bluuebunny/crossref_metadata_2025 huggingface dataset:
A Reverse Shoulder Arthroplasty Implantation With Custom-Made Humerus and Intraoperative GPS Navigation in a Rare Case of Unilateral Hip and Shoulder Dysplasia Associated With a Bone Marrow Mosaic PTEN Truncating Variant: Case Report
Authors: Colasanti Giovanni Battista , Troiano Elisa , De Sensi Alice Giulia , Di Sarno Laura , Renieri Alessandra , Mondanelli Nicola , Giannotti Sefano
Published: November 2023

Joint dysplasias always represent a great challenge for prosthetic surgeons. The common altered anatomical landmarks and the subversion of the anatomy of soft tissues surrounding the dysplastic joint are problems that can cause difficulties if approached with standard methods. Together with the resolution of functional issues related to dysplasia, the understanding of the underlying cause is fundamental. DNA analysis is generally performed via blood sampling; however, this might lead to misdiagnosis in case mosaicism is not detected in blood components. The etiology of genetic diseases can be further examined by means of whole exome sequencing and the detection of somatic mosaicism, recognized as a fundamental contributor to genetic diseases themselves. In this study, the clinical case of a patient suffering from a rare unilateral dysplasia localized to the left coxo-femoral and glenohumeral joint and treated at our center for reverse shoulder arthroplasty is reported. By virtue of the glenohumeral anatomical peculiarities, we had to devise a hybrid custom-made and navigated approach by means of a custom-made prosthetic stem and dedicated patient-specific instrumentation, using intraoperative GPS navigation for glenoid prosthesis. In addition, a genetic study was conducted on intraoperatively harvested bone marrow, which proved to be crucial in understanding the epigenetic basis of dysplasia. In fact, the patient resulted negative in blood but positive for a truncating variant of PTEN c.781C > T (p.(Gln261 *)) in 12% of the sequence analyzed in the bone marrow.
Longitudinal profile of estrogen-related thrombotic biomarkers after cessation of combined hormonal contraceptives
Authors: Hugon-Rodin Justine , Fontana Pierre , Poncet Antoine , Streuli Isabelle , Casini Alessandro , Blondon Marc
Published: November 2023

The persistence of risk of venous thromboembolism (VTE) due to combined hormonal contraceptives (CHCs), after their cessation, is unknown but important to guide clinical practice. The objective of this prospective cohort study was to define the time until normalization of estrogen-related thrombotic biomarkers after CHC cessation. We enrolled women aged 18 to 50 years who had decided to stop their CHC, excluding those with a personal history of VTE, anticoagulation, or pregnancy. The study started before cessation of CHC, with 6 visits afterwards (at 1, 2, 4, 6, and 12 weeks after cessation). Primary outcomes were normalized sensitivity ratios to activated protein C (nAPCsr) and to thrombomodulin (nTMsr), with sex hormone–binding globulin (SHBG) as a secondary end point. We also included control women without CHC. Among 66 CHC users, from baseline until 12 weeks, average levels of nAPCsr, nTMsr, and SHBG decreased from 4.11 (standard deviation [SD], 2.06), 2.53 (SD, 1.03), and 167 nmol/L (SD, 103) to 1.27 (SD, 0.82), 1.11 (SD, 0.58), and 55.4 nmol/L (SD, 26.7), respectively. On a relative scale, 85.8%, 81.3%, and 76.2% of the decrease from baseline until 12 weeks was achieved at 2 weeks and 86.7%, 85.5%, and 87.8% at 4 weeks after CHC cessation, respectively. Levels were not meaningfully modified throughout the study period among 28 control women. In conclusion, CHC cessation is followed by a rapid decrease in estrogen-related thrombotic biomarkers. Two to 4 weeks of cessation before planned major surgery or withdrawal of anticoagulants in patients with VTE appears sufficient for the majority of women. The trial is registered at www.clinicaltrials.gov as #NCT03949985.
Exosomal circCOL1A1 promotes angiogenesis via recruiting EIF4A3 protein and activating Smad2/3 pathway in colorectal cancer
Authors: Hu Gui , Lin Changwei , Gao Kai , Chen Miao , Long Fei , Tian Buning
Published: November 2023

Background

Colorectal cancer (CRC) is the third frequently diagnosed cancer with high incidence and mortality rate worldwide. Our previous report has demonstrated that circCOL1A1 (hsa_circ_0044556) functions as an oncogene in CRC, and Gene Ontology (GO) analysis has also revealed the strong association between circCOL1A1 and angiogenesis. However, the mechanism of circCOL1A1 or exosomal circCOL1A1 in CRC angiogenesis remains elusive.

Methods

Purified exosomes from CRC cells were characterized by nanoparticle tracking analyzing, electron microscopy and western blot. qRT-PCR, immunohistochemistry or western blot were employed to test the expression of circCOL1A1, EIF4A3, Smad pathway and angiogenic markers. Cell proliferation of HUVECs was monitored by CCK-8 assay. The migratory and angiogenic capabilities of HUVECs were detected by wound healing and tube formation assay, respectively. Bioinformatics analysis, RNA immunoprecipitation (RIP), RNA pull-down and FISH assays were used to detect the interactions among circCOL1A1, EIF4A3 and Smad2/3 mRNA. The in vitro findings were verified in xenograft model.

