bluuebunny/crossref_metadata_2025 huggingface dataset:
Re-thinking benign inflammation of the lactating breast: A mechanobiological model
Authors: Douglas Pamela
Published: February 2022

Despite the known benefits of breastfeeding for both infant and mother, clinical support for problems such as inflammation of the lactating breast remains a research frontier. Breast pain associated with inflammation is a common reason for premature weaning. Multiple diagnoses are used for inflammatory conditions of the lactating breast, such as engorgement, blocked ducts, phlegmon, mammary candidiasis, subacute mastitis, mastitis and white spots, which lack agreed or evidence-based aetiology, definitions and treatment. This is the first in a series of three articles which review the research literature concerning benign lactation–related breast inflammation. This article investigates aetiological models. A complex systems perspective is applied to analyse heterogeneous and interdisciplinary evidence elucidating the functional anatomy and physiology of the lactating breast; the mammary immune system, including the human milk microbiome and cellular composition; the effects of mechanical forces during lactation; and the interactions between these. This analysis gives rise to a mechanobiological model of breast inflammation, in which very high intra-alveolar and intra-ductal pressures are hypothesized to strain or rupture the tight junctions between lactocytes and ductal epithelial cells, triggering inflammatory cascades and capillary dilation. Resultant elevation of stromal tension exerts pressure on lactiferous ducts, worsening intraluminal backpressure. Rising leucocyte and epithelial cell counts in the milk and alterations in the milk microbiome are signs that the mammary immune system is recruiting mechanisms to downregulate inflammatory feedback loops. From a complex systems perspective, the key mechanism for the prevention or treatment of breast inflammation is avoidance of excessively high intra-alveolar and intra-ductal pressures, which prevents a critical mass of mechanical strain and rupture of the tight junctions between lactocytes and ductal epithelial cells.
Experience of Perceived Stress and Impact of Health Locus of Control During COVID-19 Pandemic: Investigating Entrepreneurs and Corporate Employees
Authors: Chandra Yamini , Yagnik Jignasu
Published: February 2022

The sudden, rapid and ongoing outbreak of novel coronavirus disease-2019 (COVID-19) has forced social distancing and lockdowns. Many people have already started experiencing an elevated feeling of loneliness, emotional distress, anxious and depressive thoughts related to the concerns for the disrupted social, emotional, spiritual, professional and financial wellbeing of family, friends and self. Many are feeling distressed on recurring thoughts about how long this pandemic will last, whether our family and friends will be infected and how long we will be living in this condition. Hence, the researchers of this study anticipated that the COVID-19 outbreak would be highly stressful to the people and will have psychological consequences of varying degrees. This study examines the relationship of stress, anxiety with health locus of control (HLOC) among entrepreneurs and employees serving in organisations, and the coping strategies they have adopted to overcome it. Using the quasi-experiment method, the data were collected using the perceived stress scale (PSS) and multidimensional health locus of control (MHLC) from 91 entrepreneurs and employees. The findings indicated a significant association between HLOC and stress. It was observed that respondents were aware that the current work stress is arising because of a struggle to balance personal and professional lives during the pandemic. Further, it was also observed that stress was significantly higher in employees than entrepreneurs, and HLOC types positively impacted their stress levels.
Scleroderma Renal Crisis Associated With Microangiopathic Hemolytic Anemia in a Patient With Seronegative Scleroderma and Monoclonal Gammopathy
Authors: Riley Mark , Der Mesropian Paul , Maheshwari Ana , Arslan Mustafa Erdem , Visrodia Parth , Salman Loay , Peredo-Wende Ruben , Foulke Llewellyn , Hongalgi Krishnakumar
Published: February 2022

Systemic sclerosis with negative serology, particularly that complicated by scleroderma renal crisis (SRC), is rarely encountered. We describe a patient with seronegative systemic sclerosis who developed acute kidney injury, proteinuria, and hypertensive emergency following motor vehicle-related trauma and in the setting of nonsteroidal anti-inflammatory drug use. Findings on physical examination, imaging, and skin biopsy led to a clinical diagnosis of scleroderma, despite the lack of supportive laboratory data. IgG lambda paraproteinemia was detected on workup. Bone marrow biopsy showed plasmacytosis and trace lambda-restricted plasma cells consistent with monoclonal gammopathy of undetermined significance. Chemotherapy was initially started given concern for myeloma with cast nephropathy but was later stopped after a kidney biopsy revealed thrombotic microangiopathy (TMA). The SRC associated with TMA was ultimately diagnosed, though atypical hemolytic uremic syndrome (aHUS) induced perhaps by monoclonal gammopathy or hypertension was also possible. Captopril and eculizumab were initiated for SRC and aHUS, respectively. Despite therapy, renal function did not recover, and the patient required hemodialysis indefinitely. This case highlights clinical features common to both SRC and aHUS as well as points out a few ways to differentiate between them.
Anand Teltumbde on Globalization and Ambedkar: A Left Perspective
Authors: Kalva Swamy
Published: February 2022

