONC service providers, managers, community leaders, and traditional birth attendants (TBAs). Individual in-depth interviews were conducted among 15 women with obstetric complications. The trustworthiness of the research was assured by establishing credibility, transferability, conformability, and dependability. NVivo 12 was used to assist with the thematic data analysis.

Result

Five themes emerged from the analysis: service users’ perception and experience (knowledge, perceived quality, reputation, respectful care, and gender); community-related factors (misconceptions, traditional practices, family and peer influence, and traditional birth attendants’ role); access and availability of services (infrastructure and transportation); healthcare financing (drugs and supplies, out-of-pocket expenses, and fee exemption); and health facility-related factors (competency, referral system, waiting time, and leadership).

Conclusion

Many women and their newborns in the study area suffered severe and life-threatening complications because of the non-utilization or delayed utilization of EmONC services. A key policy priority should be given to enhancing women’s awareness, eliminating misconceptions, improving women’s autonomy, and ensuring traditional practices’ role in EmONC service utilization. Community awareness interventions are required to enhance service uptake. Furthermore, the health systems must emphasize improving the quality of care, inequitable distribution of EmONC facilities, and essential drugs. The financial constraints need to be addressed to motivate women from low socioeconomic status. Furthermore, intersectoral collaboration is required to maintain a legal framework to control and prohibit home deliveries and empower women.
Potential effects of adverse childhood experiences on school engagement in youth: a dominance analysis
Authors: Webb Nathaniel J. , Miller Thaddeus L. , Stockbridge Erica L.
Published: November 2022

Background

Adverse childhood experiences (ACEs) can have severe negative impacts on childhood and adult health via worsened school engagement and educational outcomes. This study seeks to identify the relative importance of various ACEs in predicting school engagement.

Methods

We analyzed data from the National Survey of Children’s Health for school-aged children (ages 6-17) for 2018 and 2019. The primary outcome was school engagement, measured through three variables: repeating a grade, doing required homework, and caring about doing well in school. We conducted three logistic regression models with dominance analyses to identify the relative importance of ACE variables in predicting school engagement outcomes.

Results

In unadjusted and adjusted dominance analyses, parental incarceration was the most important ACE in predicting repeating a grade. Living in a household in which it was hard to cover basics like food or housing was the most important ACE in predicting doing required homework and caring about doing well in school.

Discussion

Our study points toward the large influence of out-of-school factors on school engagement. Parental incarceration and economic hardship, the most important predictors of engagement, are issues that can be addressed and mitigated through policy interventions. With limited funds available for education and public health interventions, it is crucial that these two ACEs be priority considerations when developing policy. A multi-faceted approach that reduces the incarcerated population, encourages economic well-being, and emphasizes early-childhood education has the potential to significantly improve school engagement in vulnerable populations and ultimately advance social equity.
Impact of high-risk of obstructive sleep apnea on chronic cough: data from the Korea National Health and Nutrition Examination Survey
Authors: Kim Tae Hoon , Heo I Re , Kim Ho Cheol
Published: November 2022

Background

Chronic cough is an extremely common clinical symptom of various diseases. However, the relationship between obstructive sleep apnea (OSA) and chronic cough in the general population has not been sufficiently studied.

Methods

Using the 2019 Korean National Health and Nutrition Examination Survey data, we identified a group at high-risk of OSA via the STOP-Bang questionnaire and determined the association between OSA and chronic cough by a regression model.

Results

Of the eligible 4,217 participants, 97.1% and 2.9% were classified into the non-chronic cough and chronic cough groups, respectively. The chronic cough group had higher STOP-Bang scores than those of the group without chronic cough (2.32 ± 1.38 vs. 2.80 ± 1.39; P < 0.001). In the group at high-risk of OSA, 40.4% and 52.0% of participants scored ≥ 3 in STOP-Bang, depending on the absence or presence of chronic cough (P = 0.012), respectively. Chronic cough independently correlated with impaired lung function (forced expiratory volume in one second ≥ 50–<80% predicted value, P = 0.001; <50, P < 0.001), low household income (P = 0.015), and a group at high-risk of OSA (STOP-Bang score 3–4, P = 0.004; 5–8, P < 0.001). Obesity I had a protective role against the occurrence of chronic cough (P = 0.023).

Conclusion

A high-risk for OSA is a significant risk factor for chronic cough. OSA should be considered when evaluating chronic cough patients.
A simple method for quick evaluation of the anterior tooth ratio: an observational study
Authors: Zhang Guanning , Feng Qingchen , Wei Xiaoyu , Xing Ke , Mei Hongxiang , Zhou Jiawei , Jiang Chen , Li Juan
Published: November 2022

Background

An ideal relationship of anterior teeth is closely related to postoperative function, stability, and aesthetics. Therefore, it is necessary to estimate the proportion of anterior teeth when communicating with patients about possible treatment plans and outcomes. This study aimed to establish a simple method for assessing the proportion of anterior teeth and to identify the standard ratio value to provide references for clinical work.

