bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlating Biomechanical Gait Analysis With Patient-Reported Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome
Authors: Kannan Abhishek S. , Hartwell Matthew J. , Grace Trevor , Hammond Eric , Soriano Kylen K.J. , Souza Richard B. , Zhang Alan L.
Published: September 2022

Background:

Postoperative biomechanics after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) are an outcome of interest, but correlation with patient-reported outcomes (PROs) remains unclear.

Purpose/Hypothesis:

The purpose of this study was to assess the correlation between changes in hip biomechanics in FAIS patients after hip arthroscopy and changes in PRO scores. We hypothesized that gait analysis would demonstrate significant correlations between pre- and postoperative changes in biomechanics and changes in PRO scores.

Study Design:

Descriptive laboratory study.

Methods:

FAIS patients without dysplasia or arthritis who underwent primary hip arthroscopy for labral repair and femoroplasty underwent preoperative and 1-year postoperative 3-dimensional motion tracking and biomechanical testing during normal gait. Joint kinematics calculated included flexion/extension (sagittal plane), abduction/adduction (frontal plane), and internal/external rotation (transverse plane). Peak hip angles and moments were compared between baseline and 1-year postoperative measures. At baseline, 1-year, and 2-year postoperatively, patients completed the following PRO surveys: 12-Item Short Form Health Survey (SF-12), modified Harris Hip Score (mHHS), and Hip disability and Osteoarthritis Outcome Score (HOOS). Joint kinematics that significantly improved 1 year after surgery were assessed for correlations with PRO scores.

Results:

A total of 10 patients (12 hips) were enrolled prospectively. PROs significantly improved at 1 and 2 years postoperatively compared with baseline values for HOOS, mHHS, and SF-12 Physical Component Score, with all patients achieving the minimal clinically important difference (MCID) on the HOOS Sport/Recreation and Quality of Life subscales. From preoperatively to 1-year postoperatively, significant improvements were seen in peak hip abduction angle (from −2.3° ± 1.8° to −4.6° ± 1.8°; P = .0058) and peak hip extension moment (from −1.03 ± 0.19 to −0.85 ± 0.20 N·m/kg; P = .014); however, there were no significant correlations between these changes and the pre- to postoperative changes on any PRO scores.

Conclusion:

Gait analysis of FAIS patients after hip arthroscopy demonstrated small, albeit significant, changes in postoperative hip kinetics and kinematics; however, these changes did not correlate with the large, clinically significant improvements in PROs at 1 year after surgery.

Clinical Relevance:

The results of this study suggest that the degree of improvement in short-term PROs after hip arthroscopy for FAIS may not be related to small changes in biomechanics postoperatively.
Perceived Organizational Listening Effectiveness: A Comparison of Consumer Intelligence Provider and Consumer Intelligence User Assessments
Authors: Brandt David Randall , Donohue William A.
Published: September 2022

This paper describes research focusing on how an organizational member’s role in the process—specifically, whether s/he is a consumer intelligence provider or a consumer intelligence user—may impact his/her assessment of organizational listening practices and effectiveness. After reviewing literature in three relevant areas of research, the paper describes a study in which five hypotheses are tested, each of which predicts differences between provider and user assessments. Results indicate that provider and user assessments are comparable regarding (a) creating a climate for listening to consumers and (b) capturing consumer feedback. However, user assessments of effectiveness at analysis, dissemination, and utilization consumer intelligence are significantly less favorable than those from providers. Implications for theory-building and knowledge development, implications for practitioners, and directions for future research, are discussed.
Development and validation of the conversation questionnaire: A psychometric measure of communication challenges generated from the self-reports of autistic people
Authors: Wilson Alexander C
Published: September 2022

Existing measures of communication challenges in autism are based on diagnostic criteria and research/clinical observations of autistic people, rather than what autistic people themselves identify as difficulties. In this study, the Conversation Questionnaire (CQ) was developed based on community engagement with autistic people to identify what they find challenging about conversation. This new tool was then administered online to autistic, dyslexic and neurotypical people ( N = 312) in a validation phase of the study. Item-response theory modelling indicated that a two-dimensional structure accounted for response patterns. These dimensions reflected difficulties knowing what to say (15 items) and engaging in behaviours possibly disruptive to neurotypical conversation (21 items). The dimensions showed good internal consistency and convergent and discriminant validity, and could distinguish between autistic and neurotypical people ( d = 1.59 and d = 2.07 respectively). The CQ might help contribute to diagnostic assessment for autism in adults as part of a holistic assessment. The questionnaire might also be useful with other neurodiverse groups, and provide a tool for clinicians and researchers to identify individuals’ strengths and difficulties in conversation (e.g., as part of interventions in speech and language therapy).
Becoming Dalit Women’s Voice: Engaging with Self-reflective Narrative in Bama’s Karukku
Authors: Kumar Shiv
Published: September 2022