The left leaning or the Marxian school deals with the social, economic and political ideology or a movement, which aims at establishing a communist stateless society. According to the left-leaning thinkers, the proletarian rule will exist for some point of time, after which the state will wither away. In this case, understanding Ambedkar from a left perspective would be a new paradigm. Anand Teltumbde on one side says that Ambedkar was not a Marxist and that he was under the intellectual influence of his teachers, who were known as the Fabian socialists, and on the other side says that he practiced the class politics.
What Numbers Never Revealed: Tracing Dalit Christian Modernity Through Malayalam Literature
Authors: Romeo Christina , Nayar Anupama
Published: February 2022

Kerala has a long-standing history of Christianity as well as conversions. Conversions can be dated back to the fifteenth and sixteenth centuries, which saw a large number of slave caste conversions. For the slave castes of Kerala—Pulayas and Parayas—Christianity offered a salvation from the circle of pollution. Scriptures provided the slave castes new vistas of knowledge which they encultured to form a counter discourse against the public sphere set up by the dominant castes. The public sphere of the Malayalee psyche was formed by the ideas of caste pollution, which restricted the slave castes from accessing the social space. A new Dalit perspective on the religious consciousness of the converted Christians will show the role of the Bible, Original Sin, and Repentance on their daily lives. Dalit Christian literature becomes the primary source where Christianity metamorphoses into an oppositional force in resisting oppression as well as in creating a social space with agency.
Domestic Violence: An Additive to COVID-19 Crisis
Authors: Dehury Ranjit Kumar , Samal Janmejaya
Published: February 2022

The pandemic of COVID-19 is one of its kind in the history of pandemics around the world. Apart from creating ripples in its de facto biomedical spheres it also created a whole lot of social problems around the globe. The very common preventive measures that it advocates for such as physical distancing, quarantine and isolation created problems in several of the societies. These measures created problems of social stigma, discrimination, racism and others. In addition, lockdowns imposed by several governments around the globe made people stay at home without attending workplaces. As the lockdowns were stringent and continued for protracted period that led to several forms of domestic violence around the globe. Deviations in routine work life, sitting frivolously at home, use and abuse of different substances coupled with economic imbalance in families led to many different forms of intimate partner and nuptial violence in families. Many a time it happened so that the women could not access the help owing to above mentioned preventive measures that by default has to be imposed upon the citizens and they have to stay longer with the perpetrator without help. Many a time the woman cannot even leave away the perpetrator and take help in other places as she has other family liabilities and responsibilities of caring for the children and other family members. In addition, owing to the very nature of transmission of this disease they were not even entertained by authorities to stay at shelter homes in the name of physical distancing. This article discusses the impact of COVID-19 and resultant domestic violence in an Indian context.
Menstrual Hygiene Management: Linking with Education and Development
Authors: Ganguli Barna
Published: February 2022

Menstruation is a very normal physiological process for every female falling in the reproductive age-group, but still it is considered a taboo and a subject seldom openly discussed in most of the developing countries worldwide and India is no exception.

Menstrual hygiene is still the most challenging issue because being a conservative topic, not much is spoken and discussed about it, and that is how the menstrual hygiene management (MHM) becomes an important task. As this is related to the well-being of half of the population, it becomes utmost important to address the problem.

It is seen that education has a direct impact on understanding hygiene and hygiene has a direct role to play in development. Thus, states with good social and economic indicators are better performers of MHM. The present article tries to explore the connection of MHM with that of education and development. To make a comparative study and to establish this direct relationship of education and development, four states have been selected—Bihar and Jharkhand, from lower-income groups, and Kerala and Karnataka, from higher-income groups.

The article also lays stress on the fact that optimizing menstrual hygiene interventions will require an integration of both knowledge and better living conditions alongside an augmentation of access to clean water, sanitation and hygiene facilities in addition to the availability of affordable hygienic sanitary products. Finally, the article also recommends the government to enhance the coverage and utilization of public fund on the issue so that every woman between 15 and 49 years gets the advantage of MHM irrespective of her social strata.
A Primer on Hypothesis Testing for Craniofacial Surgeons: How to Obtain Valid Conclusions From Observations and Experiments
Authors: Yu Jack C. , Shukla Dhairya , Linder Daniel , Doroodchi Atbin , Agko Mouchammed , Doroodchi Ramtin , Khodadadi Chamgordani Hesamoldin , Lin Alexander Y.
Published: February 2022

“Ability and judgment” are the only terms that appeared twice in the Hippocratic Oath and are the pillars of medicine and surgery, as clinical decision making and treatments depend on physicians’ judgments and abilities. Sound judgment requires knowledge obtained and accumulated through individual and collective experience, but more importantly from studies employing scientific methods. In a compendium article to this current one, the death of George Washington within days of onset of respiratory infection in 1799 exemplified the futility of ineffective, if not dangerous and harmful, medical treatments. The key question is how can anyone know with certainty that a particular therapy is or is not effective? Since individual differences exist in responses to corrective procedures and medications, absolute certainty is uncommon. However, as the number of patients increases, so does the confidence, at times approaching certainty. Statistical testing allows for the extraction of valid, useful information from data collected and is a critical part of all surgical disciplines. While this mini-review will not replace the need for expert statistical inputs from statisticians, it will provide a deep appreciation of and a working knowledge for these tests. We focus on hypothesis testing, the foundation to synthesize knowledge to guide, improve new treatments, and confirm or repudiate existing ones. The primer begins with hypothesis testing and systematically examine parametric and non-parametric statistical tests, ending with Mendelian randomization.
Critical shoulder angle (CSA): age and gender distribution in the general population
Authors: Gumina S. , Polizzotti G. , Spagnoli A. , Carbone S. , Candela V.
Published: February 2022