Methods

Five hundred fourteen patients were divided into derivation, standard, and validation datasets. We first deduced our novel simplified anterior tooth ratio (SATR) by finding the key teeth with the derivation datasets, then established standard values by measuring the standard models, and finally validated the diagnostic performance of SATR. Independent sample t-test was used to select key teeth. Pearson’s correlation analysis and linear regression analysis was used to test and verify the correlation between SATR and the anterior Bolton ratio. Chi-square test and diagnostic test were used to verify the diagnostic results using SATR.Pvalues of < 0.05 were considered statistically significant.

Results

Patients with an abnormal anterior Bolton ratio were more likely to have variations in the maxillary and mandibular lateral incisors. Therefore, the ratio of maxillary and mandibular lateral incisors was chosen as a simple way to assess the anterior tooth ratio and was defined as SATR (simplified anterior tooth ratio). A positive correlation was observed between SATR and anterior Bolton ratio (r = 0.702,p < 0.001), with the linear regression equation as follows: y = 0.503 + 0.328x, x = SATR, y = anterior Bolton ratio. The standard value of SATR was established (85.69% ± 3.57%) and proven reliable in clinical practice.

Conclusions

The ratio of maxillary and mandibular lateral incisors can be used to estimate the anterior tooth ratio, which showed high reliability and efficiency.
Women empowerment and access to maternity and reproductive healthcare in Pakistan: cross-validation of a Survey-based Index in Afghanistan (SWEI-A)
Authors: Dadras Omid , Dadras Mohammadyasin , Jafari Leila , Nakayama Takeo , Dadras Fateme
Published: November 2022

Background

Despite the obvious violation of women’s rights in Pakistan and the vital necessity for women empowerment, a unified country-specific index measuring women empowerment is not yet available. This study cross-validated a survey-based women empowerment index from Afghanistan to be used in Pakistan.

Methods

The data for married Pakistani women aged 15–49 in the 2017–18 Pakistan demographic health survey was used to construct the final model using the explanatory and confirmatory factor analyses. The Cronbach’s alpha test examined the internal consistency of the developed index. To assess the convergence validity of the index, the association of each emerged domain with indicators of access to reproductive and maternity care was assessed by Poisson regression analysis adjusting for wealth index.

Results

The final index had six domains; namely, labor force participation, attitude toward violence, decision-making, access to healthcare, literacy, age at critical life events predicting women empowerment of married Pakistani women with decent reliability (Cronbach’s α = 0.70), and validity (SRSEA&SRMR < 0.05, CFI&TLI > 0.92). The emerged domains were significantly associated with at least one of four indicators for access to reproductive and maternity care; indicative of a favorable convergence validity.

Conclusion

Pakistan and Afghanistan are associated as brother countries with shared religious and ethnocultural identities in which women are perceived inferior to men and in critical need of empowering efforts. The results of this study reflect upon this resemblance in sociocultural structure by yielding similar domains for women's empowerment in Pakistan building upon an index previously developed for Afghan women. The developed index could inform the design of future policies, interventions, and research recognizing the important indicators of women empowerment in Pakistan and could enhance the comparability of the results across future studies.
Creation and evaluation of a participatory child abuse and neglect workshop for medical students
Authors: Giannakas Christos , Manta Aspasia , Livanou Maria Effrosyni , Daniil Vasiliki , Paraskeva Angeliki , Georgiadou Maria-Konstantina , Griva Nefeli , Papaevangelou Vassiliki , Tsolia Maria , Leventhal John M. , Soldatou Alexandra
Published: November 2022

Background

Since child abuse and neglect (CAN) is prevalent worldwide, medical students should acquire basic knowledge, skills, and confidence in identifying and addressing CAN. Although significant educational efforts have been previously described, none has focused on using participatory methods to teach medical students CAN.

Purpose

To: 1) develop a participatory educational workshop in CAN for medical students, 2) gather, train, and establish a peer-to-peer teaching group, and 3) assess the effectiveness of the workshop in gain of knowledge and improvement of self-confidence for participants.

Methods

A two-hour workshop was created with role-playing, the use of mannikins and peer-to-peer teaching. A 15-item knowledge and a 9-item self-confidence questionnaire were used before, right after, and six months after each workshop.

Results

Nine workshops in two academic pediatric departments with a total attendance of 300 6th year medical students were conducted. For the 69 students who completed the questionnaires at all three times, there were statistically significant gains in knowledge right after (p < .001) and six months after (p < .0001) the workshops. Similarly, self-confidence increased right after (p < .0001) and six months after (p < .001) the workshops. Self-selection bias testing indicated that these 69 students who completed all three questionnaires were representative of those who completed the pre-testing and the testing right after.