Dalit writings are considered to be centred on the issue of identity politics. Most analysis rests on their claim of identity as fixed and static. They ignore an embedded process of various spatial implications, characters’ interaction with it, and a self-reflexive narrative gaze that most of the prominent Dalit writers present through their autobiographical narratives. Concentration on these concepts provides a fresh perspective to critically analyse Dalit writings and presents a different understanding of identity formation. This article proposes to unearth this process through a reading of Bama’s Karukku (2012), in English translation. It attempts to establish that identity formation in Dalit writings is a process that is based on various kinds of spatial experiences that could be divided into three stages of development. This process culminates in transforming a character into a politically conscious Dalit figure. Also, this article attempts to chart a character’s development that corroborates to body’s spatial-cultural location and its response to/within that space. It is an attempt to understand various spatial ramifications that the character experiences in an attempt to forge an identity outside the traditional definition.
Sairat Zaala Ji…
Authors: Morve Roshan K.  , Wen Xu
Published: September 2022

In Maharashtra, a few numbers of films have been produced on Dalit marginal or subaltern narratives, mainly based on the intersectionality of caste and gender conflicts. Unfortunately, these films have not received good responses nor got a box office success like Sairat movie did in the twenty-first century. In India, caste conflict, Brahminical hegemony and gender discrimination issues have produced fewer cinematic narratives about subalterns and badly left them without a voice. This article significantly exemplifies the Sairat movie to understand how a young generation in Maharashtra (especially from the rural areas) is facing caste hierarchy, class conflict, discrimination, gender-related issues and challenges in their lives. A class conflict and the characters’ struggle can be seen through the protagonists Parshya (Akash Thosar) and Archi (Rinku Rajguru) when they get married and start living their lives as an average couple, but nothing happens as a happy ending. This story re/presents the struggle of inter-caste marriage couples, social unacceptability and exclusion. They fail to resist the social, political and caste conflicts and get killed. In short, they become a victim of honour killing. To conclude, Sairat represents social, gender and caste conflict and reflects the struggle of youngsters in inter-caste marriages.
Summary of the Abrahamson and Gulerce NGA-SUB ground-motion model for subduction earthquakes
Authors: Abrahamson Norman A , Gulerce Zeynep
Published: September 2022

A set of region-specific ground-motion models (GMMs) for subduction zone earthquakes are developed based on the database compiled by the Pacific Earthquake Engineering Research Center (PEER) Next Generation Attenuation: Subduction project (NGA-SUB). The subset used to develop the GMMs includes 3914 recordings from 113 subduction interface earthquakes with magnitudes between 5 and 9.2 and 4850 recordings from 89 intraslab events with magnitudes between 5 and 7.8. The functional form of the global GMM accommodates the differences in the magnitude, distance, and depth scaling for interface and intraslab earthquakes. In addition to the global model, region-specific GMMs are developed for seven regions: Alaska, Cascadia, Central America, Japan, New Zealand, South America, and Taiwan. The magnitude scaling and the geometrical spreading parameters of the global model are used in all region-specific models, with the exception of the Taiwan region, which has a region-specific geometrical-spreading term. Four region-specific terms are included in the median GMM: the large distance (linear R) scaling, linear site amplification scaling (ln(VS30)), basin depth scaling (for Cascadia and Japan), and the constant term. The aleatory variability is also regionalized with larger aleatory variability at short periods for the Central America, Japan, and South America regions. Estimates of the epistemic uncertainty for the median and aleatory terms for each region are provided. The proposed global and region-specific GMMs are considered to be applicable to sites in the forearc region at distances up to 500 km, magnitudes of 5.0–9.5, and spectral periods from 0 to 10 s. The Cascadia-specific model is applicable to distances of 800 km including the backarc region.
Soft Tissue Deformation Modeling in the Procedure of Needle Insertion: A Kriging-Based Method
Authors: Lei Yong , Li Murong , Gao Dedong
Published: September 2022

The simulation and planning system (SPS) requires accurate and real-time feedback regarding the deformation of soft tissues during the needle insertion procedure. Traditional mechanical-based models such as the finite element method (FEM) are widely used to compute the deformations of soft tissue. However, it is difficult for the FEM or other methods to find a balance between an acceptable image fidelity and real-time deformation feedback due to their complex material properties, geometries and interaction mechanisms. In this paper, a Kriging-based method is applied to model the soft tissue deformation to strike a balance between the accuracy and efficiency of deformation feedback. Four combinations of regression and correlation functions are compared regarding their ability to predict the maximum deformations of ten characteristic markers at a fixed insertion depth. The results suggest that a first order regression function with Gaussian correlation functions can best fit the results of the ground truth. The functional response of the Kriging-based method is utilized to model the dynamic deformations of markers at a series of needle insertion depths. The feasibility of the method is verified by investigating the adaptation to step variations. Compared with the ground truth of the finite element (FE) results, the maximum residual is less than 0.92 mm in the Y direction and 0.31 mm in the X direction. The results suggest that the Kriging metamodel provides real-time deformation feedback for a target and an obstacle to a SPS.
Pou3f1 mediates the effect of Nfatc3 on ulcerative colitis-associated colorectal cancer by regulating inflammation
Authors: Lin Yan , Wang Dongxu , Zhao Hong , Li Dongyue , Li Xinning , Lin Lianjie
Published: September 2022

Background

Ulcerative colitis-associated colorectal cancer (UC-CRC) is an important complication of ulcerative colitis. Pou3f1 (POU class 3 homeobox 1) is a critical regulator for developmental events and cellular biological processes. However, the role of Pou3f1 in the development of UC-CRC is unclear.