Objective

Anatomical parameters and pathologies that can affect the critical shoulder angle (CSA) are subjects of discussion. To date, we do not know if the CSA value changes in the different decades of life in a population characterized by the same ethnicity, nor if there are differences related to gender or side. This study hypothesizes that age and gender may affect the CSA.

Methods

Patients older than 15 years old affected by a shoulder trauma and who were discharged with a diagnosis of shoulder contusion were enrolled. A true AP view of the shoulder was obtained as well as data regarding age and gender of all participants. The CSA was measured by three authors, and interoperator reliability was assessed. Eight subcategories, according to decades of life, were considered. Finally, the studied population was divided into three subcategories according to CSA values (< 30°; 30–35°; ≥ 35°).

Results

The initial sample comprised 3587 shoulder X-rays. The interobserver reproducibility was high, with an intraclass correlation coefficient of 0.865 (95% CI 0.793–0.915).

Two thousand eight hundred seventy-three radiograms were excluded. The studied group comprised 714 patients [431 females, 283 males; mean age (SD): 47.2 (20.9) years, range: 11–93 years]. The mean CSA was 33.6° (range: 24–50°; SD: 3.9°). The mean CSA values in females and males were 33.7°and 33.5°, respectively. The mean CSA values of the right and left shoulders were 33.3° and 33.9°, respectively (p > 0.05). Linear regression analysis showed a CSA increase by 0.04° every year. The mean CSA in subjects aged between 15 and 19 years was significantly lower than all the other groups, except for patients older than 80 years.

No significant differences were found between CSA subcategories, gender, or side.

Conclusions

In the general population, the mean CSA value was 33.6°. No significant differences were found regarding the mean CSA value according to gender or side. A significant positive linear correlation between CSA and age was detected. In each decade of life, the CSA value, which is genetically determined, shows a large variability.

Level of evidence: IV.
Obstacles to access to community care in urban senior-only households: a qualitative study
Authors: Gong Ni , Meng Ya , Hu Qin , Du Qianqian , Wu Xiaoyu , Zou Wenjie , Zhu Mengyao , Chen Jiayan , Luo Lan , Cheng Yu , Zhang Meifen
Published: February 2022

Background

The increased number of older adults living alone has created a substantial care need. However, the utilization rate of services and facilities to meet these needs are surprisingly low. Many of older adults experience difficulties accessing these services, although it remains unclear how these obstacles impede access to services. This study explored the obstacles and difficulties experienced by urban older adults in seeking community care.

Methods

A phenomenological study was carried out and participatory observation and in-depth interviews were employed to investigate the process of seeking care of older adults in urban communities. A total of 18 urban community-dwelling older adults aged 75 years and over were included. Data collected were analysed by content analysis.

Results

We identified the pathways by which senior-only households sought community care and encountered obstacles. (1) lack of community care information: older adults did not know where and how to get services, even though the care institutions scattered throughout the community; (2) limited mobility: older adults often suffered from various chronic diseases, which physically hindered their access to care resources; (3) complex process of achieving care: the functional fragmentation and geographical dispersion of care institutions made the care-seeking process challenging and confusing for older adults; (4) incomprehension of needs expression: limited interaction time and communication barriers between staff of institutions and the older adults were the final obstacle. Only by surmounting these obstacles one by one can older adults access the care resources effectively.

Conclusions

When older adults in the community initiated calls for help, they encountered several obstacles. Their physiological and social disadvantages limited their ability to seek care physically. Lack of integration and clear guidance in the process of providing community care exacerbated these difficulties. Reform of care services should focus on the visibility and accessibility of services for older adults.
Drug users’ awareness of and willingness to use HIV non-occupational post-exposure prophylaxis (nPEP) services in China: a mixed methods study
Authors: Jiao Kedi , Li Haochu , Zhang Dapeng , Jiang Zhenxia , Lin Yuxi , Liu Xueyuan , Xu Hengmin , Yan Xuemei , Tang Haoqing , Ma Wei
Published: February 2022

Background

Drug users are regarded as a high-risk population for HIV infection. Non-occupational post-exposure prophylaxis (nPEP) is internationally regarded as an effective biomedical prevention against HIV but still a small-scale pilot project in China at present. The aim of this study was to understand drug users’ awareness of and willingness to use nPEP service in China.

Methods

This mixed methods study consisting of a qualitative study and a cross-sectional survey was conducted in two cities of China from 2018 to 2019. The in-depth interviews were audio-taped, transcribed verbatim and analyzed using thematic framework analysis. Univariate and multivariate logistic regressions were used to examine factors associated with drug users’ awareness of and willingness to use nPEP.