Conclusions

We successfully established a peer-to-peer teaching group to conduct nine participatory workshops that improved the participants’ knowledge and self-confidence in CAN. This feasible and novel active learning approach may help address inadequacies in medical curricula.
Estimating critical values from electrocardiogram using a deep ordinal convolutional neural network
Authors: Wei Guodong , Di Xinxin , Zhang Wenrui , Geng Shijia , Zhang Deyun , Wang Kai , Fu Zhaoji , Hong Shenda
Published: November 2022

Background

Critical values are commonly used in clinical laboratory tests to define health-related conditions of varying degrees. Knowing the values, people can quickly become aware of health risks, and the health professionals can take immediate actions and save lives.

Methods

In this paper, we propose a method that extends the concept of critical value to one of the most commonly used physiological signals in the clinical environment—Electrocardiogram (ECG). We first construct a mapping from common ECG diagnostic conclusions to critical values. After that, we build a 61-layer deep convolutional neural network named CardioV, which is characterized by an ordinal classifier.

Results

We conduct experiments on a large public ECG dataset, and demonstrate that CardioV achieves a mean absolute error of 0.4984 and a ROC-AUC score of 0.8735. In addition, we find that the model performs better for extreme critical values and the younger age group, while gender does not affect the performance. The ablation study confirms that the ordinal classification mechanism suits for estimating the critical values which contain ranking information. Moreover, model interpretation techniques help us discover that CardioV focuses on the characteristic ECG locations during the critical value estimation process.

Conclusions

As an ordinal classifier, CardioV performs well in estimating ECG critical values that can help people quickly identify different heart conditions. We obtain ROC-AUC scores above 0.8 for all four critical value categories, and find that the extreme values (0 (no risk) and 3 (high risk)) have better model performance than the other two (1 (low risk) and 2 (medium risk)). Results also show that gender does not affect the performance, and the older age group has worse performance than the younger age group. In addition, visualization techniques reveal that the model pays more attention to characteristic ECG locations.
Conceptual model for nurse educators to facilitate their presence in large class groups of nursing students through reflective practices: a theory synthesis
Authors: Froneman Kathleen , du Plessis Emmerentia , van Graan Anneke Catherina
Published: November 2022

Background

Nurse educators are required to be present and reflective while directly involving nursing students in teaching–learning using creative and innovative interaction. Heavy daily workloads (including the teaching of large classes, clinical supervision and research) could hamper facilitating their presence through reflective practices. There is insufficient information on how nurse educators can facilitate their presence through reflective practices in large class groups of nursing students. 

Methods

The researchers followed Walker and Avant’s strategy of statement and theory synthesis to develop this model. Three iterative steps to theory synthesis involved identifying, defining, and classifying main and related concepts, defining relational statements, and organising the main and related concepts, relational statements, and the conceptual framework into an integrated and efficient representation. This was done by reviewing the literature. Conclusion statements were formulated using statement synthesis.

Results

A model to facilitate the presence of nurse educators in large class settings using reflective practices was developed as a theoretical framework to guide teaching–learning practices. Six conclusion statements emerged on the theoretical constructs presence and reflective practices of nurse educators.

Conclusions

The model addresses the gap in the literature and contributes substantially to deepening the body of knowledge in the nursing education domain of South Africa and internationally, to serve as a model for guiding nurse educators in their teaching–learning practices.
“You can kind of just feel the power behind what someone's saying”: a participatory-realist evaluation of peer support for young people coping with complex mental health and substance use challenges
Authors: Halsall Tanya , Daley Mardi , Hawke Lisa , Henderson Joanna , Matheson Kimberly
Published: November 2022

Background

Youth peer support, as a practice that aligns youth engagement and participatory approaches, has become increasingly popular in the context of youth mental health services. However, there is a need for more evidence that describes how and why youth peer support practice might be effective. This study was designed to examine a peer support service for youth experiencing complex challenges with mental health, physical health and/or substance use to better understand key features and underlying mechanisms that lead to improved client outcomes.

Methods

We applied a hybrid realist-participatory approach to explore key issues and underlying theoretical assumptions within a youth peer support approach for young people (age 14–26) experiencing complex mental health and substance use challenges. We used semi-structured interviews and focus groups with staff, including peers (N = 8), clinical service providers and administrative staff (N = 15), to develop the theories and a client survey to validate them. Our qualitative thematic analysis applied a retroductive approach that involved both inductive and deductive processes. For the client survey (N = 77), we calculated descriptive statistics to examine participant profiles and usage patterns. Pearson correlations were examined to determine relationships among concepts outlined in the program theories, including context, mechanism and outcome variables.

Results

Our analyses resulted in one over-arching context, one over-arching outcome and four program theories. Program theories were focused on mechanisms related to 1) positive identity development through identification with peers, 2) enhanced social connections, 3) observational learning and 4) enhanced autonomy and empowerment.