Methods

In vivo, a UC-CRC mouse model was induced by azoxymethane (AOM) and dextran sulfate sodium (DSS). Body weight, colon length, mucosal damage, tumor formation, and survival rate were assessed to determine the progression of UC-CRC. Western blot, quantitative real-time PCR, ELISA, immunohistochemistry, immunofluorescence and TUNEL were performed to examine the severity of inflammation and tumorigenesis. In vitro, LPS-treated mouse bone marrow-derived macrophages (BMDMs) and RAW264.7 cells were used to study the role of Pou3f1 in inflammation. ChIP and luciferase reporter assays were used to confirm the interaction between Nfatc3 and Pou3f1.

Results

Pou3f1 expression was increased in the colons of UC-CRC mice, and its inhibition attenuated mucosal injury, reduced colon tumorigenesis and increased survival ratio. Knockdown of Pou3f1 suppressed cell proliferation and increased cell death in colon tumors. Both the in vivo and in vitro results showed that Pou3f1 depletion reduced the production of proinflammation mediators. In addition, ChIP and luciferase reporter assays demonstrated that Nfatc3 directly bound with the Pou3f1 promoter to induce its expression. The effect of Nfatc3 on the inflammatory response in macrophages was suppressed by Pou3f1 knockdown.

Conclusion

Overall, it outlines that Pou3f1 mediates the role of Nfatc3 in regulating macrophage inflammation and carcinogenesis in UC-CRC development.
Melatonin and cancer suppression: insights into its effects on DNA methylation
Authors: Davoodvandi Amirhossein , Nikfar Banafsheh , Reiter Russel J. , Asemi Zatollah
Published: September 2022

Melatonin is an important naturally occurring hormone in mammals. Melatonin-mediated biological effects include the regulation of circadian rhythms, which is important for optimal human health. Also, melatonin has a broad range of immunoenhancing actions. Moreover, its oncostatic properties, especially regarding breast cancer, involve a variety cancer-inhibitory processes and are well documented. Due to their promising effects on the prognosis of cancer patients, anti-cancer drugs with epigenetic actions have attracted a significant amount of attention in recent years. Epigenetic modifications of cancers are categorized into three major processes including non-coding RNAs, histone modification, and DNA methylation. Hence, the modification of the latter epigenetic event is currently considered an effective strategy for treatment of cancer patients. Thereby, this report summarizes the available evidence that investigated melatonin-induced effects in altering the status of DNA methylation in different cancer cells and models, e.g., malignant glioma and breast carcinoma. Also, we discuss the role of artificial light at night (ALAN)-mediated inhibitory effects on melatonin secretion and subsequent impact on global DNA methylation of cancer cells.
The long-term impact of the earthquake on substance use
Authors: Amiri Hadis , Riyahifar Sevda , Nakhaee Nouzar , Nekoei-Moghadam Mahmoud
Published: September 2022

Earthquake is associated with several health conditions such as posttraumatic stress disorder (PTSD), depression, and cardiovascular disease. However, the association between earthquakes and substance use has been less studied to date. We conducted a historical cohort study 17 years after the Bam earthquake by enrolling 818 households using multi-stage cluster sampling. The sample consisted of earthquake-exposed and non-exposed citizens. The ASSIST screening test was used to determine substance use. Logistic regression analysis was used to evaluate the association of variables of interest with substance use. Nearly 60% of the study subjects were female and the mean ± SD age of the sample was 46.6 ± 11.5 years. The prevalence of tobacco, alcohol, and other drug use in the exposed group was 19.5%, 24.9%, and 21.6%, respectively. The corresponding figures in the non-exposed group were 15.6%, 19.3%, and 20.1%, respectively (P > 0.05). The logistic regression model found no association between the history of earthquake exposure and the risk of any current drug use. Our results showed those 17 years after the Bam earthquake, there was no relationship between earthquake exposure and substance use.
Variation of the element composition of municipal sewage sludges in the context of new regulations on phosphorus recovery in Germany
Authors: Sichler Theresa Constanze , Montag David , Barjenbruch Matthias , Mauch Tatjana , Sommerfeld Thomas , Ehm Jan-Hendrik , Adam Christian
Published: September 2022

Phosphorus (P) recovery is obligatory for all sewage sludges with more than 20 g P/kg dry matter (DM) from 2029 in Germany. Nine wastewater treatment plants (WWTPs) were chosen to investigate variations of phosphorus contents and other parameters in sewage sludge over the year. Monthly sewage sludge samples from each WWTP were analyzed for phosphorus and other matrix elements (C, N, H, Ca, Fe, Al, etc.), for several trace elements (As, Cr, Mo, Ni, Pb, Sn) and loss of ignition. Among the nine WWTPs, there are four which have phosphorus contents both above and below the recovery limit of 20 g/kg DM along the year. Considering the average phosphorus content over the year, only one of them is below the limit. Compared to other matrix elements and parameters, phosphorus fluctuations are low with an average of 7% over all nine WWTPs. In total, only hydrogen and carbon are more constant in the sludge. In several WWTPs with chemical phosphorus elimination, phosphorus fluctuations showed similar courses like iron and/or aluminum. WWTPs with chamber filter presses rather showed dilution effects of calcium dosage. As result of this study, monthly phosphorus measurement is highly recommended to determine whether a WWTP is below the 20 g/kg DM limit.