Results

CRC cell-derived exosomal circCOL1A1 promoted angiogenesis of HUVECs via recruiting EIF4A3. EIF4A3 was elevated in CRC tissues, and it stimulated angiogenesis of HUVECs through directly binding and stabilizing Smad2/3 mRNA. Moreover, exosomal circCOL1A1 promoted angiogenesis via inducing Smad2/3 signaling pathway in vitro, and it also accelerated tumor growth and angiogenesis in vivo.

Conclusion

CRC cell-derived exosomal circCOL1A1 promoted angiogenesis via recruiting EIF4A3 and activating Smad2/3 signaling.
Endovascular treatment of postoperative hemorrhage after pancreatectomy: a retrospective study
Authors: Izumi Hideki , Yoshii Hisamichi , Fujino Rika , Takeo Shigeya , Nomura Eiji , Mukai Masaya , Suda Satoshi , Tomita Kosuke , Kamei Shunsuke , Ogawa Yukihisa , Hasebe Terumitsu , Makuuchi Hiroyasu
Published: November 2023

Background

Ruptured aneurysm is a serious complication of distal pancreatectomy (DP) or pancreatoduodenectomy (PD) that can be life-threatening if not treated promptly. This study aimed to examine the efficacy of a Viabahn stent graft for stopping bleeding after pancreatectomy.

Methods

Between April 2016 and June 2022, we performed 245 pancreatectomies in our institution. Six patients experienced postoperative bleeding and underwent endovascular treatment.

Results

All six cases of bleeding occurred post-PD (3.7%). The bleeding was from gastroduodenal artery (GDA) pseudoaneurysms in three patients, and Viabahn stent grafts were inserted. All three patients did not show liver function abnormalities or hepatic blood flow disorders. One patient with a Viabahn stent graft experienced rebleeding, which required further management to obtain hemostasis. Of the six cases in which there was hemorrhage, one case of bleeding from the native hepatic artery could not be managed.

Conclusions

Using the Viabahn stent graft is an effective treatment option for postoperative bleeding from GDA pseudoaneurysms following PD. In most cases, using this device resulted in successful hemostasis, without observed abnormalities in hepatic function or blood flow.
A pilot observational study of gait changes over time before and after an unplanned hospital visit in long-term care residents with dementia
Authors: Nabavi Hoda , Mehdizadeh Sina , Shum Leia C. , Flint Alastair J. , Mansfield Avril , Taati Babak , Iaboni Andrea
Published: November 2023

Background

Older adults with dementia living in long-term care (LTC) have high rates of hospitalization. Two common causes of unplanned hospital visits for LTC residents are deterioration in health status and falls. Early detection of health deterioration or increasing falls risk may present an opportunity to intervene and prevent hospitalization. There is some evidence that impairments in older adults’ gait, such as reduced gait speed, increased variability, and poor balance may be associated with hospitalization. However, it is not clear whether changes in gait are observable and measurable before an unplanned hospital visit and whether these changes persist after the acute medical issue has been resolved. The objective of this study was to examine gait changes before and after an unplanned acute care hospital visit in people with dementia.

Methods

We performed a secondary analysis of quantitative gait measures extracted from videos of natural gait captured over time on a dementia care unit and collected information about unplanned hospitalization from health records.

Results

Gait changes in study participants before hospital visits were characterized by decreasing stability and step length, and increasing step variability, although these changes were also observed in participants without hospital visits. In an age and sex-adjusted mixed effects model, gait speed and step length declined more quickly in those with a hospital visit compared to those without.

Conclusions

These results provide preliminary evidence that clinically meaningful longitudinal gait changes may be captured by repeated non-invasive gait monitoring, although a larger study is needed to identify changes specific to future medical events.
Effect of 4-weeks exercise program using wearable hip-assist robot (EX1) in older adults: one group pre- and post- test
Authors: Shin Jang-hoon , Byeon Naeun , Yu Heeju , Yun Geonhyang , Kim Hyunjin , Lim Seungyeop , Kim Dongwoo , Lee Hwang-Jae , Lee Wan-hee
Published: November 2023

Background

Older adults have muscle loss and are at risk of falling. Recently, research in the healthcare field has been actively conducted, and Samsung Electronics has developed EX1, a hip joint assisted robot for exercise. This study aimed to verify the effect of a 4-week combined exercise program applying EX1 on older adults.

Methods

This study design was an evaluator-blinded, pre- and post-test. A total of 21 older adults performed an exercise program consisting of walking and fitness wearing EX1 for 50 min per session, 3 days a week during the 4-week exercise period. For comparison before and after participating in the exercise program, the spatio-temporal parameters, pelvic movement were analyzed by G-Walk, functional outcomes were evaluated by TUG, muscle power were evaluated by RUSI, and waist-hip ratio were analyzed by Inbody. All data were analyzed before and after exercise using paired t-test, and the statistical significance level was set at 0.05.

Results

In spatio-temporal parameters, stride length showed statistically significant improvements after exercise with EX1 (P < 0.01). Also, propulsion showed statistically significant improvements after exercise with EX1 (P < 0.01) Regarding changes of the gait posture, there was a statistically significant improvement in pelvic movement (P < 0.05). In the functional evaluation, the time required was statistically significantly reduced in the timed up and go test (P < 0.05).

Conclusion

These results demonstrate that a 4-week exercise program with EX1 was effective in improving the functional gait of the elderly. However, because the participants were 21, it is difficult to generalize the results.