Conclusions

This study serves as a unique example of a participatory-realist hybrid approach. Findings highlight possible key components of youth peer practice and shed light on the functional mechanisms that underlie successful peer practice. These key components can be examined in other settings to develop more comprehensive theories of change with respect to youth peer support and can eventually be used to develop guidelines and standards to strengthen practice. This research contributes to an expanding body of literature on youth peer support in mental health and connects peer practice with several social theories. This research begins to lay a foundation for enhanced youth peer support program design and improved outcomes for young people experiencing complex mental health and substance use challenges.
Attitude towards COVID-19 vaccination among healthcare workers: a cross sectional study from Egypt
Authors: Tharwat Samar , Nassar Dalia Kamal , Nassar Mohammed Kamal , Saad Ahmed Mohammed , Hamdy Fatma
Published: November 2022

Background

Herd immunity is necessary to contain the coronavirus disease 2019 (COVID-19) pandemic. Vaccination is the fastest and safest pandemic control strategy. Healthcare workers (HCWs) are essential in providing vaccination information. The aim of this study was to assess intent to be vaccinated against COVID-19 among HCWs in Egypt and to determine the factors that may influence their decision.

Methods

A questionnaire-based cross-sectional study was conducted among HCWs who care for patients in several hospitals in Delta region, Egypt. The questionnaire included sociodemographic, clinical, and occupational data, intention to receive the COVID-19 vaccine, and beliefs and attitudes towards COVID-19 and its vaccination.

Results

The study included 455 HCWs with a mean age of 36.55 years (SD = 10.31) and 80% were females. The acceptance rate for the COVID-19 vaccine was 70.5%, while hesitancy and resistancy were both 17.6 and 11.9% respectively. About one-third (33.4%) of the subjects had previously contracted COVID-19. Most participants believed that they had a higher risk of contracting COVID-19 (71.6%). More than 64% believed they were at risk for vaccination side effects. Fear of infection and being at high risk of infection were the main drivers for COVID-19 vaccination, while the major barriers were waiting for additional experience with these new vaccines and having doubts about the vaccines’ efficacy.

Conclusions

The acceptance of the COVID-19 vaccination among HCWs is very high. This crucial group needs to be the focus of educational initiatives and campaigns designed to increase public awareness of the safety and effectiveness of COVID-19 vaccination.
The placement of percutaneous retrograde acetabular posterior column screw based on imaging anatomical study of acetabular posterior column corridor
Authors: Yu Kequan , Zhou Runtao , Gao Shichang , Liang Anlin , Yang Mingming , Yang Haitao
Published: November 2022

Objective

To explore the entry point, orientation, and fixation range of retrograde acetabular posterior column screw.

Method

The computed tomography data of 100 normal adult pelvises (50 males and 50 females, respectively) were collected and pelvis three-dimensional (3D) reconstruction was performed by using Mimics software and the 3D model was imported into Geomagic Studio software. The perspective of acetabular posterior column was carried out orienting from ischial tuberosity to iliac fossa in the Mimics software. Virtual screw was inserted perpendicular to the transverse section of acetabular posterior column corridor, and the maximum screw diameter, entry point, orientation, exit point were measured. The screw fixation range, the easy-to-penetrate sites, and intraoperative optimal fluoroscopic views were assessed.

Results

The acetabular posterior column corridor showed a triangular-prism shape. The virtual screw entry point was located at the midline between the medial and lateral edges of the ischial tuberosity. The distance between the entry point and the distal ischial tuberosity was around 13 mm. The distances between the exit point and the true pelvis rim, and ipsilateral anterior sacroiliac joint line were (19.33 ± 2.60) mm and (23.65 ± 2.42) mm in males, respectively. As for females, those two data were (17.63 ± 2.00) mm and (24.94 ± 2.39) mm, respectively. The maximum diameters of screws were (17.21 ± 1.41) mm in males and (15.54 ± 1.51) mm in females. The angle between the retrograde posterior column screw and the sagittal plane was lateral inclination (10.52 ± 3.04)° in males, and that was lateral inclination (7.72 ± 2.99)° in females. Correspondingly, the angle between the screw and the coronal plane was anterior inclination (15.00 ± 4.92)° in males, and that was anterior inclination (12.94 ± 4.72)° in females. Retrograde acetabular posterior column screw through ischial tuberosity can fix the acetabular posterior column fractures which were not 4 cm above the femoral head center. The easy-to-penetrate sites were located at the transition between the posterior acetabular wall and the ischium, the middle of the acetabulum, and 1 cm below the greater sciatic notch, respectively. The iliac oblique 10°, iliac oblique 60°, and obturator oblique 60° views were the intraoperative optimal fluoroscopic views to assess whether the screw was safely inserted.

Conclusion

Retrograde acetabular posterior column screw entry point is located at the midline between the medial and lateral edges of the ischial tuberosity, which is 1.3 cm far from the distal ischial tuberosity. The screw direction is about 10° lateral inclination and 15° anterior inclination, which can fix the acetabular posterior column fractures which were not 4 cm above the femoral head center.
Promising results in a 3-year follow-up for adults undergoing a one-stage surgery for residual talipes equinovarus as part of a humanitarian mission in Vietnam
Authors: Palmanovich Ezequiel , Ip Wing , Em Huynh , Spanko Jeffrey , Nyska Meir , Lehnert Bruce , Tavdi Alex , Ohana Nissim , Segal David
Published: November 2022

Background

Rigid talipes equinovarus (TEV) is a complex foot deformity in which the foot is fixed in a plantarflexed, inverted, and adducted position. This pathology has the potential to severely limit basic life activities, which can be devastating for patients in developing countries. The objective of this study was to present the outcomes of patients with mature bones presenting with severe rigid TEV deformity who were operated on during a humanitarian mission to Vietnam using a single lateral approach and a simple and inexpensive fixation technique.

