bluuebunny/crossref_metadata_2025 huggingface dataset:
Opting out of Marriage? Factors Predicting Non-Marriage by Midlife across Race, Ethnicity, and Gender
Authors: Zhang Xing , Sassler Sharon
Published: November 2022

Over the last few decades, a growing proportion of Americans have never married. Factors contributing to adolescent expectations for marriage and the likelihood of non-marriage by midlife, however, remain understudied. We explore attitudinal and economic factors associated with non-marriage among a sample of White, Black, and Hispanic men and women in their early 30s through early 40s. Data are from Waves I, II, IV, and V of Add Health ( n = 7,297). We use logistic regression analysis to assess how adolescent expectations to remain unmarried in adolescence and economic factors in adulthood are associated with never marrying among respondents approaching their fourth decade of life. Negative adolescent expectations regarding marriage are highly predictive of non-marriage in later life, particularly among White adults. Economic factors, such as educational attainment, educational mobility, earnings, and job instability, are more predictive of non-marriage for Black adults, and for men. Our findings suggest how ideational and structural factors challenge the institution of marriage at different times in the life course. Adolescent expectations for marriage are important predictors of subsequent union formation, but economic factors continue to differentiate union outcomes among older adults.
Book review: Nandini Oza, The Struggle for Narmada: An Oral History of the Narmada Bachao Andolan by Adivasi Leaders Keshavbhau and Kevalsingh Vasave
Authors: Bagchi Subrata Sankar , Paul Satyaki
Published: November 2022

Nandini Oza, The Struggle for Narmada: An Oral History of the Narmada Bachao Andolan by Adivasi Leaders Keshavbhau and Kevalsingh Vasave. Orient BlackSwan, 2022, 320 pp., ₹915. ISBN: 978-9354422973.
Investigating the use of a local Chinese  character textbook (Learn Chinese  Characters Easily) for teaching at the Confucius classroom of Federal Polytechnic Oko, Nigeria
Authors: Okoye Somtochukwu Daniel , Edeh Emmanuel Chidiebere , Zhang Yincang
Published: November 2022

The present study investigated the use of the local Chinese character textbook Learn Chinese Characters Easily by Chinese language (second language) learners at the Confucius classroom of Federal Polytechnic Oko, Nigeria. A sample of 50 students out of the 65 selected from the Confucius classroom were randomly investigated for their opinions on their use of the local Chinese character textbook. The findings indicated that the use of the local Chinese character textbook has aroused students’ interest in Chinese characters through their learning experiences; that the organization and content of the textbook were found to be moderately satisfactory; and that the students admitted that the textbook has helped them improve their Chinese proficiency. Overall, the local textbook is essential for the users but needs improvement in the few areas indicated by the research. Finally, the study offered some innovative suggestions for optimizing the textbook and improving learners’ experiences and learning outcomes.
‘The more you give, the better it is for you. You know the reward is greater than the effort’: the Compassionate Communities Connectors’ experience
Authors: Aoun Samar M , Richmond Robyn , Noonan Kerrie , Gunton Kerry , Rumbold Bruce
Published: November 2022

Background:

The Compassionate Communities Connectors programme is a volunteer-led initiative designed to enhance the social networks of families living with chronic or life-limiting illnesses. Specially trained volunteers supported existing members of the families’ social networks and also enlisted the support of community members, Caring Helpers, to address the social and practical needs of these families. The programme is an initiative of The South West Compassionate Communities Network in Western Australia, in partnership with the health service.

Objective:

To explore the experiences and views of Connectors implementing this model of care with a particular focus on its feasibility and acceptability from their perspective.

Methods:

Semi-structured telephone interviews were undertaken with 11 Connectors covering their experience with 37 patients/family carers (March 2021 to April 2022). A deductive content analysis was used in analysing interview transcripts.

Results:

Six themes captured the Connectors’ view of their role and its impact on their clients and themselves: Mutual benefits from connection and reciprocity; It is ok to ask for and receive help; Sense of community as being ‘part of a village’; Making a difference in social connectedness; Frustrations when not achieving everything you want to; Reflecting on the difference with traditional volunteering. These themes are complemented by a social network mapping example and a vignette demonstrating the increase both in connections and interaction between these connections and the process by which such changes took place.