Trial registration

Clinical Research Information Service, KCT0007367. Registered 08/06/2022.
A happy home? Socio-economic inequalities in depressive symptoms and the role of housing quality in nine European countries
Authors: McElroy Brendan , Walsh Edel
Published: November 2023

Background

This study examines the prevalence of and socio-economic inequalities in depressive symptoms in nine high-income European countries, focusing in particular on the role of housing quality.

Methods

Using the European Social Survey, a concentration index of depressive symptoms in each country is estimated. The role of housing quality is assessed by examining the risk factors associated with the concentration index, using the Recentred Influence Function method. To contextualise the housing quality results, other predictors of inequalities in depressive symptoms inequalities are also quantified and discussed.

Results

Our results indicate that inequalities in depressive symptoms are concentrated among poorer respondents both in each country and in total. Austria and Belgium have the lowest inequalities and France has the highest. No geographic pattern is evident. Housing problems are associated with higher inequalities in six of the nine countries in the sample. While no association is evident for indicators of socio-economic status such as years of education and income, financial strain is significant.

Conclusions

This study is the first to estimate the degree of socio-economic inequality in depressive symptoms across European countries. The association between poor housing and poorer inequalities suggests that housing has a role to play lowering depressive symptoms inequalities.
Quantifying the impacts of posture changes on office worker productivity: an exploratory study using effective computer interactions as a real-time indicator
Authors: Wang Hong , Yu Diran , Zeng Yu , Zhou Tongyu , Wang Weixiang , Liu Xuan , Pei Zhichao , Yu Yumeng , Wang Chaoju , Deng Yingqi , Cheshmehzangi Ali
Published: November 2023

Background

Working in a standing posture is considered to improve musculoskeletal comfort and can help enhance office workers’ performance in the long term. However, there is a lack of a quantitative, real-time measure that reflects on whether office workers can immediately become more concentrated and work more efficiently when they switch to a standing posture.

Methods

To tackle this problem, this study proposed that the number of effective computer interactions could be used as a real-time indicator to measure the productivity of office workers whose work is primarily computer-based. Using this metric, we conducted an exploratory study to investigate the correlation between posture and productivity changes at a 10-minute resolution for eight participants.

Results

The study found that when allowed to use sit-stand desks to adjust postures, participants chose to switch to standing posture for about 47 min on average once a day; standing work was most frequent between 2:30 − 4:00 pm, followed by 10:30 − 11:30 am, during which time the number of computer interactions also became higher, showing a significant positive correlation. In addition, participants were approximately 6.5% more productive than when they could only work in a sitting posture.

Conclusion

This study revealed that posture changes could have an immediate improvement in productivity.
Effect of knee osteoarthritis on the postoperative outcome of proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures in the elderly: a retrospective analysis
Authors: Lv Jiaxing , Li Xiaolong , Qiu Wenkui , Ji Jianjun , Cao Lichao , Li Lei , Zhang Yihong , Su Zhenyan
Published: November 2023

Background

The proximal femoral nail anti-rotation (PFNA) is a commonly used internal fixation system for intertrochanteric fractures (IFs) in older adults. Knee osteoarthritis (KOA) is a degenerative lower extremity disease that occurs most frequently in the elderly. Some patients have already had KOA before the IFs. However, whether KOA impacts the postoperative outcome of IFs has not been reported.

Objective

This study aimed to investigate the effect of KOA on the fracture side on the outcome after PFNA for IFs in the elderly.

Methods

Between January 2016 and November 2021, 297 elderly patients treated with PFNA for IFs were enrolled in this study. They were divided into two groups according to the American Rheumatism Association KOA clinical and radiographic criteria: the control group and the KOA group. Intraoperative bleeding, operative time, length of hospital stay, postoperative time out of bed, fracture healing time, postoperative complications, postoperative Harris hip function score, and Barthel ability to daily living Score were compared between the two groups. Follow-up was routinely scheduled at 1, 3, 6, and 12 months postoperatively.

Results

Based on the exclusion criteria, 254 patients who met the requirements were left to be included in this study, including the control group (n = 133) and the KOA group (n = 121). Patients were followed up for a mean of 17.5 months (12–24 months). There was no significant difference between the two groups in preoperative demographic data, intraoperative blood loss, operation time, and length of stay in the hospital. The control group was statistically significant compared to the KOA group in terms of postoperative time out of bed (17.8 ± 4.0 days vs. 19.1 ± 5.8 days), fracture healing time (13.7 ± 2.2 weeks vs. 14.6 ± 3.7 weeks), and postoperative complications (12.8 vs. 23.1%). The Harris hip function score and Barthel ability to daily living score were higher in the control group than in the KOA group at 1, 3, 6, and 12 months postoperatively (the control group: 63.8 ± 10.9, 71.8 ± 10.3, 81.5 ± 8.7, and 91.6 ± 6.3 vs. The KOA group 61.0 ± 10.4, 68.6 ± 9.1, 79.0 ± 9.2, and 88.5 ± 5.9).

Conclusions

In elderly patients with IFs combined with KOA of the fracture side treated with PFNA internal fixation, KOA increases the incidence of postoperative complications of the fracture, prolongs postoperative time out of bed and fracture healing, and reduces postoperative hip function and ability to daily living. Therefore, treating KOA on the fractured side needs to be considered when treating IFs in the elderly.
Assessment of safety during hospitalization for patients undergoing Surgery after neoadjuvant therapy for moderately advanced Esophageal cancer
Authors: Xiong Chenyi , Ji Hongyun , Li Feng , Jiang Zhihua , Pang Zhonghao , Li Xiaoran
Published: November 2023

Purpose

To study the safety of patients with moderately advanced esophageal cancer during their hospital stay after undergoing surgery.