Methods

This is a retrospective analysis of prospectively collected data. We analyzed the outcomes of patients who underwent surgery for a severe rigid TEV that prevented them from walking minimal distances unaided. All feet were fixed in a non-plantigrade position. The surgeries were conducted as part of two International Extremity Project (IEP) missions in Can Tho, Vietnam (2013 and 2018). Pre- and post-operative AOFAS scores were compared using the paired sample t-test.

Results

We operated on 14 feet of 12 patients, 6 (50%) of whom were males, aged 34.42 ± 11.7 (range 12 to 58). Four patients were followed for three months, two patients were followed for 12 months, and eight patients were followed for three years. On the final follow-up visit of each patient, all 14 operated feet were plantigrade with good alignment, and patients reported an improvement in daily activity. After 3 years of follow-up, the mean AOFAS score of eight patients with available data improved by 42.88 ± 3.91 points (95% CI 39.61 to 46.14, P < 0.01). Our patients also reported an improvement in mobility. At the final follow-up examination, no recurrence of the deformity was observed in any of the patients.

Conclusions

Using low-technical surgical modalities, we were able to achieve plantigrade and walkable feet in patients with mature bones who had fixed rigid equinovarus.

Level of evidence

Level IV- Case Series.
Optimization of soil microbial fuel cell for sustainable bio-electricity production: combined effects of electrode material, electrode spacing, and substrate feeding frequency on power generation and microbial community diversity
Authors: Simeon Imologie Meshack , Weig Alfons , Freitag Ruth
Published: November 2022

Background

Microbial fuel cells (MFCs) are among the leading research topics in the field of alternative energy sources due to their multifunctional potential. However, their low bio-energy production rate and unstable performance limit their application in the real world. Therefore, optimization is needed to deploy MFCs beyond laboratory-scale experiments. In this study, we investigated the combined influence of electrode material (EM), electrode spacing (ES), and substrate feeding interval (SFI) on microbial community diversity and the electrochemical behavior of a soil MFC (S-MFC) for sustainable bio-electricity generation.

Results

Two EMs (carbon felt (CF) and stainless steel/epoxy/carbon black composite (SEC)) were tested in an S-MFC under three levels of ES (2, 4, and 8 cm) and SFI (4, 6, and 8 days). After 30 days of operation, all MFCs achieved open-circuit voltage in the range of 782 + 12.2 mV regardless of the treatment. However, the maximum power of the SEC–MFC was 3.6 times higher than that of the CF–MFC under the same experimental conditions. The best solution, based on the interactive influence of the two discrete variables, was obtained with SEC at an ES of 4.31 cm and an SFI of 7.4 days during an operating period of 66 days. Analysis of the experimental treatment effects of the variables revealed the order SFI < ES < EM, indicating that EM is the most influential factor affecting the performance of S-MFC. The performance of S-MFC at a given ES value was found to be dependent on the levels of SFI with the SEC electrode, but this interactive influence was found to be insignificant with the CF electrode. The microbial bioinformatic analysis of the samples from the S-MFCs revealed that both electrodes (SEC and CF) supported the robust metabolism of electroactive microbes with similar morphological and compositional characteristics, independent of ES and SFI. The complex microbial community showed significant compositional changes at the anode and cathode over time.

Conclusion

This study has demonstrated that the performance of S-MFC depends mainly on the electrode materials and not on the diversity of the constituent microbial communities. The performance of S-MFCs can be improved using electrode materials with pseudocapacitive properties and a larger surface area, instead of using unmodified CF electrodes commonly used in S-MFC systems.
Dynamical analysis in controlled globally coupled map lattices
Authors: Yu Yadan , Liang Wei , Jing Taiyan
Published: November 2022

This paper investigates a globally coupled map lattice. Rigorous proofs to the existence of chaos in the sense of both Li–Yorke and Devaney in two controlled globally coupled map lattices are presented. In addition, the existence of Li–Yorke chaos and Devaney chaos for a general discrete dynamical system in ${\mathbf {R}}^{N}$

R
N

and $l^{\infty}$

l
∞

is considered. For illustration, two examples are provided.
New insights into epigenetic regulation of resistance to PD-1/PD-L1 blockade cancer immunotherapy: mechanisms and therapeutic opportunities
Authors: Dai Mengyuan , Liu Miao , Yang Hua , Küçük Can , You Hua
Published: November 2022