Conclusion:

Volunteering as a Connector has been a positive and feasible experience for fostering a sense of community among participants, developing relationships with other community members, seeing the difference that the Connector role makes in the lives of those involved in the enhanced network and fostering growth in Connectors’ emotional capacity and compassion. The work is challenging but rewarding and differs in several respects from traditional volunteering, particularly in the agency Connectors can bring to their role. A public health approach based on a close partnership between health services and communities/civic institutions is the optimal practice model.
The intricacy of interactions: qualitative exploration of preferences and perceptions of advance care planning among healthcare professionals, patients and those close to them
Authors: Hendry Annie , Pottle Jacqueline , Johnstone Rosalynde , Poolman Marlise , Hiscock Julia
Published: November 2022

Objectives:

Advance care planning (ACP) is a way of documenting preferences in case of a change or decline in health via verbal discussion and may include a written document. ACP relates not only to treatment preferences but to all aspects of future care such as place of death, plans for dependents and spiritual beliefs. Research has shown that ACP can have a positive impact but needs further understanding to enhance communication and increase uptake. This article focusses on the importance and intricacy of interactions and why a preference-based approach may be beneficial for the future.

Methods:

This article reports two separate, but related, pieces of qualitative research. First, focus groups to evaluate perspectives of healthcare professionals (HCPs) following their attendance at a North Wales ACP training workshop. The second study comprised interviews exploring the views of patients, those close to them and HCPs regarding ACP.

Results:

ACP interactions are complex and intricate. There is an association with end of life rather than changes in health among patients and HCPs often view discussions as akin to ‘breaking bad news’. Good communication between patients, loved ones and HCPs is essential to reduce distress and ensure preferences are understood. Trust between patients and HCPs is of high importance and often a patient will have a preferred HCP who they feel comfortable discussing ACP with.

Conclusion:

A preference-based approach to ACP has potential to widen participation in ACP, relieve anxiety and ease burden for patients and carers. Further research is needed to identify ways to increase inclusivity.
Victim-blaming and image-based sexual abuse
Authors: Flynn Asher , Cama Elena , Powell Anastasia , Scott Adrian J
Published: November 2022

Image-based sexual abuse (IBSA) is a growing, global problem. This article reports on a mixed-methods, multi-jurisdictional study of IBSA across the United Kingdom, Australia and Aotearoa/New Zealand. Attitudes of blame and minimisation of harms among a sample of the general population ( n = 6109) were analysed using two multiple regression analyses that assessed the ability of three demographic and three experiential characteristics to predict attitudes. Interviews were also conducted with 43 stakeholders and analysed thematically. Survey respondents who attributed more blame and minimised harms to a greater extent tended to be men, heterosexual, and had experienced or perpetrated more IBSA behaviours. Those who reported greater engagement in sexual self-image behaviours were also more likely to minimise harms. Interview participants suggested attitudes of blame and minimisation may be linked to broader problematic attitudes around sexual violence and sexual double standards, with women more likely to experience blame for IBSA. Our findings are of international relevance and highlight the need for multifaceted policies, education campaigns and training that challenge these attitudes.
Pleiotropic fitness effects of the lncRNA Uhg4 in Drosophila melanogaster
Authors: MacPherson Rebecca A. , Shankar Vijay , Sunkara Lakshmi T. , Hannah Rachel C. , Campbell Marion R. , Anholt Robert R. H. , Mackay Trudy F. C.
Published: November 2022

Background

Long noncoding RNAs (lncRNAs) are a diverse class of RNAs that are critical for gene regulation, DNA repair, and splicing, and have been implicated in development, stress response, and cancer. However, the functions of many lncRNAs remain unknown. In Drosophila melanogaster, U snoRNA host gene 4 (Uhg4) encodes an antisense long noncoding RNA that is host to seven small nucleolar RNAs (snoRNAs). Uhg4 is expressed ubiquitously during development and in all adult tissues, with maximal expression in ovaries; however, it has no annotated function(s).