Methods

The clinical and pathological data of 66 patients with locally advanced esophageal cancer discharged from the Department of Thoracic Surgery of Jiangsu University Hospital from January 2017 to October 2022 were selected, of whom 32 underwent direct surgery (control group) and 34 underwent neoadjuvant therapy followed by surgery (experimental group), to retrospectively analyze whether there were differences in surgical outcomes, complication rates, biochemical and infection indicators between the two groups.

Results

The number of lymph node dissections, lymph node dissection rate, and hemoglobin value on the first day after the operation in the experimental group were smaller than those in the control group, and the difference was statistically significant (P < 0.05). The thoracic drainage volume of the experimental group was more than that of the control group, and the difference was statistically significant (P < 0.05). The incidence of pulmonary complications in the experimental group was higher than that in the control group, especially pulmonary infection, and the difference was statistically significant (P < 0.05). Compared with the control group, the experimental group was more prone to anastomotic leakage, and the difference was statistically significant (P < 0.05).

Conclusion

Neoadjuvant therapy combined with surgery for patients with advanced esophageal cancer is generally safe during hospitalization.
An online soft sensor method for biochemical reaction process based on JS-ISSA-XGBoost
Authors: Zhang Ligang , Wang Bo , Shen Yao , Nie Yongxin
Published: November 2023

Background

A method combining offline techniques and the just-in-time learning strategy (JITL) is proposed, because the biochemical reaction process often encounters changing features and parameters over time.

Methods

Firstly, multiple sub-databases in the fermentation process are constructed offline by an improved fuzzy C-means algorithm and the sample data are adaptively pruned by a similarity query threshold. Secondly, an improved eXtreme Gradient Boosting (XGBoost) method is used on the online modeling stage to build soft sensor models, and the multi-similarity-driven just-in-time learning strategy is used to increase the diversity of the model. Finally, to improve the generalization of the whole algorithm, the output of the base learner is fused by an improved Stacking integration model and then the predictive output is performed.

Results

Applying the constructed soft sensor model to the problem of predicting cell concentration and product concentration in Pichia pastoris fermentation process. The experimental results show that the root mean square error of the cell concentration is 0.0260, the coefficient of determination is 0.9945, the root mean square error of the product concentration is 2.6688, and the coefficient of determination is 0.9970. It shows that the proposed method has the advantages of timely prediction and high prediction accuracy, which validates the effectiveness and practicality of the method.

Conclusion

The JS-ISSA-XGBoost is an extensive and excellent soft measurement model that meets the practical needs for real-time monitoring of parameters and prediction of control in biochemical reactions.
Impact of Treviamet® & Treviamet XR® on quality of life besides glycemic control in type 2 DM patients
Authors: Khan Asima , Kanpurwala Muhammad Adnan , Khan Riasat Ali , Mahmudi Najum F. , Lohano Verumal , Ahmed Shakeel , Khan Majid , Uddin Fareed , Ali Syed Mohammad , Saghir Maliha , Baqar Abidi Syed Hussain , Kamal Jahanzeb
Published: November 2023

Background

Maintaining the quality of life is the main objective of managing type 2 diabetes (T2DM) (QoL). Since it is a key factor in patient motivation and adherence, treatment-related QoL has always been considered when choosing glucose-lowering medicines. The objective of the study was to evaluate the quality of life besides glycemic control among type 2 diabetes mellitus patients receiving Treviamet® & Treviamet XR® (Sitagliptin with Metformin) in routine care.

Methods

It was a prospective, open-label, non-randomized clinical trial including T2DM patients uncontrolled on Metformin therapy. All patients received Treviamet® & Treviamet XR® for six months. Sequential changes in QoL, fasting plasma glucose, HbA1c, body weight, and blood pressure were monitored from baseline to 3 consecutive follow-up visits. The frequency of adverse events (AEs) was also noted throughout the study.

Results

A total of 504 patients were screened; 188 completed all three follow-ups. The mean QoL score significantly declined from 57.09% at baseline to 33.64% at the 3rd follow-up visit (p < 0.01). Moreover, a significant decline in mean HbA1c and FPG levels was observed from baseline to 3rd follow-up visit (p < 0.01). Minor adverse events were observed, including abdominal discomfort, nausea, flatulence, and indigestion. Gender, HbA1c, diarrhea, and abdominal discomfort were significant predictors of a patient’s QoL, as revealed by the Linear Regression Model (R2 = 0.265, F(16, 99) = 2.231).

Conclusion

Treviamet® & Treviamet XR® significantly improved glycemic control (HbA1c levels) and QoL in T2DM patients without serious adverse events.

Trial registration

ClinicalTrials.gov identifier (NCT05167513), Date of registration: December 22, 2021.
Effect of SEC III protocol on upper airway dimensions in growing class III patients: a retrospective study
Authors: Elkalza Ahmed R. , Yacout Yomna M.
Published: November 2023

Background

The primary objective of the study was to evaluate the effects of SEC III (Splints, Class III Elastics, and Chin cup) protocol on the upper airway dimensions using lateral cephalometric radiographs. The secondary objectives were to evaluate the skeletal and dental effects of the SEC III protocol using lateral cephalometric radiographs.