Programmed cell death protein 1(PD-1) is a type of immune-inhibitory checkpoint protein, which delivers inhibitory signals to cytotoxic T cells by binding to the programmed death ligand-1 (PD-L1) displayed on the surface of cancer cells. Antibodies blocking PD-1/PD-L1 interaction have been extensively used in treatment of human malignancies and have achieved promising outcomes in recent years. However, gradual development of resistance to PD-1/PD-L1 blockade has decreased the effectiveness of this immunotherapy in cancer patients. The underlying epigenetic mechanisms need to be elucidated for application of novel strategies overcoming this immunotherapy resistance. Epigenetic aberrations contribute to cancerogenesis by promoting different hallmarks of cancer. Moreover, these alterations may lead to therapy resistance, thereby leading to poor prognosis. Recently, the epigenetic regulatory drugs have been shown to decrease the resistance to PD-1/PD-L1 inhibitors in certain cancer patients. Inhibitors of the non-coding RNAs, DNA methyltransferases, and histone deacetylases combined with PD-1/PD-L1 inhibitors have shown considerable therapeutic efficacy against carcinomas as well as blood cancers. Importantly, DNA methylation-mediated epigenetic silencing can inhibit antigen processing and presentation, which promotes cancerogenesis and aggravates resistance to PD-1/PD-L1 blockade immunotherapy. These observations altogether suggest that the combination of the epigenetic regulatory drugs with PD-1/PD-L1 inhibitors may present potential solution to the resistance caused by monotherapy with PD-1/PD-L1 inhibitors.
Sphingosine kinase 1 contributes to the metastatic potential of epithelial ovarian cancer to the adipocyte-rich niche
Authors: Wang Chen , Ye Taiyang , Wang Wenjing , Song Keqi , Zhu Jie , Dai Lan , Di Wen
Published: November 2022

Unlike many solid tumors, epithelial ovarian cancer (EOC) has a clear metastatic predilection to the adipocyte-rich niche, especially the omentum. However, the underlying mechanism driving this process remains incomplete. Here we show that SphK1 is over-expressed in omental metastases compared with ovarian primary tumors in EOC patients. In vitro, inhibition of SphK1 suppressed the metastatic ability of EOC induced by adipocytes. In vivo, blockage of SphK1 could attenuate the omental metastasis of EOC. Importantly, SphK1 modulates adipocyte-induced E/N-cadherin switch through Twist1, a key process in EOC metastasis. Our study reveals a previously unrecognized role of SphK1 in modulating the metastatic tropism of EOC to the adipocyte-rich niche, suggesting a new target for EOC therapy.
Adverse childhood experiences and binge-eating disorder in early adolescents
Authors: Chu Jonathan , Raney Julia H. , Ganson Kyle T. , Wu Kelsey , Rupanagunta Ananya , Testa Alexander , Jackson Dylan B. , Murray Stuart B. , Nagata Jason M.
Published: November 2022

Background

Adverse childhood experiences (ACEs) are common and linked to negative health outcomes. Previous studies have found associations between ACEs and binge-eating disorder (BED), though they have mainly focused on adults and use cross-sectional data. The objective of this study was to examine the associations between ACEs and BED in a large, national cohort of 9–14-year-old early adolescents in the US.

Methods

We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,145, 2016–2020). Logistic regression analyses were used to determine the associations between self-reported ACEs and BED based on the Kiddie Schedule for Affective Disorders and Schizophrenia at two-year follow-up, adjusting for sex, race/ethnicity, baseline household income, parental education, site, and baseline binge-eating disorder.

Results

In the sample, (49% female, 46% racial/ethnic minority), 82.8% of adolescents reported at least one ACE and 1.2% had a diagnosis of BED at two-year follow-up. The mean number of ACEs was higher in those with a diagnosis of BED compared to those without (2.6 ± 0.14 vs 1.7 ± 0.02). The association between number of ACEs and BED in general had a dose–response relationship. One ACE (adjusted odds ratio [aOR] 3.48, 95% confidence interval [CI] 1.11–10.89), two ACEs (aOR 3.88, 95% CI 1.28–11.74), and three or more ACEs (aOR 8.94, 95% CI 3.01–26.54) were all associated with higher odds of BED at two-year follow-up. When stratified by types of ACEs, history of household mental illness (aOR 2.18, 95% 1.31–3.63), household violence (aOR 2.43, 95% CI 1.42–4.15), and criminal household member (aOR 2.14, 95% CI 1.23–3.73) were most associated with BED at two-year follow-up.

Conclusions

Children and adolescents who have experienced ACEs, particularly household challenges, have higher odds of developing BED. Clinicians may consider screening for ACEs and providing trauma-focused care when evaluating patients for BED.
Silence and related symptoms in children and adolescents: a network approach to selective mutism
Authors: Vogel Felix , Reichert Julian , Schwenck Christina
Published: November 2022

Background

Silence in certain situations represents the core symptom of selective mutism (SM). However, it is unclear what additional symptoms are part of this disorder. Although knowledge of symptoms is essential for diagnostics and intervention, to date, only scarce research exists on circumscribed symptoms of SM. Given the large overlap between SM and social anxiety disorder (SAD), it remains also unclear which symptoms can differentiate both disorders.