Results

We used CRISPR-Cas9 germline gene editing to generate multiple deletions spanning the promoter region and first exon of Uhg4. Females showed arrested egg development and both males and females were sterile. In addition, Uhg4 deletion mutants showed delayed development and decreased viability, and changes in sleep and responses to stress. Whole-genome RNA sequencing of Uhg4 deletion flies and their controls identified co-regulated genes and genetic interaction networks associated with Uhg4. Gene ontology analyses highlighted a broad spectrum of biological processes, including regulation of transcription and translation, morphogenesis, and stress response.

Conclusion

Uhg4 is a lncRNA essential for reproduction with pleiotropic effects on multiple fitness traits.
Meta-analysis of genome-wide association studies uncovers shared candidate genes across breeds for pig fatness trait
Authors: Zeng Haonan , Zhong Zhanming , Xu Zhiting , Teng Jinyan , Wei Chen , Chen Zitao , Zhang Wenjing , Ding Xiangdong , Li Jiaqi , Zhang Zhe
Published: November 2022

Background

Average backfat thickness (BFT) is a critical complex trait in pig and an important indicator for fat deposition and lean rate. Usually, genome-wide association study (GWAS) was used to discover quantitative trait loci (QTLs) of BFT in a single population. However, the power of GWAS is limited by sample size in a single population. Alternatively, meta-analysis of GWAS (metaGWAS) is an attractive method to increase the statistical power by integrating data from multiple breeds and populations. The aim of this study is to identify shared genetic characterization of BFT across breeds in pigs via metaGWAS. 

Results

In this study, we performed metaGWAS on BFT using 15,353 pigs (5,143 Duroc, 7,275 Yorkshire, and 2,935 Landrace) from 19 populations. We detected 40 genome-wide significant SNPs (Bonferroni corrected P < 0.05) and defined five breed-shared QTLs in across-breed metaGWAS. Markers within the five QTL regions explained 7 ~ 9% additive genetic variance and showed strong heritability enrichment. Furthermore, by integrating information from multiple bioinformatics databases, we annotated 46 candidate genes located in the five QTLs. Among them, three important (MC4R, PPARD, and SLC27A1) and seven suggestive candidate genes (PHLPP1, NUDT3, ILRUN, RELCH, KCNQ5, ITPR3, and U3) were identified.

Conclusion

QTLs and candidate genes underlying BFT across breeds were identified via metaGWAS from multiple populations. Our findings contribute to the understanding of the genetic architecture of BFT and the regulating mechanism underlying fat deposition in pigs.
Atherogenic index of plasma is an independent predictor of mitral annular calcification
Authors: Uzunget Sezen Baglan , Sahin Kader Eliz
Published: November 2022

Background

In the latest reports, atherogenic indices have been related to acute coronary syndromes, stable coronary artery disease, heart failure and future cardiac events. Conventional atherosclerosis risk factors have been associated with mitral annular calcification (MAC), but data on the relationship between atherogenic indices and MAC are lacking. We aimed to investigate a possible relationship between MAC and atherogenic indices.

Methods

In total 741 patients (n = 427 with MAC and n = 314 without MAC) who were examined in our cardiology clinic from February 2016 to October 2021 were recruited in the study. Mitral annular calcification was diagnosed by transthoracic 2-dimensional echocardiography. The atherogenic coefficient (AC), Castelli risk index 1 (CRI-1), Castelli risk index 2 (CRI-2) and atherogenic index of plasma (AIP) were calculated by utilizing standard lipid test values.

Results

There was no statistically significant difference in sex, age, diabetes and hypertension status between the patient and the control groups. Serum triglyceride level, AIP, Hs-CRP, smoking and BMI were independently significantly associated with MAC in multiple regression analysis (p < 0.001).