Results

There were 401 and 19 participants included in quantitative and qualitative study respectively. Among participants in quantitative study, 30.2% had heard of nPEP and 56.7% reported willingness to use nPEP in future HIV exposure. In multivariate analyses, nPEP awareness was associated with age, sex, education level, AIDS knowledge score and HIV risk perception. nPEP willingness was associated with AIDS knowledge score, HIV risk perception, alcohol use, monthly income and awareness of nPEP. The qualitative results showed the barriers to nPEP willingness included the fatigue after taking drugs, high cost and side effects of nPEP medication, long nPEP course, and fear of privacy disclosure.

Conclusion

Drug users had low nPEP awareness and only about half participants reported willingness to use nPEP. It is essential to promote nPEP education campaigns among drug users, especially for elders, women and those with lower education level. Simultaneously, price regulation, side effect management, psychological support and privacy protection need to be managed well when nPEP is routinized.
The impact of malocclusion on the oral health related quality of life of 11–14-year-old children
Authors: Baskaradoss Jagan K. , Geevarghese Amrita , Alsaadi Waad , Alemam Huda , Alghaihab Amjad , Almutairi Amal Saad , Almthen Abeer
Published: February 2022

Background

The relationship between malocclusion and the oral health related quality of life (OHRQoL) of children needs to be explored further as existing literature presents conflicting evidence. This study aims to determine the association between malocclusion and OHRQoL of 11–14-year-old children.

Methods

This cross-sectional study was conducted among 250 caregiver/child dyads seeking orthodontic consultation at a tertiary care hospital. The OHRQoL was assessed using child perception questionnaire for 11–14-year-old children (CPQ11–14) and the severity of malocclusion was assessed using the Dental Aesthetic Index (DAI). CPQ11–14 scores ranged from 0 to 64, with lower scores representing better quality of life. Analysis of variance (ANOVA) was used to assess differences between domain and total CPQ11–14 scores.

Results

The mean CPQ11–14 score was 19.89 ± 9.8. Mean scores for the oral symptoms, functional limitations, emotional well-being, and social well-being domains were 5.26 ± 3.22, 3.67 ± 3.58, 3.98 ± 3.89 and 2.08 ± 2.98, respectively. Normal or slight malocclusion was seen in 37.6%, definite malocclusion was seen in 22.4%, severe malocclusion in 15.2% and handicapping malocclusion in 24.8% of the subjects. In comparisons by pairs, it was found that children with handicapping malocclusion had significantly (p < 0.05) higher scores for the social well-being domain as compared with children having normal/minor malocclusion, indicating a poorer quality of life.

Conclusion

Handicapping malocclusion had a significant negative impact on the social well-being domain of OHRQoL among 11–14-year-old children in this population.
Feasibility and effect of adding a concurrent parental component to a school-based wellness program using two modes of mobile-based technology – mixed methods evaluation of RCT
Authors: Golan Moria , Benifla Shakked , Samo Aviv , Alon Noa , Mozeikov Maya
Published: February 2022

Background

This study assessed the feasibility and effect of two mobile modes (WhatsApp vs. a specially designed app) in their delivery of updates and assignments to parents.

Methods

Two three-armed, randomized, controlled feasibility studies were conducted. In each trial, four schools with a total of 418 students in grade 5th, mean age 10.1 years, were randomly allocated to the control arm, youth-only arm, or youth & parental component arm. Only the data of those that completed all three assessments (pre, post and 3 months post program) were analyzed: 133 in the first trial and 137 in the second.

In the youth-only arm, students participated in an interactive age-tailored prevention program delivered in 10 weekly, 90-min sessions on self-care behaviors, media literacy, self-esteem, and positive body image. The control groups in both studies received three health- and nutrition-related sessions.

In the parental arm, in addition to the ‘Favoring-Myself–Young’s ten sessions program, parents received updates and were requested to complete shared assignments with their children. In the first year, the assignments were sent via WhatsApp, and in the following year via “Favoring Myself” smartphone application.

Facilitators were third year undergraduate students. They used a detailed semi-structured guide and received 4-weekly hours of didactic and group dynamic supervision. Mixed-methods assessments were performed using semi-structured interviews with ten parents and five school staff members each year, as well as a computerized self-report questionnaire.

Results

Feasibility of parent-adolescent shared assignments in both digital modes was lower than expected. The use of WhatsApp had higher feasibility and uptake than the use of the special application.

The addition of the concurrent parental component via WhatsApp was associated with superior improvement in self-esteem and identification of advertisement strategies, compared with the youth-only program. However, adolescents in the youth-only program delivered via the smartphone application demonstrated superior improvement compared to those in the youth and parental component arm.

Conclusions

Although the addition of the concurrent parenting component was praised by the actively participating parents, overall, under the chosen structure and population, it did not prove to add statistically significant value to the youth-only arm.