Methods

A network analysis of potential symptoms of SM was performed based on a mixed sample of N = 899 children and adolescents with and without indication of SM (n = 629 with silence in certain situations). In a preliminary analysis, we demonstrated that children with and without silence in certain situations do not differ with respect to their network structure, justifying an analysis on the entire mixed sample. Possible communities (symptom clusters) within the network and thus potential latent variables were examined, and symptoms were analyzed in terms of their centrality (the extent to which they are associated with other symptoms in the network). To investigate the differentiability of symptoms of the SM network from symptoms of SAD, we computed a network that additionally contains symptoms of SAD.

Results

In the resulting network on symptoms of SM, silence was, as expected, the symptom with the highest centrality. We identified two communities (symptom cluster): (1) symptoms associated with the fear response of freezing, (2) symptoms associated with speech production and avoidance. SM network symptoms and SAD symptoms largely formed two separate symptom clusters, with only selectivity of speaking behavior (more talkative at home and taciturn or mute outside the home) falling into a common cluster with SAD symptoms.

Conclusions

Silence appears to have been confirmed by analysis as a core symptom of SM. Additional anxiety-related symptoms, such as avoidance behavior or motor inhibition associated with freezing, seem to co-occur with silence. The two communities of SM potentially indicate different mechanisms of silence. The symptoms of SM appear to be distinguishable from those of SAD, although there seems to be overlap in terms of difficulty speaking in situations outside the home.
Six-month stability and predictive validity of the personality inventory for ICD-11
Authors: Stricker Johannes , Jakob Louisa , Köhler Denis , Pietrowsky Reinhard
Published: November 2022

Background

The International Classification of Diseases 11th Revision (ICD-11) personality disorder model comprises, among other elements, five maladaptive personality trait domains (negative affectivity, detachment, dissociality, disinhibition, anankastia). Recently, the personality inventory for ICD-11 (PiCD) has emerged as one of the most widely used measures of these ICD-11 personality trait domains.

Methods

The current study contributed to the validation of the PiCD validation by exploring its stability and predictive links with psychological distress over 6 months in a sample of 206 German community adults.

Results

The PiCD trait domain scales displayed strong differential (all r ≥ .80) and absolute stability (all |d| ≤ .09). Additionally, PiCD negative affectivity predicted depression, anxiety, and stress, and PiCD detachment predicted depression over 6 months beyond baseline.

Conclusion

In sum, this study demonstrated the stability of the PiCD trait domain scores, supporting their utility for capturing relatively stable traits as described in the ICD-11. Additionally, we provided the first evidence for the predictive validity of some of the PiCD trait domain scores.
Liquid and supercritical CO2 as an organic solvent in Hadean seafloor hydrothermal systems: implications for prebiotic chemical evolution
Authors: Shibuya Takazo , Takai Ken
Published: November 2022

Prebiotic chemical evolution and the emergence of life in the seafloor hydrothermal systems of Hadean Earth is among the most plausible and popular hypotheses for the origin of earthly life. In contrast, many studies pointed out that this hypothesis intrinsically harbors a critical unsolved problem called the “water paradox”: Abundant water limits dehydration synthesis and instead facilitates hydrolysis of organic molecules during the early stage of chemical evolution. However, many of these criticisms have not referred to the abundant liquid/supercritical CO2 (L/SC-CO2) fluids and pools in modern hydrothermal systems, which not only create dry environments but also behave as hydrophobic solvents at and beneath the seafloor. In this paper, we theorize the generation and preservation of a L/SC-CO2 pool in modern seafloor hydrothermal systems and reinterpret the fossil hydrothermal systems preserved in early Archean seafloor basalts. The theoretical estimation of subseafloor phase separation and phase segregation of CO2-rich hydrothermal fluids suggests the presence of L/SC-CO2 fluids and pools in Hadean seafloor hydrothermal systems. Because they behave as hydrophobic organic solvents, L/SC-CO2 can potentially initiate the dehydration synthesis of organic molecules in seafloor hydrothermal systems. Moreover, at the interface between L/SC-CO2 and H2O-rich fluid (seawater or hydrothermal fluid), amphiphilic molecules might be generated and triggered into self-assembled growth. Based on the abundant occurrence and physicochemical properties of L/SC-CO2 fluids, we propose a new stepwise concept for the origin of life, whereby prebiotic chemical evolution was co-hosted and facilitated by L/SC-CO2 in Hadean water-rich seafloor hydrothermal systems. This “liquid/supercritical CO2 hypothesis” potentially overcomes the water paradox and strengthens the idea that earthly life was hatched in deep-sea hydrothermal systems.
Comparative analysis of international codes of practice for pile foundation design considering negative skin friction effect
Authors: Zhanabayeva Assel , Abdialim Shynggys , Satyanaga Alfrendo , Kim Jong , Moon Sung-Woo
Published: November 2022