Conclusion

Higher AIP was related to the existence of MAC and also predict the presence of MAC independently. Studies evaluating the modification of these indices are needed.
Efficacy and safety of ERCP in patients with situs inversus totalis: multicenter case series and literature review
Authors: Ding Bin , Wang Jun , Wei Xing , Du Yu , Xia Liang , Sun Chenyi , Han Kun , Yang Xue , Guo Xuegang , Pan Yanglin , Wang Xiangping
Published: November 2022

Background

Endoscopic retrograde cholangiopancreatography (ERCP) in patients with situs inversus totalis (SIT) is rarely understood due to its rarity. Patient position and endoscope manipulation were the main concerns in published case reports. The aim of this study was to investigate the efficacy and safety of ERCP in SIT patients.

Methods

Patients with SIT who underwent ERCP were enrolled in nine endoscopic centers in China. ERCP procedural details and complications in SIT patients were retrieved from electronic medical record. The data was retrospectively analyzed.

Results

From 2011 to 2021, totally 14 patients with SIT undergoing ERCP were identified. The mean age was 56.8 years old and the male–female ratio was 5:2. The main indication for ERCP was common bile duct stones (13/14, 92.9%). All procedure were performed by experienced endoscopists. 21.4% (3/14) of patients were under regular position (prone), while 78.6% under modified position (supine, left or right lateral). Difficult cannulation was occurred in 71.4% (10/14) of patients. The rate of successful cannulation was 85.7% (12/14). Complication occurred in 3 patients (3/14, 21.4%), including 1 bleeding, 1 pneumonia and 1 acute myocardial infarction. No post-pancreatitis or death happened. Compared to patients in modified position, those in prone position had numerically less successful cannulations (66.7% vs. 90.9%) and higher adverse events (33.3% vs. 18.2%).

Conclusions

ERCP in patient with SIT is challenging even for experienced endoscopists, modified patient positions might have potential benefits concerning more successful cannulations and less complications. More case experiences are need for comprehensive understanding of ERCP in patients with SIT.
CT Scans and Cancer Risks: A Systematic Review and Dose-response Meta-analysis
Authors: Cao Chun-Feng , Ma Kun-Long , Shan Hua , Liu Tang-Fen , Zhao Si-Qiao , Wan Yi , Jun-Zhang  , Wang Hai-Qiang
Published: November 2022

Background

There is still uncertainty on whether ionizing radiation from CT scans can increase the risks of cancer. This study aimed to identify the association of cumulative ionizing radiation from CT scans with pertaining cancer risks in adults.

Methods

Five databases were searched from their inception to November 15, 2020. Observational studies reporting cancer risks from CT scans in adults were included. The main outcome included quantified cancer risks as cancer case numbers in exposed/unexposed adult participants with unified converted measures to odds ratio (OR) for relative risk, hazard ratio. Global background radiation (2.4 mSv per year) was used as control for lifetime attribution risk (LAR), with the same period from incubation after exposure until survival to 100 years.

Results

25 studies were included with a sum of 111,649,943 participants (mean age: 45.37 years, 83.4% women), comprising 2,049,943 actual participants from 6 studies with an average follow-up period as 30.1 years (range, 5 to 80 years); 109,600,000 participants from 19 studies using LAR. The cancer risks for adults following CT scans were inordinately increased (LAR adults, OR, 10.00 [95% CI, 5.87 to 17.05]; actual adults, OR, 1.17 [95%CI, 0.89 to 1.55]; combined, OR, 5.89 [95%CI, 3.46 to 10.35]). Moreover, cancer risks elevated with increase of radiation dose (OR, 33.31 [95% CI, 21.33 to 52.02]), and multiple CT scan sites (OR, 14.08 [95% CI, 6.60 to 30.05]). The risk of solid malignancy was higher than leukemia. Notably, there were no significant differences for age, gender, country, continent, study quality and studying time phrases.

Conclusions

Based on 111.6 million adult participants from 3 continents (Asia, Europe and America), this meta-analysis identifies an inordinately increase in cancer risks from CT scans for adults. Moreover, the cancer risks were positively correlated with radiation dose and CT sites. The meta-analysis highlights the awareness of potential cancer risks of CT scans as well as more reasonable methodology to quantify cancer risks in terms of life expectancy as 100 years for LAR.