Trial registrations

NCT03216018(12.7.2017) and NCT03540277 (26.4.2018).
Prevention is political: political party affiliation predicts perceived risk and prevention behaviors for COVID-19
Authors: Kiviniemi Marc T. , Orom Heather , Hay Jennifer L. , Waters Erika A.
Published: February 2022

Background

Many US politicians have provided mixed messages about the risks posed by SARS-CoV-2/COVID-19 and whether and to what extent prevention practices should be put in place to prevent transmission. This politicization of the virus and pandemic may affect individuals’ risk perceptions and willingness to take precautions. We examined how political party affiliation relates to risk perception for one’s own and other people’s likelihood of SARS-CoV-2 infection/COVID-19 illness.

Methods

We surveyed members of a nationally-representative, probability-sampling based survey panel (N = 410) to examine their risk perceptions, precautionary behaviors, and political party affiliation.

Results

The more strongly one identified as a Republican, the less risk one perceived to oneself from SARS-CoV-2/COVID-19 and the less risk one perceived other people faced. Moreover, those identifying as more strongly Republican engaged in fewer preventive behaviors.

Conclusions

This differential response may affect virus transmission patterns and poses a considerable challenge for health communications efforts.
Effective interventions to improve long-term physiotherapy exercise adherence among patients with lower limb osteoarthritis. A systematic review
Authors: Cinthuja Pathmanathan , Krishnamoorthy Nidhya , Shivapatham Gamalendira
Published: February 2022

Introduction

Osteoarthritis (OA) is a chronic condition. Physiotherapy is known to be beneficial for people with OA. Patient adherence to physiotherapy exercise is essential for the effective management of OA.

Objectives

To determine different methods used to enhance physiotherapy exercise adherence for a period of more than 12 months among patients with OA and to report the most effective methods to enhance exercise adherence among people with lower limb OA.

Design

Systematic review.

Methods

PubMed, Pedro, Web of Science, and EMBASE databases were searched for randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies published in the English language from 2000 to 2020. The literature search was done on 27 August 2020. Two researchers independently conducted the screening, eligibility assessment, data extraction, methodology quality assessment using the PEDro scale, and risk of bias assessment using RoB2. A narrative synthesis of key outcomes is presented, percentage of adherence rate; Preferred Reporting Items for Systematic Review was used to report the review. Meta-analysis was not performed due to heterogeneity of studies. The study protocol was registered in Prospero (Prospero ID: CRD42020205653).

Results

The primary search strategy identified 5839 potentially relevant articles, of which 5157 remained after discarding duplicates. After screening based on title and abstract, 40 papers were potentially eligible for inclusion. Five of these papers met all predefined eligibility criteria. Introducing methods to enhance exercise adherence has caused a significant increase in exercise adherence for less than 6 or 12 months. There were no significant differences in adherence for more than 12 months with different methods. The results indicate that booster-sessions (89.69%) and telephone-linked communication (86%) had higher percentages for exercise adherence. Secondary outcomes such as pain, stiffness and function show positive outcomes with increasing exercise adherence. However, there were no significant differences on these secondary outcomes.

Conclusion

The booster sessions and telephone-linked communication appear to enhance exercise adherence for more than 12 months among patients with OA. However, the number of high-quality studies is inadequate to confirm our findings. Therefore, more studies with higher methodological quality are needed to determine the best strategies to enhance long-term exercise adherence among people with OA.
Real world data on cardiometabolic diseases in U.S. adults during the SARS-CoV-2 pandemic: a decentralized registry study
Authors: Shah Parth , Magee Kim , Buccellato Kiara H. , Ismond McKenna , Watson Jalisa
Published: February 2022

Background

Pre-existing cardiometabolic comorbidities place SARS-CoV-2 positive patients at a greater risk for poorer clinical course and mortality than those without it. We aimed to analyze real-world registry data focused primarily on participants with cardiometabolic diseases (CMD), which were remotely obtained via a digital platform.

Methods

Participants were divided into two groups: CMD or no cardiometabolic disease (non-CMD). They were evaluated based on their medical history, current medications/supplements, COVID-19 status, demographics, and baseline characteristics. The frequency of medications/supplements for CMD were compared using relative risks and 95% confidence intervals. The WHO (Five) Well-Being Index (WHO-5) were collected monthly for 6 months to assess psychological well-being which included cheerfulness, calmness, vigor, rest, and engagement with daily activities of interest.

Results

The 791 enrollees represented 49 U.S. states. The CMD group had significantly higher (p < 0.0001) BMI (mean + 3.04 kg/m2) and age (mean + 9.15 years) compared to non-CMD group. In the CMD group, participants who tested positive for COVID-19 had lower (p < 0.0001) well-being scores than those without COVID-19. For the 274 participants on CMD medications/supplements, there was no statistical difference in risk of COVID-19 contracture based on medication/supplement type; however, all six participants who were not being treated for CMD were COVID-19 positive (RR ~ 104). For 89 participants who were on treatment for diabetes or insulin resistance, there was a 90% reduced risk of COVID-19 incidence (p = 0.0187).

Conclusion

The well-being score of the CMD group was dependent on whether they tested positive for COVID-19. Type of CMD treatment did not impact COVID-19 status, but absence of treatment significantly increased COVID-19 incidence. With respect to SARS-CoV-2, our analysis supports continued use of the statins, ACE-I, ARBs, and diabetes medications in CMD patients.