Methods

The pre- and post-treatment lateral cephalometric radiographs of 24 patients treated using the SEC III protocol were used to address the aim of the study. Children in the pre-pubertal (CS-1 or CS-2) or circumpubertal (CS-3 or CS-4) skeletal maturation stage and having class III dentoskeletal malocclusion were included in the study. Patients with a history of previous orthodontic treatment, maxillofacial surgery or trauma, tonsillectomy, adenoidectomy, or craniofacial malformations were excluded. The pre-treatment and post-treatment lateral cephalometric radiographs were traced, then airway measurements, skeletal measurements, and dental measurements were performed. The results were analysed using paired samples t-test or Wilcoxon signed rank test according to the data normality.

Results

Data of 6 males and 18 females were analysed (Mean age = 11.21 ± 1.02 years). Duration of active treatment was 5.75 ± 1.03 months. Treatment using SEC III protocol resulted in a significant increase in ANB angle (2.92 ± 1.50 degrees, p < 0.001) and Wits appraisal (3.31 ± 1.99 mm) (p < 0.001). The increase in the mandibular plane angle (0.75 ± 1.42 degrees, p = 0.02) and the maxillary length (2.29 ± 2.69 mm, p < 0.001) was statistically significant. Contrarily, the mandibular length did not change significantly (p = 0.10). The maxillary incisors were significantly proclined (4.38 ± 4.28 degrees; p < 0.001), while the mandibular incisors were significantly retroclined (-5.79 ± 6.21 degrees; p < 0.001) following treatment. The change in the nasopharyngeal airway and the retropalatal airway was not statistically significant. The middle and inferior pharyngeal space (retroglossal airway) significantly decreased by 1.33 ± 1.97 mm (p = 0.003) and 1.96 ± 2.48 mm (p = 0.001), respectively.

Conclusions

Early class III correction using SEC III protocol reduced the retroglossal airway dimensions but did not affect the nasopharyngeal and retropalatal airway dimensions. Correction of the class III dentoskeletal relationship was obtained through both skeletal and dental changes.
Spatial variations and determinants of knowledge of ovulatory period among young women in Ethiopia: a spatial and multilevel analysis using 2016 EDHS
Authors: Aragaw Fantu Mamo , Alemayehu Meron Asmamaw , Derseh Nebiyu Mekonnen , Agimas Muluken Chanie , Shewaye Daniel Alayu , Eshetu Habitu Birhan , Asmamaw Desale Bihonegn , Asratie Melaku Hunie , Belachew Tadele Biresaw , Negash Wubshet Debebe
Published: November 2023

Background

Knowledge of the ovulatory period enables women in avoiding and engaging in sexual intercourse either to avoid and to have pregnancy as desired. It has been reported that young people have less knowledge of the ovulatory period. There is limited evidence about the spatial variability of knowledge of the ovulatory period among young women in Ethiopia. Hence, this study aimed to assess the spatial variation and factors sociated with knowledge of the ovulatory period among youths in Ethiopia for providing geographically targeted interventions.

Method

A secondary data analysis was carried out using the 2016 Ethiopian Demographic and Health Surveys with a total weighted sample of 6143 youths. Multilevel logistic regression analysis was utilized to identify factors influencing knowledge of the ovulatory period. ArcGIS version 10.7 software and Kuldorff’s SaTScan version 9.6 was used for the spatial analysis.

Results

Being older youth [AOR = 1.98; 1.46, 2.70], youths having primary education [AOR = 1.70; 1.23, 2.35], youths having secondary & higher education [AOR = 2.30; 1.41, 3.74], youths whose husbands have primary education [AOR = 1.39; 1.02, 1.91], and youths who use contraception [AOR = 1.66; 1.24, 2.22] were significant predictors of knowledge of ovulatory period. Knowledge of the ovulatory period among youth had non random spatial distribution across Ethiopia, and the primary clusters of incorrect knowledge of the ovulatory period were observed in Somalia, SNNPR, Benishangul gumuz, and Gambella regions of Ethiopia.

Conclusion

There was a non-random spatial pattern in the distribution of knowledge of the ovulation period among young women in Ethiopia. Age of youth, educational status, education of husband, and contraceptive use were significant predictors of knowledge of the ovulatory period among young women in Ethiopia. Hence, interventions should prioritize at-risk youths residing in regions with limited knowledge of the ovulatory period to enhance their awareness of the fertility window.
The district operation centres in one of the largest local health authorities in Italy to manage COVID-19 surveillance and homecare: first implementation and results of a survey addressed to general practitioners
Authors: Frisicale Emanuela Maria , Barbara Andrea , Perilli Alessio , Carini Elettra , Grossi Adriano , Simonetti Leonardo , Tammam Giulia , Axelrod Svetlana , Tanese Angelo , Goletti Mauro , Parente Paolo
Published: November 2023

Background

COVID-19 pandemic represented a shock for healthcare systems. Italy was one of the first country to deal with a huge number of patients to be diagnosed, isolated, and treated with scarce evidence-based guidelines and resources. Several organizational and structural changes were needed to face the pandemic at local level. The article aims at studying the perceived impact of the newly implemented District Operation Centres (DOCs) of Local Health Authority (LHA) Roma 1 in managing active surveillance and home care of COVID-19 patients and their close contacts in cooperation with general practitioners (GPs).

Methods

A questionnaire, developed according to Delphi methodology, was validated by 7 experts and administered to a randomized sample of GPs and family paediatricians (FPs). All medical doctors selected received a phone interview between December 2020 and January 2021. The questionnaire investigated general characteristics of the sample, relations with DOC and its usefulness, and potential developments. A descriptive analysis was performed and inferential statistical tests were used to assess differences.