Prospero trial registration number

CRD42019133487.
Mental health outcomes following COVID-19 infection: impacts of post-COVID impairments and fatigue on depression, anxiety, and insomnia — a web survey in Sweden
Authors: Badinlou Farzaneh , Lundgren Tobias , Jansson-Fröjmark Markus
Published: November 2022

Background

The negative impact of the COVID-19 pandemic on the mental health is now clearly established. However, information on the levels of mental ill health of people infected with COVID-19 and potential correlates of poor mental health is still limited. Therefore, the current study aimed to study indicative of potential mental health problems in individuals with a history of probable or confirmed SARS CoV-2 infection/infections and address the impacts of post-COVID impairments and fatigue following COVID-19 infection/infections on depression, anxiety, and insomnia.

Methods

A web-survey including demographics, questions related to COVID-19 status and post-COVID impairments, and standardized measures of depression, anxiety, insomnia, and fatigue was completed by 507 individuals with a history of probable or confirmed SARS CoV-2 infection/infections.

Results

We found significant rates of significant depression, anxiety, and insomnia in our sample, with more than 70% experiencing levels above the clinical cut offs for at least one psychological health problems. Higher levels of depression, anxiety, and insomnia were associated with the severity of COVID-19 infection in the acute phase, hospitalization because of COVID-19, and higher levels of post-COVID impairments and fatigue. Reduced motivation emerged as the strongest predictor for mental ill health.

Conclusions

These findings highlight that individuals infected with COVID-19, especially those who still have experienced post-COVID impairments, are more likely to suffer from mental ill-health and may be more vulnerable for poor mental health outcomes. Therefore, more effective actions are needed to take in order to promote and protect mental health of individuals with a history of COVID-19 infection.
Obesity marker trajectories and cognitive impairment in older adults: a 10-year follow-up in Taichung community health study for elders
Authors: Li Tsai-Chung , Li Chia-Ing , Liu Chiu-Shong , Lin Chih-Hsueh , Yang Shing-Yu , Lin Cheng-Chieh
Published: November 2022

Background

Obesity and cognitive impairment prevalence increases as age increases. Recent growing evidence finds links between obesity and cognitive impairment in older adults. However, the association between the two is controversial. This study aims to identify obesity marker trajectory patterns, and to assess whether these patterns are associated with cognitive impairment and cognitive decline during a 10-year follow-up period among community-dwelling older adults.

Methods

A total of 626 older adults aged 65 and older were involved in the study, with at least two repeated measurements at baseline, one-year or 10-year follow-up. Cognitive function was measured through the Mini Mental State Examination. Obesity markers included body mass index, waist circumference, waist-to-hip (WHR), fat mass (FM), and abdominal fat (AF) measured by dual-energy X-ray absorptiometry. Multivariate logistic regression analyses were performed to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of cognitive impairment and cognitive decline for obesity marker trajectory patterns.

Results

After a 10-year follow-up, 168 older adults with incident cognitive impairment and 156 with rapid cognitive decline were defined as the top 25th percentile of cognitive decline. Four distinct trajectory groups of obesity markers were identified. In multivariate logistic regression analyses, a low likelihood of cognitive impairment was observed in the consistently high-level group from FM trajectory (ORs = 0.41, 95% CI = 0.20–0.85); the high-level U-shaped group from WHR trajectory (0.43, 0.22–0.84); and the median-level flat inverse U-shaped, consistently high-level, and low-level flat U-shaped groups from AF trajectory (0.44, 0.26–0.77; 0.33, 0.18–0.61; 0.39, 0.18–0.82). In addition, a low likelihood of rapid decline was found in the low-level, slightly increasing trend group from WHR trajectory (0.43, 0.22–0.85).