Graphical Abstract
Hazardous chemicals in non-polar extracts from paper and cardboard food packaging: an effect-based evaluation
Authors: Selin Erica , Wänn Mimmi , Svensson Kettil , Gravenfors Erik , Giovanoulis Georgios , Oskarsson Agneta , Lundqvist Johan
Published: September 2022

Background

Food contact articles are used in our everyday life and information regarding the potential health hazards of migrating chemicals for humans is scarce. In this study, an effect-based evaluation of non-polar extracts of food contact articles made of paper and board was conducted with a panel of eight bioassay endpoints. These, health-relevant endpoints, included oxidative stress, inflammation, genotoxicity, xenobiotic metabolism and hormone receptor effects.

Results

In total, 62 food contact articles were pooled into 19 groups, in which articles intended to be used for similar types of food item(s) were pooled, and extracted with acetone:n-hexane (1:4). These were then tested in the effect-based bioassays. Bioactivities were detected for multiple materials in six out of eight assays, the two assays showing no effects were NFκB and androgen receptor agonistic response. In essence, the detection rates of the tested non-polar extracts were 72% for antagonistic effects on the estrogen receptor, 72% for antagonistic effects on the androgen receptor, 47% for oxidative stress, 28% for agonistic effects on the estrogen receptor and 33% for genotoxicity. The bioequivalent concentrations ranges in extracts of 10 mg food contact article/mL cell culture media were: for oxidative stress from 2.45 to 5.64 µM tBHQ equivalents, estrogen receptor agonistic activity from 1.66 to 6.33 ρM estradiol equivalents, estrogen receptor antagonistic activity from 1.21 × 10–3 to 4.20 × 10–3 μM raloxifene equivalents and androgen antagonistic activity 0.08–0.46 μM hydroxyflutamide equivalents. The extracts that were bioactive in multiple assays were: baking moulds, boxes for popcorn, infant formula/skimmed milk, porridge/flour mixes, pizza, fries’ and hamburgers as well as packages for frozen food.

Conclusion

Non-polar extracts of food contact articles contain compounds that can activate molecular initiating events in toxicity pathways of high relevance to human health. These events included endocrine-disruptive activities, oxidative stress and genotoxicity. Effect-based methods proved to be a valuable tool for evaluating food package articles, as they can detect potentially hazardous effects of both known and unknown chemicals as well as potential cocktail effects.
Evaluating patient-reported outcome measures (PROMs) for clinical trials and clinical practice in adult patients with uveitis or scleritis: a systematic review
Authors: O’Donovan Charles , Panthagani Jesse , Aiyegbusi Olalekan Lee , Liu Xiaoxuan , Bayliss Susan , Calvert Melanie , Pesudovs Konrad , Denniston Alastair , Moore David , Braithwaite Tasanee
Published: September 2022

Patient reported outcome measures (PROMs) capture impact of disease and treatment on quality of life, and have an emerging role in clinical trial outcome measurement. This study included a systematic review and quality appraisal of PROMs developed or validated for use in adults with uveitis or scleritis. We searched MEDLINE, EMBASE, PsycINFO, CINAHL and grey literature sources, to 5 November 2021. We used established quality criteria to grade each PROM instrument in multiple domains from A (high quality) to C (low quality), and assessed content development, validity, reliability and responsiveness. For instruments developed using classic test theory-based psychometric approaches, we assessed acceptability, item targeting and internal consistency. For instruments developed using Item Response Theory (IRT) (e.g. Rasch analysis), we assessed response categories, dimensionality, measurement precision, item fit statistics, differential item functioning and targeting. We identified and appraised four instruments applicable to certain uveitis types, but none for scleritis. Specifically, the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ), a 3-part PROM for Birdshot retinochoroiditis (Birdshot Disease & Medication Symptoms Questionnaire [BD&MSQ], the quality of life (QoL) impact of Birdshot Chorioretinopathy [QoL BCR], and the QoL impact of BCR medication [QoL Meds], the Kings Sarcoidosis Questionnaire (KSQ), and a PROM for cytomegalovirus retinitis. These instruments had limited coverage for these heterogeneous conditions, with a focus on very rare subtypes. Psychometric appraisal revealed considerable variability between instruments, limited content development, and only one developed using Item Response Theory. In conclusion, there are few validated PROMs for patients with uveitis and none for scleritis, and existing instruments have suboptimal psychometric performance. We articulate why we do not recommend their inclusion as clinical trial outcome measures for drug licensing purposes, and highlight an unmet need for PROMs applicable to uveitis and scleritis.
Optimal experimental designs for estimating genetic and non-genetic effects underlying infectious disease transmission
Authors: Pooley Christopher , Marion Glenn , Bishop Stephen , Doeschl-Wilson Andrea
Published: September 2022

Background

The spread of infectious diseases in populations is controlled by the susceptibility (propensity to acquire infection), infectivity (propensity to transmit infection), and recoverability (propensity to recover/die) of individuals. Estimating genetic risk factors for these three underlying host epidemiological traits can help reduce disease spread through genetic control strategies. Previous studies have identified important ‘disease resistance single nucleotide polymorphisms (SNPs)’, but how these affect the underlying traits is an unresolved question. Recent advances in computational statistics make it now possible to estimate the effects of SNPs on host traits from epidemic data (e.g. infection and/or recovery times of individuals or diagnostic test results). However, little is known about how to effectively design disease transmission experiments or field studies to maximise the precision with which these effects can be estimated.