Results

In April 2020 the LHA Roma 1 implemented one DOCs in each local health district. 215 medical doctors were interviewed, reaching the sample target for health districts (80% CL and 10% MOE) and the whole LHA (90% CL and 5% MOE). Several aspects in the management of COVID-19 cases and close contacts of COVID-19 cases, and of the support of DOCs to GPs/FPs were investigated. More than 55% of the GPs and FPs interviewed found the DOCs useful and more than 78% would recommend a service DOC-like to other LHAs. The medical professionals interviewed would use DOCs in the future as support in treating vulnerable patients, utilizing digital health tools, enlisting specialist doctors, establishing networks, and facilitating professional counselling by nurses.

Conclusions

This study is an attempt to evaluate an organizational change happened during COVID-19 pandemic. DOCs were created to support GPs and FPs as a link between primary healthcare and public health. Although several difficulties were disclosed, DOCs’ experience can help to overcome the fragmentation of the systems and the duality between primary care and public health and make the system more resilient.
Adverse drug reactions in hospitals: population estimates for Portugal and the ICD-9-CM to ICD-10-CM crosswalk
Authors: Ascenção Raquel , Nogueira Paulo , Sampaio Filipa , Henriques Adriana , Costa Andreia
Published: November 2023

Background

Adverse drug reactions (ADR), both preventable and non-preventable, are frequent and pose a significant burden. This study aimed to produce up-to-date estimates for ADR rates in hospitals, in Portugal, from 2010 to 2018. In addition, it explores possible pitfalls when crosswalking between ICD-9-CM and ICD-10-CM code sets for ADR identification.

Methods

The Portuguese Hospital Morbidity Database was used to identify hospital episodes (outpatient or inpatient) with at least one ICD code of ADR. Since the study period spanned from 2010 to 2018, both ICD-9-CM and ICD-10-CM codes based on previously published studies were used to define episodes. This was an exploratory study, and descriptive statistics were used to provide ADR rates and summarise episode features for the full period (2010–2018) as well as for the ICD-9-CM (2010–2016) and ICD -10-CM (2017–2018) eras.

Results

Between 2010 and 2018, ADR occurred in 162,985 hospital episodes, corresponding to 1.00% of the total number of episodes during the same period. Higher rates were seen in the oldest age groups. In the same period, the mean annual rate of episodes related to ADR was 174.2/100,000 population. The episode rate (per 100,000 population) was generally higher in males, except in young adults (aged '15–20', '25–30' and '30–35' years), although the overall frequency of ADR in hospital episodes was higher in females.

Conclusions

Despite the ICD-10-CM transition, administrative health data in Portugal remain a feasible source for producing up-to-date estimates on ADR in hospitals. There is a need for future research to identify target recipients for preventive interventions and improve medication safety practices in Portugal.
Roles of gut microbiota in atrial fibrillation: insights from Mendelian randomization analysis and genetic data from over 430,000 cohort study participants
Authors: Dai Huajie , Hou Tianzhichao , Wang Qi , Hou Yanan , Zhu Zheng , Zhu Yijie , Zhao Zhiyun , Li Mian , Lin Hong , Wang Shuangyuan , Zheng Ruizhi , Xu Yu , Lu Jieli , Wang Tiange , Ning Guang , Wang Weiqing , Zheng Jie , Bi Yufang , Xu Min
Published: November 2023

Background

Gut microbiota imbalances have been suggested as a contributing factor to atrial fibrillation (AF), but the causal relationship is not fully understood.

Objectives

To explore the causal relationships between the gut microbiota and AF using Mendelian randomization (MR) analysis.

Methods

Summary statistics were from genome-wide association studies (GWAS) of 207 gut microbial taxa (5 phyla, 10 classes, 13 orders, 26 families, 48 genera, and 105 species) (the Dutch Microbiome Project) and two large meta-GWASs of AF. The significant results were validated in FinnGen cohort and over 430,000 UK Biobank participants. Mediation MR analyses were conducted for AF risk factors, including type 2 diabetes, coronary artery disease (CAD), body mass index (BMI), blood lipids, blood pressure, and obstructive sleep apnea, to explore the potential mediation effect of these risk factors in between the gut microbiota and AF.

Results

Two microbial taxa causally associated with AF: species Eubacterium ramulus (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04–1.12, P = 0.0001, false discovery rate (FDR) adjusted p-value = 0.023) and genus Holdemania (OR 1.15, 95% CI 1.07–1.25, P = 0.0004, FDR adjusted p-value = 0.042). Genus Holdemania was associated with incident AF risk in the UK Biobank. The proportion of mediation effect of species Eubacterium ramulus via CAD was 8.05% (95% CI 1.73% − 14.95%, P = 0.008), while the proportion of genus Holdemania on AF via BMI was 12.01% (95% CI 5.17% − 19.39%, P = 0.0005).

Conclusions

This study provided genetic evidence to support a potential causal mechanism between gut microbiota and AF and suggested the mediation role of AF risk factors.
A combined encoder–transformer–decoder network for volumetric segmentation of adrenal tumors
Authors: Wang Liping , Ye Mingtao , Lu Yanjie , Qiu Qicang , Niu Zhongfeng , Shi Hengfeng , Wang Jian
Published: November 2023

Background

The morphology of the adrenal tumor and the clinical statistics of the adrenal tumor area are two crucial diagnostic and differential diagnostic features, indicating precise tumor segmentation is essential. Therefore, we build a CT image segmentation method based on an encoder–decoder structure combined with a Transformer for volumetric segmentation of adrenal tumors.