Trial registration: ClinicalTrials.gov Identifier: NCT04348942.
Tryptophan-sorbitol based carbon quantum dots for theranostics against hepatocellular carcinoma
Authors: Wang Yang , Chen Jun , Tian Jiekang , Wang Guanchen , Luo Weikang , Huang Zebing , Huang Yan , Li Ning , Guo Mingming , Fan Xuegong
Published: February 2022

Background

Despite novel advances in screening, targeting and immunotherapies, early diagnosis and satisfactory treatments against hepatocellular carcinoma (HCC) remain formidable challenges. Given the unique advantages, carbon quantum dots (CQDs) become a smart theranostic nanomaterial for cancer diagnosis and therapy.

Results

In this work, a type of bio-friendly CQDs, trichrome-tryptophan-sorbitol CQDs (TC-WS-CQDs), is synthesized from natural biocompatible tryptophan via the one-pot hydrothermal method. Compared with normal hepatocytes, a much stronger green fluorescence is detected in HCC cells, indicating the ability of TC-WS-CQDs to target HCC cells. Furthermore, green-emitting TC-WS-CQDs generate large amounts of reactive oxygen species (ROS), leading to autophagy of HCC cells. Additionally, the green-emitting TC-WS-CQDs perform significant tumor inhibition by inducing autophagy via p53-AMPK pathway in vitro and in vivo studies with almost no systemic toxicity.

Conclusions

The results may highlight a promising anticancer nanotheranostic strategy with integration of diagnosis, targeting, and therapy.

Graphical Abstract
Construction of a circRNA-miRNA-mRNA network based on differentially co-expressed circular RNA in gastric cancer tissue and plasma by bioinformatics analysis
Authors: Gong Yu , Jiao Yuwen , Qi Xiaoyang , Fu Jinjin , Qian Jun , Zhu Jie , Yang Haojun , Tang Liming
Published: February 2022

Background

Increasing evidence implicates circular RNAs (circRNAs) have been involved in human cancer progression. However, the mechanism remains unclear. In this study, we identified novel circRNAs related to gastric cancer and constructed a circRNA-miRNA-mRNA network.

Methods

Microarray datasets GSE83521 and GSE93541 were obtained from the Gene Expression Omnibus (GEO). Then, we used computational biology to identify circRNAs that were differentially expressed in both GC tissue and plasma compared to normal controls; then, we detected the expression of the selected circRNAs in gastric cell lines by quantitative real-time polymerase chain reaction (qRT-PCR). We also identified circRNA-related candidate miRNAs and their target genes with online tools. Combining the predicted miRNAs and target mRNAs, a competing endogenous RNA regulatory network was established. Functional and pathway enrichment analyses were performed, and interactions between proteins were predicted by using String and Cytoscape. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to elucidate the possible functions of these differentially expressed circRNAs. The regulatory network constructed using the microarray datasets (GSE83521 and GSE93541) contained three differentially co-expressed circRNAs (DECs). A circRNA-miRNA-mRNA network was constructed based on 3 circRNAs, 43 miRNAs and 119 mRNAs.

Results

GO and KEGG analysis showed that the regulation of apoptotic signaling pathway and PI3K−Akt signaling pathway were highest degrees of enrichment respectively. We established a protein-protein interaction (PPI) network consisting of 165 nodes and 170 edges and identified hub genes by using MCODE plugin in Cytoscape. Furthermore, a core circRNA-miRNA-mRNA network was constructed based on hub genes. Hsa_circ_0001013 was finally determined to play an important role in the pathogenesis of GC according to the core circRNA-miRNA-mRNA network.

Conclusions

We propose a new circRNA-miRNA-mRNA network that is associated with the pathogenesis of GC. The network may become a new molecular biomarker and could be used to develop potential therapeutic strategies for gastric cancer.
How to set the agenda for hepatitis C: a theory-driven policy analysis
Authors: Kind Julia , Maeschli Bettina , Bruggmann Philip
Published: February 2022

Background

Hepatitis C virus (HCV) represents a significant public health burden. When new HCV drugs arrived in 2014, the disease became curable, but the administration remained reluctant to address this public health issue. However, the Swiss parliament recently decided to integrate HCV into the next national HIV programme. This study investigates how HCV came onto the political agenda in Switzerland and which actors and factors were influential in this process.

Methods

The data collection is based on document analysis and semi-structured interviews. The transcripts were coded by deriving the codes from the data in terms of content followed by the application of the multiple streams framework.

Results

Health authorities, unlike experts, did not see the HCV epidemic as a relevant public health threat. Due to cost-related restriction of access to treatment, the potential of the new HCV drugs could not be fully exploited. The administration’s position proved difficult to change, despite evidence to the contrary. For 30 years, authorities set the agenda in health policy regarding HCV, unheeded by politicians. But recently, a policy entrepreneur has for the first time successfully managed to put HCV on the political agenda. After years of education and lobbying, it used the window of opportunity in the form of the new edition of the national HIV programme. The parliamentary decision to include HCV in this programme broke the long-standing primacy of the administration in the field of HCV, which had long prevented a more active handling of the HCV field.