Results

In this paper, we develop and validate analytical expressions for the precision of the estimates of SNP effects on the three above host traits for a disease transmission experiment with one or more non-interacting contact groups. Maximising these expressions leads to three distinct ‘experimental’ designs, each specifying a different set of ideal SNP genotype compositions across groups: (a) appropriate for a single contact-group, (b) a multi-group design termed “pure”, and (c) a multi-group design termed “mixed”, where ‘pure’ and ‘mixed’ refer to groupings that consist of individuals with uniformly the same or different SNP genotypes, respectively. Precision estimates for susceptibility and recoverability were found to be less sensitive to the experimental design than estimates for infectivity. Whereas the analytical expressions suggest that the multi-group pure and mixed designs estimate SNP effects with similar precision, the mixed design is preferred because it uses information from naturally-occurring rather than artificial infections. The same design principles apply to estimates of the epidemiological impact of other categorical fixed effects, such as breed, line, family, sex, or vaccination status. Estimation of SNP effect precisions from a given experimental setup is implemented in an online software toolSIRE-PC.

Conclusions

Methodology was developed to aid the design of disease transmission experiments for estimating the effect of individual SNPs and other categorical variables that underlie host susceptibility, infectivity and recoverability. Designs that maximize the precision of estimates were derived.
DMRscaler: a scale-aware method to identify regions of differential DNA methylation spanning basepair to multi-megabase features
Authors: Bondhus Leroy , Wei Angela , Arboleda Valerie A.
Published: September 2022

Background

Pathogenic mutations in genes that control chromatin function have been implicated in rare genetic syndromes. These chromatin modifiers exhibit extraordinary diversity in the scale of the epigenetic changes they affect, from single basepair modifications by DNMT1 to whole genome structural changes by PRM1/2. Patterns of DNA methylation are related to a diverse set of epigenetic features across this full range of epigenetic scale, making DNA methylation valuable for mapping regions of general epigenetic dysregulation. However, existing methods are unable to accurately identify regions of differential methylation across this full range of epigenetic scale directly from DNA methylation data.

Results

To address this, we developed DMRscaler, a novel method that uses an iterative windowing procedure to capture regions of differential DNA methylation (DMRs) ranging in size from single basepairs to whole chromosomes. We benchmarked DMRscaler against several DMR callers in simulated and natural data comparing XX and XY peripheral blood samples. DMRscaler was the only method that accurately called DMRs ranging in size from 100 bp to 1 Mb (pearson's r = 0.94) and up to 152 Mb on the X-chromosome. We then analyzed methylation data from rare-disease cohorts that harbor chromatin modifier gene mutations in NSD1, EZH2, and KAT6A where DMRscaler identified novel DMRs spanning gene clusters involved in development.

Conclusion

Taken together, our results show DMRscaler is uniquely able to capture the size of DMR features across the full range of epigenetic scale and identify novel, co-regulated regions that drive epigenetic dysregulation in human disease.
Patients’ health literacy and health behaviour assessment in primary health care: evidence from a cross-sectional survey
Authors: Šulinskaitė Kristina , Zagurskienė Daiva , Blaževičienė Aurelija
Published: September 2022

Background

Health literacy is defined as a person's ability to find, understand, and use health-related information when making health-related decisions. Patients with lower health literacy more frequently face difficulties when they have health issues or need medical help. Such patients are less likely to visit health care facilities and receive less help, which subsequently leads to higher hospitalization and mortality rates. Patients with better health literacy skills pay more attention to their health behaviours.

Methods

This is a cross-sectional survey conducted in two primary health care centres—one public and one private—in Lithuania. The study enrolled patients who were visiting family physicians (n = 399). The study used the Health Literacy Survey European Questionnaire (HLS-EU-Q47). Calculation of means and two independent samples were used for statistical analysis, and a correlation coefficient was calculated.

Results

The majority (40.6%) of respondents had problematic health literacy, while only 7% had excellent health literacy. Better health literacy was observed among younger patients (aged below 30 years), residing in urban areas, having higher education, and living with a partner. Inadequate or problematic health literacy was noted among 83.6% of respondents aged 59 years and older; similar rates were also observed among patients with basic or primary education (76.1%), secondary education (76.6%), and divorced patients (86%). Respondents with better health literacy also had better health behaviours (p < 0.05).

Conclusions

Health literacy is influenced by age, residence, education, and family status. Patients with better health literacy also reported better health behaviours.
Translation, cultural adaptation and validation of the Somatic Symptom Scale-8 (SSS-8) for the Brazilian Portuguese language
Authors: Pollo Camila Fernandes , Meneguin Silmara , Miot Hélio Amante , de Oliveira César
Published: September 2022

Background

Assessment tools are commonly used in different fields of health to assist in the diagnosis, the evaluation of the response to treatment, the measurement of quality of life and the establishment of the prognosis.

Objectives

Translate, culturally adapt and perform the psychometric validation of the Somatic Symptom Scale (SSS-8) for use in the Brazilian population.