Conclusion

FM and AF trajectories with consistent high levels and WHR trajectory with high level with U-shaped group are associated with low risks of incident cognitive impairment in older adults. Similarly, WHR trajectory with a low but slowly increasing trend is associated with a decreased risk of cognitive decline.
The impact of conditional cash transfers for HIV prevention on peer relationships: perspectives from female recipients and non-recipients in HPTN 068
Authors: Ndimande-Khoza Makhosazane Nomhle , Scorgie Fiona , Delany-Moretlwe Sinead , Selin Amanda , Twine Rhian , Kahn Kathleen , Pettifor Audrey , MacPhail Catherine
Published: November 2022

CCTs are currently being explored for HIV prevention among adolescent girls and young women (AGYW) in Southern Africa. However, little is known about how CCT geared towards adolescents’ influence peer relationships, despite evidence that peer relationships form a critical part of development in adolescence. This article presents findings from a qualitative study that explored CCT recipients’ and non-recipients’ perspectives on the impact of CCTs paid to AGYW on peer relationships.

HPTN 068 was a randomised controlled trial that assessed whether providing CCT to AGYW and their households reduces AGYW’s risk of acquiring HIV. As part of this trial, we conducted interviews and focus group discussions with sub-samples of AGYW (n = 39), who were both cash recipients and non-recipients. Through content analysis, we explored ways in which the CCT positively or negatively impacted on peer relationships.

From the recipients’ viewpoint, the CCT improved their social standing within their peer groups. It facilitated peer identity and promoted social connectedness among AGYW receiving the CCT. Receipt of the CCT enabled AGYW to resemble and behave like their peers who had money, allowing their poverty to become “invisible”. The CCT facilitated social interactions, information sharing, and instrumental social support among AGYW. CCT recipients experienced an increase in their social capital, evident in their ability to network, share, and reciprocate with others. However, the CCT also evoked negative emotions such as jealousy, anxiety, and resentment among non-recipients and led to a deterioration of personal relationships.

CCTs have enormous benefits for AGYW, but they may also have a negative impact on peer relationships. The implementation of HIV prevention interventions focused on structural drivers needs to be conscious of these dynamics and ensure that the negative consequences do not outweigh benefits.
Spatial statistical machine learning models to assess the relationship between development vulnerabilities and educational factors in children in Queensland, Australia
Authors: Draidi Areed Wala , Price Aiden , Arnett Kathryn , Mengersen Kerrie
Published: November 2022

Background

The health and development of children during their first year of full time school is known to impact their social, emotional, and academic capabilities throughout and beyond early education. Physical health, motor development, social and emotional well-being, learning styles, language and communication, cognitive skills, and general knowledge are all considered to be important aspects of a child’s health and development. It is important for many organisations and governmental agencies to continually improve their understanding of the factors which determine or influence development vulnerabilities among children. This article studies the relationships between development vulnerabilities and educational factors among children in Queensland, Australia.

Methods

Spatial statistical machine learning models are reviewed and compared in the context of a study of geographic variation in the association between development vulnerabilities and attendance at preschool among children in Queensland, Australia. A new spatial random forest (SRF) model is suggested that can explain more of the spatial variation in data than other approaches.

Results

In the case study, spatial models were shown to provide a better fit compared to models that ignored the spatial variation in the data. The SRF model was shown to be the only model which can explain all of the spatial variation in each of the development vulnerabilities considered in the case study. The spatial analysis revealed that the attendance at preschool factor has a strong influence on the physical health domain vulnerability and emotional maturity vulnerability among children in their first year of school.

Conclusion

This study confirmed that it is important to take into account the spatial nature of data when fitting statistical machine learning models. A new spatial random forest model was introduced and was shown to explain more of the spatial variation and provide a better model fit in the case study of development vulnerabilities among children in Queensland. At small-area population level, increased attendance at preschool was strongly associated with reduced physical and emotional development vulnerabilities among children in their first year of school.
Stressors related to the Covid-19 pandemic, climate change, and the Ukraine crisis, and their impact on stress symptoms in Germany: analysis of cross-sectional survey data
Authors: Weierstall-Pust Roland , Schnell Thomas , Heßmann Philipp , Feld Michael , Höfer Max , Plate Anna , Müller Matthias J.
Published: November 2022

Background

Climate change, the Covid-19 pandemic, and the Ukraine crisis are considered unprecedented global stressors, potentially associated with serious health consequences. However, simultaneous effects of these stressors are not yet understood, making it difficult to evaluate their relative contribution to the population burden and potential future manifestations in clinically significant psychiatric disorders. This study aimed at disentangling the relative contribution of the three stressor groups on current sub-clinical stress symptoms.