Conclusions

The case of HCV in Switzerland shows that evidence alone is not enough to bring about health policy changes. A policy entrepreneur is needed who overcomes resistance, brings together the three streams—problem, policy and political—and exploits the window of opportunity at the right time. To be successful, the policy entrepreneur must identify the indicators that map the problem, network and convince decision-makers, recognize policy windows and use them—as has been the case with HCV in Switzerland.
A systematic review of proxy-report questionnaires assessing physical activity, sedentary behavior and/or sleep in young children (aged 0–5 years)
Authors: Arts Jelle , Gubbels Jessica S. , Verhoeff Arnoud P. , Chinapaw Mai. J. M. , Lettink Annelinde , Altenburg Teatske M.
Published: February 2022

Background

Accurate proxy-report questionnaires, adapted to the child’s developmental stage, are required to monitor 24-h movement behaviors in young children, especially for large samples and low-resource settings.

Objectives

This review aimed to summarize available studies evaluating measurement properties of proxy-report questionnaires assessing physical activity, sedentary behavior and/or sleep in children aged 0–5 years.

Methods

Systematic literature searches were carried out in the PubMed, Embase and SPORTDiscus databases, up to January 2021. For physical activity and sedentary behavior questionnaires this is a review update, whereas for sleep questionnaires we included all relevant studies published up to now. Studies had to evaluate at least one of the measurement properties of a proxy-report questionnaire assessing at least duration and/or frequency of physical activity, sedentary behavior and/or sleep in 0- to 5-year-old children. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline was used to evaluate the quality of evidence.

Results

Thirty-three studies were included, examining a total of 37 questionnaires. Ten questionnaires were designed for infants, two for toddlers, 11 for preschoolers, and 14 for a broader age range targeting multiple of these age groups. Twenty questionnaires assessed constructs of sleep, four assessed constructs of physical activity, two assessed screen behavior, five assessed constructs of both physical activity and sedentary behavior, and six assessed constructs of all 24-h movement behaviors. Content validity was evaluated for six questionnaires, structural validity for two, internal consistency for three, test-retest reliability for 16, measurement error for one, criterion validity for one, and construct validity for 26 questionnaires. None of the questionnaires were considered sufficiently valid and/or reliable for assessing one or more movement behaviors in 0- to 5-year-old children, and the quality of evidence was mostly low or very low.

Conclusions

Valid and/or reliable questionnaires assessing 24-h movement behaviors in 0- to 5-year-olds are lacking. High-quality studies are therefore required, to develop proxy-report questionnaires and evaluate their measurement properties.

PROSPERO registration number

CRD42020169268.
Interaction between a diabetes-related methylation site (TXNIP cg19693031) and variant (GLUT1 rs841853) on fasting blood glucose levels among non-diabetics
Authors: Tsai Hao-Hung , Shen Chao-Yu , Ho Chien-Chang , Hsu Shu-Yi , Tantoh Disline Manli , Nfor Oswald Ndi , Chiu Shin-Lin , Chou Ying-Hsiang , Liaw Yung-Po
Published: February 2022

Background

Type 2 diabetes mellitus (T2DM) is caused by a combination of environmental, genetic, and epigenetic factors including, fasting blood glucose (FBG), genetic variant rs841853, and cg19693031 methylation. We evaluated the interaction between rs841853 and cg19693031 on the FBG levels of non-diabetic Taiwanese adults.

Methods

We used Taiwan Biobank (TWB) data collected between 2008 and 2016. The TWB data source contains information on basic demographics, personal lifestyles, medical history, methylation, and genotype. The study participants included 1300 people with DNA methylation data. The association of cg19693031 methylation (stratified into quartiles) with rs841853 and FBG was determined using multiple linear regression analysis. The beta-coefficients (β) and p-values were estimated.

Results

The mean ± standard deviation (SD) of FBG in rs841853-CC individuals (92.07 ± 7.78) did not differ significantly from that in the CA + AA individuals (91.62 ± 7.14). However, the cg19693031 methylation levels were significantly different in the two groups (0.7716 ± 0.05 in CC individuals and 0.7631 ± 0.05 in CA + AA individuals (p = 0.002). The cg19693031 methylation levels according to quartiles were β < 0.738592 (< Q1), 0.738592 ≤ 0.769992 (Q1–Q2), 0.769992 ≤ 0.800918 (Q2–Q3), and β ≥ 0.800918 (≥ Q3). FBG increased with decreasing cg19693031 methylation levels in a dose–response manner (ptrend = 0.005). The β-coefficient was − 0.0236 (p = 0.965) for Q2–Q3, 1.0317 (p = 0.058) for Q1–Q2, and 1.3336 (p = 0.019 for < Q1 compared to the reference quartile (≥ Q3). The genetic variant rs841853 was not significantly associated with FBG. However, its interaction with cg19693031 methylation was significant (p-value = 0.036). Based on stratification by rs841853 genotypes, only the CC group retained the inverse and dose–response association between FBG and cg19693031 methylation. The β (p-value) was 0.8082 (0.255) for Q2–Q3, 1.6930 (0.022) for Q1–Q2, and 2.2190 (0.004) for < Q1 compared to the reference quartile (≥ Q3). The ptrend was 0.002.