Methods

This study included a total of 182 patients with adrenal metastases, and an adrenal tumor volumetric segmentation method combining encoder–decoder structure and Transformer was constructed. The Dice Score coefficient (DSC), Hausdorff distance, Intersection over union (IOU), Average surface distance (ASD) and Mean average error (MAE) were calculated to evaluate the performance of the segmentation method.

Results

Analyses were made among our proposed method and other CNN-based and transformer-based methods. The results showed excellent segmentation performance, with a mean DSC of 0.858, a mean Hausdorff distance of 10.996, a mean IOU of 0.814, a mean MAE of 0.0005, and a mean ASD of 0.509. The boxplot of all test samples' segmentation performance implies that the proposed method has the lowest skewness and the highest average prediction performance.

Conclusions

Our proposed method can directly generate 3D lesion maps and showed excellent segmentation performance. The comparison of segmentation metrics and visualization results showed that our proposed method performed very well in the segmentation.
Optimizing the maximum reported cluster size for the multinomial-based spatial scan statistic
Authors: Moon Jisu , Kim Minseok , Jung Inkyung
Published: November 2023

Background

Correctly identifying spatial disease cluster is a fundamental concern in public health and epidemiology. The spatial scan statistic is widely used for detecting spatial disease clusters in spatial epidemiology and disease surveillance. Many studies default to a maximum reported cluster size (MRCS) set at 50% of the total population when searching for spatial clusters. However, this default setting can sometimes report clusters larger than true clusters, which include less relevant regions. For the Poisson, Bernoulli, ordinal, normal, and exponential models, a Gini coefficient has been developed to optimize the MRCS. Yet, no measure is available for the multinomial model.

Results

We propose two versions of a spatial cluster information criterion (SCIC) for selecting the optimal MRCS value for the multinomial-based spatial scan statistic. Our simulation study suggests that SCIC improves the accuracy of reporting true clusters. Analysis of the Korea Community Health Survey (KCHS) data further demonstrates that our method identifies more meaningful small clusters compared to the default setting.

Conclusions

Our method focuses on improving the performance of the spatial scan statistic by optimizing the MRCS value when using the multinomial model. In public health and disease surveillance, the proposed method can be used to provide more accurate and meaningful spatial cluster detection for multinomial data, such as disease subtypes.
Effects of a social network intervention on HIV seroconversion among people who inject drugs in Ukraine: moderation by network gender composition
Authors: Wiginton John Mark , Booth Robert , Smith Laramie R. , Shakya Sajina , da Silva Cristina Espinosa , Patterson Thomas L. , Pitpitan Eileen V.
Published: November 2023

Background

Women who inject drugs in Ukraine are disproportionately burdened by HIV. To help address the needs of this population, a greater understanding of how interventions may uniquely benefit women who inject drugs is needed.

Methods

Data come from a randomized controlled trial of a social network intervention targeting people who inject drugs in Ukraine (N = 1195). Indexes, plus two of their injection network members, received HIV testing and counseling (control arm) or HIV testing and counseling plus a social network intervention (intervention arm), in which indexes were trained to influence network members’ risk behaviors. We used Cox regressions with interaction terms to assess differences in time to HIV seroconversion between arms by network gender composition and gender of the index. For significant interaction terms, we calculated simple effects, generated survival functions using Kaplan–Meier methods, and compared survival curves using log-rank tests.

Results

At 12 months, there were 45 seroconversions among women (40.0 [28.3, 51.7] per 100 person years) and 111 among men (28.4 [23.1, 33.6] per 100 person years) in the control arm; there were 27 seroconversions among women (17.1 [10.7, 23.6] per 100 person years) and 77 among men (18.7 [14.5, 22.9] per 100 person years) in the intervention arm. Network gender composition (but not gender of the index) moderated the intervention effect on HIV incidence (p < 0.05). Specifically, the intervention appeared to be even more protective against HIV acquisition as female gender composition increased. In the intervention arm, the HIV seroconversion hazard rate was 44% lower with 1 network female; 61% lower with 2 network females; and 72% lower with 3 network females.

Conclusions

A greater number of women in an injection network, coupled with the provision of risk-reduction strategies, is associated with HIV risk-mitigation, though the mechanisms through which this occurs remain unclear. Findings can support new research and practice directions that prioritize women who inject drugs and more thoughtfully support their health and wellbeing.
Policies to prevent zoonotic spillover: a systematic scoping review of evaluative evidence
Authors: Clifford Astbury Chloe , Lee Kirsten M. , Mcleod Ryan , Aguiar Raphael , Atique Asma , Balolong Marilen , Clarke Janielle , Demeshko Anastassia , Labonté Ronald , Ruckert Arne , Sibal Priyanka , Togño Kathleen Chelsea , Viens A. M. , Wiktorowicz Mary , Yambayamba Marc K. , Yau Amy , Penney Tarra L.
Published: November 2023

Background

Emerging infectious diseases of zoonotic origin present a critical threat to global population health. As accelerating globalisation makes epidemics and pandemics more difficult to contain, there is a need for effective preventive interventions that reduce the risk of zoonotic spillover events. Public policies can play a key role in preventing spillover events. The aim of this review is to identify and describe evaluations of public policies that target the determinants of zoonotic spillover. Our approach is informed by a One Health perspective, acknowledging the inter-connectedness of human, animal and environmental health.