Methods

Cross-cultural adaptation followed a combination of guidelines and for psychometric evaluation a sample of 300 patients was recruited. All recommended measurement properties by the Consensus-based Standards for the selection of health status Measurement Instruments were evaluated, including analysis by an expert committee and analysis by the target public. The Skindex-16 was used for the evaluation of convergent validity and Cronbach’s alpha was used for the determination of the internal consistency of the translated version of the SSS-8.

Results

The final version received approval from five experts and the agreement index was 100% for all items. During the pretest, the scale was administered to 300 patients with psoriasis and none of the items needed to be altered. A moderate correlation was found between the Skindex-16 and SSS-8-BRA. In the analysis of internal consistency, Cronbach’s alpha for the SSS-8-BRA was 0.81.

Conclusion

The SSS-8 is a valid and reliable tool for the assessment of somatic symptoms in the Brazilian population.
Transient alterations in plasma sodium concentrations with NER1006 bowel preparation: an analysis of three phase III, randomized clinical trials
Authors: Cash Brooks D. , Allen Christopher , Poppers David M.
Published: September 2022

Background

This analysis characterized changes in sodium levels in patients receiving the 1 L polyethylene glycol-based preparation NER1006.

Methods

Data were pooled from three phase III, randomized clinical trials. A post hoc subanalysis included adults who received a 2-day split-dose (evening/morning) NER1006 regimen, a 1-day split-dose (morning only) regimen, or evening-before regimen and had an increase in sodium concentrations from normal to above the upper limit of normal (143–148 mmol/L) at ≥ 1 of three post-treatment visits. Blood samples were collected at baseline, day of colonoscopy (visit 2), 2 ± 1 days post-colonoscopy (visit 3), and 7 ± 1 days post-colonoscopy (visit 4).

Results

A total of 214 of 1028 patients were included. Of the 214 patients, sodium concentration increased from a mean baseline value of 141.8 mmol/L to a mean of 147.1 mmol/L (median increase from baseline of approximately 5 mmol/L). The mean sodium concentration was within normal range at visit 3 (142.3 mmol/L) and visit 4 (142.4 mmol/L), as was the median sodium concentration. Overall, ~ 90% of patients had a normal serum concentration at visits 3 and 4. Based on day of colonoscopy test results, there were four adverse events involving hypernatremia (0.4% of 1028), which were mild and did not require medical intervention; sodium levels returned to normal range by visit 3.

Conclusion

NER1006 was associated with small, transient increases in sodium levels that were not considered clinically significant.

Trial registration NOCT (ClinicalTrials.gov: NCT02254486 [registered October 2, 2014]), MORA (ClinTrials.gov: NCT02273167 [registered October 23, 2014]; EudraCT number: 2014-002185-78 [registered August 13, 2014]), DAYB (ClinicalTrials.gov: NCT02273141 [registered October 23, 2014]; EudraCT Number: 2014-002186-30 [registered August 12, 2014])
Clinical characteristics and outcomes in those with primary extrahepatic malignancy and malignant ascites
Authors: Alshuwaykh Omar , Cheung Amanda , Goel Aparna , Kwong Allison , Dhanasekaran Renumathy , Ghaziani T. Tara , Ahmed Aijaz , Daugherty Tami , Dronamraju Deepti , Kumari Radhika , Nguyen Mindie , Kim W. Ray , Kwo Paul Yien
Published: September 2022

Background

Malignancy-related ascites accounts for approximately 10% of causes of ascites. Our AIM was to characterize the ascites fluid and correlate clinical outcomes in those with extrahepatic malignancy and ascites.

Methods

241 subjects with extrahepatic solid tumors and ascites were reviewed from 1/1/2000 to 12/31/2019, 119 without liver metastasis and 122 with liver metastasis.

Results

Ascites fluid consistent with peritoneal carcinomatosis (PC) was most common, 150/241 (62%), followed by fluid reflecting the presence of portal hypertension (PH), 69/241 (29%). 22/241 (9%) had low SAAG and low ascites fluid total protein, with evidence of PC on cytology and or imaging in 20/22. Lung cancer was the most common malignancy in subjects with ascites due to PC at 36/150 (24%), pancreatic cancer was the most common in subjects with ascites with features of PH at 16/69 (23%). Chemotherapy or immunotherapy alone was the most common management approach. Significantly higher 5-year, 3-year and 1-year mortality rate were noted in subjects with evidence of PC on cytology/imaging versus subjects with no evidence of PC, and in subjects with liver metastasis compared to subjects without liver metastasis. Subjects with pancreatic cancer and evidence of PC on cytology/imaging had higher 1 and 5-year mortality rates compared to subjects without PC.

Conclusions

Ascites in solid tumor malignancy is most commonly due to PC. We also observed ascites fluid with characteristics of PH in 29% of subjects. Higher mortality rates in subjects with peritoneal carcinomatosis and liver metastasis were noted. These findings may help inform prognosis and treatment strategies.
Poorly differentiated cluster grade-a vital predictor for lymph node metastasis and oncological outcomes in patients with T1 colorectal cancer: a retrospective study
Authors: Ji Xiaolin , Kang Mei , Zhao Xianzhi , Li Xiaoyu , Guo Yingjie , Xie Ping , Yu Yanan , Tian Zibin
Published: September 2022

Background

T1 colorectal cancers have a low lymph node metastasis rate and good prognosis. Thus, endoscopic resection is an attractive choice. This study aimed to describe the value of poorly differentiated cluster grade in identifying endoscopically curable T1 colorectal cancers.