Conclusion

Summarily, methylation at cg19693031 was inversely associated with fasting blood glucose in a dose-dependent manner. The inverse association was more prominent in rs841853-CC individuals, suggesting that rs841853 could modulate the association between cg19693031 methylation and FBG. Our results suggest that genetic variants may be involved in epigenetic mechanisms associated with FBG, a hallmark of diabetes. Therefore, integrating genetic and epigenetic data may provide more insight into the early-onset of diabetes.
Escaping social rejection, gaining total capital: the complex psychological experience of female genital mutilation/cutting (FGM/C) among the Izzi in Southeast Nigeria
Authors: Omigbodun Olayinka , Bella-Awusah Tolulope , Emma-Echiegu Nkechi , Abdulmalik Jibril , Omigbodun Akinyinka , Doucet Marie-Hélène , Groleau Danielle
Published: February 2022

Background

While the deleterious effects of FGM/C on physical health are well documented, the psychological experience of this harmful practice is a neglected area of research, which limits global mental health actions. As FGM/C was a traditional practice in some areas of Nigeria, the study aimed to understand the psychological experience of FGM/C in context.

Methods

This qualitative study was completed in urban and rural Izzi communities in Southeast Nigeria where FGM/C was widely practiced. In-depth interviews were completed with 38 women of the same ethnicity using the McGill Illness Narrative Interview (MINI) to explore the collective psychological experience of FGM/C before, during and after the procedure. The MINI was successfully adapted to explore the meaning and experience of FGM/C. We completed thematic content analysis and used the concepts of total capital and habitus by Bourdieu to interpret the data.

Results

During the period of adolescence, Izzi young women who had not yet undergone FGM/C reported retrospectively being subjected to intense stigma, humiliation and rejection by their cut peers. Alongside the social benefits from FGM/C the ongoing psychological suffering led many to accept or request to be cut, to end their psychological torture. Virtually all women reported symptoms of severe distress before, during and after the procedure. Some expressed the emotion of relief from knowing their psychological torture would end and that they would gain social acceptance and total capital from being cut. Newly cut young women also expressed that they looked forward to harassing and stigmatizing uncut ones, therein engaging in a complex habitus that underscores their severe trauma as well as their newly acquired enhanced social status.

Conclusion

FGM/C is profoundly embedded in the local culture, prevention strategies need to involve the whole community to develop preventive pathways in a participatory way that empowers girls and women while preventing the deleterious psychological effects of FGM/C and corresponding stigma. Results suggest the need to provide psychological support for girls and women of practicing Izzi communities of Southeast Nigeria.
Assessment of maternal and child health care services performance in the context of COVID-19 pandemic in Addis Ababa, Ethiopia: evidence from routine service data
Authors: Gebreegziabher Senedu Bekele , Marrye Solomon Sisay , Kumssa Tsegaye Hailu , Merga Kassa Haile , Feleke Alemu Kibret , Dare Degu Jerene , Hallström Inger Kristensson , Yimer Solomon Abebe , Shargie Mulatu Biru
Published: February 2022

Background

In many settings, health care service provision has been modified to managing COVID-19 cases, and this has been affecting the provision of maternal and child health services. The aim of this study was to assess trends in selected maternal and child health services performance in the context of COVID-19 pandemic.

Methods

A cross-sectional data review was conducted in Addis Ababa, Ethiopia from April to May 2021. Routine health management information system database was reviewed from Addis Ababa Health Bureau for the period from July 2019 to March 2021 across all quarters. Proportion and mean with standard deviation were computed. T-test was used to assess statistically significant differences in services mean performance.

Results

Postnatal care  visit, new contraceptives accepters, safe abortion care and number of under-5 years old children treated for pneumonia significantly decreased by 9.3% (p-value 0.04), 20.3% (p-value 0.004), 23.7% (p-value 0.01) and 77.2% (p-value < 0.001), respectively during the first 8 months of the COVID-19 pandemic compared to the previous 8 months’ average performance. The trends in Antenatal care first visit, new contraceptive accepters, pentavalent-3 vaccination and under-five children treated for pneumonia began to decline in January to  March 2020, a quarter when the COVID-19 pandemic began; with accelerated declines in April to June 2020 following national lockdown. The trends for the stated services began to increase during July–September 2020, the last quarter of national lockdown. Contraceptive accepters and pentavalent-1 vaccination continued to decline and showed no recovery until January–March 2021 when this study was completed.

Conclusions

Most of the maternal and child health services performance declined following the onset of COVID-19 pandemic and national lockdown, and most of the services began recovering during July–September 2020, the last quarter of national lockdown. However, new and repeat contraceptive accepters and pentavalent-1 recipients continue to decline and show no recovery during end of the study period. Implementing COVID-19 prevention measures and assuring the community about the safety of service delivery is imperative to ensure continuity of the maternal and child health services. Regular monitoring and evaluation of services performance is required to identify slowly recovering services and respond to potentially volatile changes during the COVID-19 pandemic.