Negative skin friction (NSF) effect on pile foundation design attracts the attention of geotechnical engineers and requires comprehensive research. However, the ways of consideration of NSF for the pile foundation design vary with different design codes. This study aims to compare design code requirements adhering to Construction Codes and Regulations (i.e., SNiP), Eurocode 7 (EC7), Canadian Highway Bridge Design Code (CHBDC), and AASHTO for the pile foundation design subjected to NSF and provide insights for the understanding effect of NSF on the behavior of pile foundation. The overall objective is achieved by designing three cases of a driven pile for given design conditions in Astana city. Then, a sensitivity analysis was performed to estimate the effects of the dimensions of the pile foundation and the shear strength of soils on the bearing resistance. The comparative analysis shows that pile foundation design adhering to CHBDC and AASHTO results in a more conservative strategy than SNiP and EC7 when considering Kazakhstani soil engineering conditions.
Assessment of undernutrition using the composite index of anthropometric failure (CIAF) and its determinants: A cross-sectional study in the rural area of the Bogor District in Indonesia
Authors: Permatasari Tria Astika Endah , Chadirin Yudi
Published: November 2022

Background

The Composite Index of Anthropometric Failure (CIAF) can comprehensively identify undernutrition by combining several indicators of nutritional status – namely, weight-for-age, length/height-for-age and weight-for-length/height – to determine the nutritional status of children under five years of age. This study aims to assess undernutrition using the CIAF and its determinants on children under five years of age in the Bogor District, Indonesia.

Methods

A cross-sectional study was conducted during February–May 2019 among 330 mother-children pairs (with children under five), selected by systematic random sampling from four villages as undernutrition pockets in the rural area of Bogor District, Indonesia. The nutritional status of the children was assessed by measuring weight and length/height. Z-score was calculated using WHO Anthro software and was categorized based on conventional indices, including weight-for-age (WAZ), length/height-for-age (HAZ) and weight-for-length/height (WHZ). The CIAF is measured based on a combination of conventional index measurements. In addition, mothers’ and childrens’ characteristics and clean living behaviour are assessed via structured questionnaires. Environmental sanitation is assessed using the environment meter. Binary logistic regression analysis with SPSS version 22.0 is used to analyse the dominant factors associated with undernutrition.

Results

Among children under five, 42.1% experienced anthropometric failure (overall prevalence of undernutrition based on the CIAF), 2.4% experienced wasting only, 5.8% were classified as both wasting and underweight, 2.1% as wasting, underweight and stunting, 16.4% as underweight and stunting, 11.5% as stunting only, and 3.9% as underweight only. Assessment of nutritional status using a conventional anthropometric index shows that respective prevalences of underweight, stunted and wasted were 27.8, 29.7, and 10.6%. The mother’s height is the most dominant factor associated with anthropometric failure [p = 0.008; AOR = 1.95; 95% CI: 2.19–3.19]. The most dominant factors associated with the conventional undernutrition indices of underweight, stunted and wasted are, respectively, family income [p = 0.018; AOR = 5.44; 95% CI: 1.34–22.11], mother’s height [p = < 0.001; AOR = 3.29; 95% CI:1.83–5.91] and child’s age [p = 0.013; AOR = 2.59; 95% CI: 1.22–5.47].

Conclusion

Nearly half of children under five experience anthropometric failure. Specific nutrition improvement interventions and specific nutrition interventions during pregnancy and lactation are needed, especially for malnourished mothers, to prevent malnutrition in infant.
Evaluation of teaching forensic nursing course on undergraduate nursing student’s forensic nursing knowledge
Authors: Doğan Muzaffer Berna , Eycan Özgül , Yazıcı Aybüke , Gülatar Berfe , Çapan Melike , Temel Sena Merve
Published: November 2022

Background

The aim of the forensic nursing (FN) education is to provide nursing students with the basic knowledge of FN that they can use in the clinical area.

Objective

The study evaluated the effect of integrating forensic nursing into the undergraduate nursing curriculum on 2nd- and 4th-year students’ knowledge level of FN.

Participants

The target population of this study was composed of 2nd- and 4th-year students in the nursing department at a foundation university in Istanbul. The study was conducted with 95 nursing students who agreed to participate in the study.

Methods

The research was planned as cross-sectional and descriptive. The questionnaire form was developed with the help of literature by experts in the field. Each correct answer was scored as 4 points, and the total score could range from 0 to 100.

Results

The average age was 21.64 ± 1.16, and 66.3% (n = 63) was female. Out of the 95 students, 50.5% (n = 48) were in 2nd year, and 49.5% (n = 47) were in 4th year. A total of 47.4% (n = 45) of the students took a FN course, and 52.6% (n = 50) did not take FN course. The average level of knowledge for those who took FN course was 52.09 ± 12.31 and for those who did not take FN course was 46.16 ± 12.18. According to the status of taking FN course, a significant difference was found between the average level of knowledge (p < 0.05).

Conclusions

These results emphasize the importance of integration of FN into the undergraduate nursing curriculum.