Methods

We included 183 T1 colorectal cancer patients who underwent curative resection. Univariate and multivariate logistic regressions were used to identify lymph node metastasis predictors. The Akaike information criterion was used to determine whether poorly differentiated cluster grade was the best predictor. Backward regression was used to screen the variables. Survival analyses were conducted to determine the prognostic predictive power of poorly differentiated cluster grade. Correlations among predictors and concordance between our pathologists were also investigated.

Results

Poorly differentiated cluster grade was an independent predictor for lymph node metastasis (adjusted odds ratio [OR]G 3 = 0.001; 95% confidence interval [95% CI]G 3 =  < 0.001, 0.139) in T1 colorectal cancer patients; moreover, it had the best predictive value (AIC = 61.626) among all indicators. It was also screened for inclusion in the predictive model. Accordingly, a high poorly differentiated cluster grade independently indicated shorter overall survival (hazard ratio [HR]G 2 = 4.315; 95% CIG 2 = 1.506, 12.568; HRG 3 = 5.049; 95% CIG 3 = 1.326, 19.222) and disease-free survival (HRG 3 = 6.621; 95% CIG 3 = 1.472, 29.786).

Conclusions

Poorly differentiated cluster grade is a vital reference to manage T1 colorectal cancer. It could serve as an indicator to screen endoscopically curable T1 colorectal cancers.
Cardiovascular disease risk and all-cause mortality associated with accelerometer-measured physical activity and sedentary time ‒ a prospective population-based study in older adults
Authors: Länsitie Miia , Kangas Maarit , Jokelainen Jari , Venojärvi Mika , Timonen Markku , Keinänen-Kiukaanniemi Sirkka , Korpelainen Raija
Published: September 2022

Background

Low levels of physical activity (PA) and high sedentary time (ST) are common in older adults and lack of PA is a risk factor for cardiovascular disease (CVD). Knowledge about associations with accelerometer-measured PA, ST and CVD risk in older adults is insufficient. This study examines the associations of accelerometer-measured PA and ST with cardiovascular risk measured using the Framingham risk score (FRS) and all-cause mortality in older adults.

Methods

A population-based sample of 660 (277 men, 383 women) older people (mean age 68.9) participated in the Oulu45 cohort study from 2013‒2015. PA and ST were measured with wrist-worn accelerometers at baseline for two weeks. Ten-year CVD risk (%) was estimated with FRS. The data for all-cause mortality were identified from the Digital and Population Data Services Agency, Finland after an average of 6.2 years follow-up. The associations between moderate to vigorous physical activity (MVPA), light physical activity (LPA), ST and FRS were analyzed using the multivariable linear regression analysis. Associations between LPA, ST and mortality were analyzed using the Cox proportional-hazard regression models.

Results

Each 10 min increase in MVPA (β = -0.779, 95% CI -1.186 to -0.371, p < 0.001) and LPA (β = -0.293, 95% CI -0.448 to -0.138, p < 0.001) was negatively associated with FRS while a 10 min increase in ST (β = 0.290, 95% CI 0.158 to 0.421, p < 0.001) was positively associated with FRS. After adjustment for waist circumference, only ST was significantly associated with FRS. Each 10 min increase in LPA was associated with 6.5% lower all-cause mortality risk (HR = 0.935, 95% CI 0.884 to 0.990, p = 0.020) and each 10 min increase in ST with 5.6% increased mortality risk (HR = 1.056, 95% CI 1.007 to 1.108, p = 0.025).

Conclusion

A higher amount of daily physical activity, at any intensity level, and avoidance of sedentary time are associated with reduced cardiovascular disease risk in older people. Higher time spent in light physical activity and lower sedentary time are associated with lower all-cause mortality.
How formal caregiver’s BPSD knowledge influences positive aspects of caregiving: the mediating role of attitude and the moderating role of self-efficacy
Authors: Hu Rui , Lai Bingbing , Ma Wenhao , Zhang Yuan , Deng Yujiao , Liu Lianqi , Lv Zeping , Chan Chetwyn , Zhang Fan , Tao Qian
Published: September 2022

Background

The current study investigated the relationship between behavioural and psychological symptoms of dementia (BPSD) knowledge and positive aspects of caregiving (PAC), in addition, how caregiving attitude and self-efficacy mediate or moderate this relationship.

Methods

Two hundred twenty-nine formal caregivers (51males and 178females) who has worked in nursing homes for more than a month were recruited.With a cross-sectional, face-to-face survey, structural questionnaires were implemented to evaluate formal caregiver’s BPSD knowledge, attitude, self-efficacy and PAC.A 13-item self-developed questionnaire was used to assess caregiver’s BPSD knowledge about disease characteristics, care and risks, and treatment needs. Dementia attitude, self-efficacy and positive aspects of caregiving were measured by dementia attitude scale, the General self-efficacy scale, and Chinese version of positive aspects of caregiving respectively. Model 5 in the PROCESS micro was employed in order to verify the mediating effect of attitude and the moderating effect of self-efficacy on the relationship between BPSD knowledge and PAC.