Methods

In this systematic scoping review, we searched Medline, SCOPUS, Web of Science and Global Health in May 2021 using search terms combining animal health and the animal-human interface, public policy, prevention and zoonoses. We screened titles and abstracts, extracted data and reported our process in line with PRISMA-ScR guidelines. We also searched relevant organisations’ websites for evaluations published in the grey literature. All evaluations of public policies aiming to prevent zoonotic spillover events were eligible for inclusion. We summarised key data from each study, mapping policies along the spillover pathway.

Results

Our review found 95 publications evaluating 111 policies. We identified 27 unique policy options including habitat protection; trade regulations; border control and quarantine procedures; farm and market biosecurity measures; public information campaigns; and vaccination programmes, as well as multi-component programmes. These were implemented by many sectors, highlighting the cross-sectoral nature of zoonotic spillover prevention. Reports emphasised the importance of surveillance data in both guiding prevention efforts and enabling policy evaluation, as well as the importance of industry and private sector actors in implementing many of these policies. Thoughtful engagement with stakeholders ranging from subsistence hunters and farmers to industrial animal agriculture operations is key for policy success in this area.

Conclusion

This review outlines the state of the evaluative evidence around policies to prevent zoonotic spillover in order to guide policy decision-making and focus research efforts. Since we found that most of the existing policy evaluations target ‘downstream’ determinants, additional research could focus on evaluating policies targeting ‘upstream’ determinants of zoonotic spillover, such as land use change, and policies impacting infection intensity and pathogen shedding in animal populations, such as those targeting animal welfare.
Factors associated with health-seeking patterns among internally displaced persons in complex humanitarian emergency, Northeast Nigeria: a cross-sectional study
Authors: Gidado Saheed , Musa Melton , Ba’aba Ahmed Ibrahim , Okeke Lilian Akudo , Nguku Patrick M , Hadejia Idris Suleman , Hassan Isa Ali , Bande Ibrahim Muhammad , Onuoha Martins , Ugbenyo Gideon , Godwin Ntadom , Usman Rabi , Manu Jibrin Idris , Mohammed Abede Momoh , Abdullahi Muhammad Maijawa , Bammami Mohammed Isa , Nuorti Pekka , Atkins Salla
Published: November 2023

Background

Currently, over two million persons are internally displaced because of the complex humanitarian emergency in Nigeria’s northeast region. Due to crowded and unsanitary living conditions, the risk of communicable disease transmission, morbidity, and mortality among this population is high. This study explored patterns and factors associated with health-seeking among internally displaced persons (IDPs) in northeast Nigeria to inform and strengthen disease surveillance and response activities.

Methods

In a cross-sectional study conducted during June–October 2022, we employed stratified sampling technique to select 2,373 IDPs from 12 IDPs camps. A semi-structured tool was used to collect data on health-seeking patterns, socio-demographics, households, and IDPs camps characteristics. We classified health-seeking patterns into three outcome categories: ‘facility care’ (reference category), ‘non-facility care’ (patent medicine vendors, chemists, traditional healers, religious centers), and ‘home care/no care’. We performed complex survey data analysis and obtained weighted statistical estimates. Univariate analysis was conducted to describe respondents’ characteristics and health-seeking patterns. We fitted weighted multivariable multinomial logistic regression models to identify factors associated with health-seeking patterns.

Results

Of 2,373 respondents, 71.8% were 18 to 39 years old, 78.1% were females, and 81.0% had no formal education. Among the respondents, 75.7% (95% CI: 72.9–78.6) sought ‘facility care’, 11.1% (95% CI: 9.1–13.1) sought ‘non-facility care’, while 13.2% (95% CI: 10.9–15.4) practiced ‘home care/no care’. Respondents who perceived illness was severe (Adjusted Odds Ratio (AOR) = 0.15, [95% CI: 0.08–0.30]) and resided in officially-recognized camps (AOR = 0.26, [95% CI: 0.17–0.39]) were less likely to seek ‘non-facility care’ compared to ‘facility care’. Similarly, respondents who resided in officially-recognized camps (AOR = 0.58, [95% CI: 0.36–0.92]), and received disease surveillance information (AOR = 0.42, [95% CI: 0.26–0.67) were less likely to practice ‘home care/no care’ rather than seek ‘facility care’.

Conclusions

This population exhibited heterogeneous patterns of health-seeking at facility and non-facility centers. Perception of illness severity and camps’ status were major factors associated with health-seeking. To enhance surveillance, non-facility care providers should be systematically integrated into the surveillance network while ramping up risk communication to shape perception of illness severity, prioritizing unofficial camps.
Phycobiliproteins from microalgae: research progress in sustainable production and extraction processes
Authors: Wang Jinxin , Qin Song , Lin Jian , Wang Qi , Li Wenjun , Gao Yonglin
Published: November 2023

Phycobiliproteins (PBPs), one of the functional proteins from algae, are natural pigment–protein complex containing various amino acids and phycobilins. It has various activities, such as anti-inflammatory and antioxidant properties. And are potential for applications in food, cosmetics, and biomedicine. Improving their metabolic yield is of great interest. Microalgaes are one of the important sources of PBPs, with high growth rate and have the potential for large-scale production. The key to large-scale PBPs production depends on accumulation and recovery of massive productive alga in the upstream stage and the efficiency of microalgae cells breakup and extract PBPs in the downstream stage. Therefore, we reviewed the status quo in the research and development of PBPs production, summarized the advances in each stage and the feasibility of scaled-up production, and demonstrated challenges and future directions in this field.