Results

The results showed that greater BPSD knowledge was associated with increased PAC, and this relationship was fully mediated by increased friendly attitude toward people with dementia. Moreover, direct effect was moderated by self-efficacy, and that only among those with high self-efficacy, the direct effect of BPSD knowledge was found on promoting PAC.

Conclusions

By elucidating the knowledge-attitude-practice pathway in handling patient’s BPSD, the current study extends existing literature and provides insights for developing psychoeducation programs among formal caregivers.
Systemic immune-inflammation index predicts postoperative delirium in elderly patients after surgery: a retrospective cohort study
Authors: Song Yuxiang , Luo Yungen , Zhang Faqiang , Ma Yulong , Lou Jingsheng , Li Hao , Liu Yanhong , Mi Weidong , Cao Jiangbei
Published: September 2022

Background

Postoperative delirium (POD) is a common complication among elderly patients after surgery. It is unclear whether the systemic immune-inflammation index (SII) can be a predictor of POD. We explored the prognostic value of the SII in predicting POD in elderly patients undergoing non-neurosurgery and non-cardiac surgery in a large retrospective cohort.

Methods

We enrolled elderly patients undergoing non-neurosurgery and non-cardiac surgery between January 2014 and August 2019. Univariate and multivariate logistic regression analyses were performed to explore the correlation between POD and the SII value as both a continuous and categorical variable. Then, propensity score matching (PSM) analysis was applied to eliminate the confounding effect of covariates and prove our results. Subgroup analyses were then performed to discover the association between the SII and POD in different subgroups.

Results

A total of 29,608 patients with a median age of 70 years (IQR: 67–74) were enrolled in the retrospective cohort. The cut-off value of the SII was 650, which was determined by the receiver operating characteristic (ROC) curve. The ORs of an SII value > 650 was 2.709 (95% CI:2.373–3.092, P < 0.001), 1.615 (95% CI:1.384–1.882, P < 0.001), 1.855 (95% CI:1.602–2.146, P < 0.001), and 1.302 (95% CI:1.106–1.531, P = 0.001) for prediction of POD in univariate model and three multivariate regression models. After PSM, the OR of an SII value > 650 was 1.301 (95% CI: 1.062–1.598, P = 0.011). The subgroup analysis indicated that the SII indicates a significantly increased risk of POD in patients with Hb < 130 g/L, 4*109/L < WBC ≤ 10*109/L, albumin < 39 g/L, or duration of MAP < 60 mmHg ≥ 5 min. The SII was found to be a useful prognostic predictor of POD for patients of different ages, sexes, and ASA classifications.

Conclusions

The SII had a predictive value for POD in patients undergoing non-neurosurgery and non-cardiac surgery. As an index generated from routine blood tests, the SII has advantages regarding cost and time. After further validation, the SII may provide a new option for POD prediction.
“There is no joy in the family anymore”: a mixed-methods study on the experience and impact of maternal mortality on families in Ghana
Authors: Lawrence Emma R. , Appiah-Kubi Adu , Lawrence Hannah R. , Lui Maxine Y. , Owusu-Antwi Ruth , Konney Thomas , Moyer Cheryl A.
Published: September 2022

Background

Maternal mortality has a multifaceted impact on families, especially in low- and middle-income countries, where rates of maternal mortality are high and resources can be lacking. The objective of this study was to explore the ways that maternal mortality influences the physical and emotional wellbeing, financial stability, and caregiving structure of families, and identifies sources of and gaps in support.

Methods

Our study used a mixed-methods design. All maternal mortalities in an 18-month period at a tertiary hospital in Ghana were identified using death certificates. Participants were 51 family members (either husbands or other heads of households) in families affected by maternal mortality. A questionnaire assessed demographic characteristics and changes in family health, income, and family structure. Two validated scales assessing psychological wellbeing were administered: the Patient Health Questionnaire-9 and the Inventory of Complicated Grief. Semi-structured interviews were conducted to assess impact on family wellbeing.

Results

Quantitative and qualitative results converged to highlight large, negative impacts of maternal mortality on four areas of family wellbeing: 1) mental health and emotional wellbeing; 2) physical health; 3) family structure; 4) financial stability and security. On the Patient Health Questionnaire-9, 54% (27/50) of participants reported elevated depressive symptoms, with 14% (7/50) of scores falling in the moderately severe or severe ranges. On the Inventory of Complicated Grief, 38% (19/50) exceeded the cutoff for significant impairment in functioning. Worsened family health was associated with greater complicated grief (b = 21.41,p = .004); there were no other significant predictors of depressive symptom severity or complicated grief. Effects on family health centered on concerns about the nutritional status and health of the surviving infant. Family structure was primarily affected by fracturing of the central family unit by sending children to live with relatives. Immense economic strain resulted from hospital bills, funeral expenses, and loss of income. The majority of participants received helpful support from their family (41/51, 80.4%), the community (32/51, 62.7%), and their religious institution (43/51, 84.3%); however, support often stopped soon after the death.

Conclusions

Maternal mortality has profound negative impacts on families in Ghana. Impacts are experienced by husbands and heads of households, as well as surviving children. Both immediate and sustained support is needed for families following a maternal death, especially mental health and financial support.