Methods

A cross-sectional, representative survey study was conducted two months after the outbreak of the Ukraine war in Germany. Proportional quota sampling was applied for age, gender, income, and regional characteristics. Data were recruited by means of an online survey. 3094 data sets (1560 females) were included. Age ranged from 18–89 (M: 50.4 years;SD: 17.2). The Subclinical Stress Questionnaire (SSQ-25) served as main outcome measure. In collaboration with a professional media agency, 20 items were generated to capture salient population stressors. A three-factor exploratory structural equation model confirmed the appropriateness of this scale.

Results

(1) Differences in subjective rankings revealed that stressors related to the Ukraine crisis were rated as most worrying, followed by climate change, and the Covid-19 pandemic (Generalized-Linear-Model: Epsilon = .97;F(1.94, 6001.14) = 1026.12,p < .001;ηp2 = .25). (2) In a linear regression model (R2 = .39), Covid-19 pandemic stressors were the only meaningful predictors for current ill-health (standardizedβ = .48). Ukraine crisis did not predict stress symptom profiles in the present sample. (3) Older and male individuals report less and/or less severe stress symptoms, although effect sizes were small (range:η2.11—.21). An older age also reduced the impact of Covid-19 stressors.

Conclusions

Researchers from the health sciences must consider overlapping effects from population stressors. Although the Ukraine crisis and climate change mark salient stressors, including economic threats, the Covid-19 pandemic still has a profound effect on ill-health and must be considered as a relevant factor in future manifestations of psychiatric and associated health consequences.
Associations between e-health literacy and chronic disease self-management in older Chinese patients with chronic non-communicable diseases: a mediation analysis
Authors: Wu Ying , Wen Jing , Wang Xiaohui , Wang Qingyao , Wang Wen , Wang Xiangjia , Xie Jiang , Cong Li
Published: November 2022

Background

Chronic non-communicable diseases (CNCDs) are an urgent public health issue in China, especially among older adults. Hence, self-management is crucial for disease progression and treatment. Electronic health (e-health) literacy and self-efficacy positively correlate with self-management. However, we know little about their underlying mechanisms in older adults with CNCDs.

Objective

To explore the factors that influence chronic disease self-management (CDSM) and verify self-efficacy as the mediator between e-health literacy and self-management behavior in older patients with CNCDs.

Methods

This cross-sectional study included 289 older patients with CNCDs from Hunan province, China, between July and November 2021. E-health literacy, self-efficacy, social support, and CDSM data were collected through questionnaires. The influence of each factor on CDSM was explored with multiple linear regression analysis. Intermediary effects were computed via a structural equation model.

Results

The total CDSM score in the patients was 29.39 ± 9.60 and only 46 (15.92%) patients used smart healthcare devices. The regression analysis showed e-health literacy, self-efficacy, and social support were the factors that affected CDSM. Furthermore, the structural equation model revealed that self-efficacy directly affected CDSM (β = 0.45, P < 0.01), whereas e-health literacy affected it directly (β = 0.42, P < 0.01) and indirectly (β = 0.429, P < 0.01) through self-efficacy.

Conclusions

This study revealed that self-management among older patients with CNCDs is at a low level, and few of them use smart healthcare devices. Self-efficacy plays a partial intermediary role between e-health literacy and self-management in older patients with CNCDs. Thus, efforts to improve their CDSM by targeting e-health literacy may be more effective when considering self-efficacy.
Exploring the factors affecting violence among Iranian male adolescents
Authors: Solimannejad Tahereh , Ebrahimi Marziyeh , Solimannejad Mohamad
Published: November 2022

Increasing violence behaviors among high school adolescents affects different dimensions of the efficiency of educational institutions. The present qualitative research was conducted in 2021 to explain violence behaviors among male adolescents in Karaj, Iran. Twenty senior high school students were selected using purposive sampling with maximum variation. Individual semi-structured interviews conducted based on the participants’ experiences were analyzed in MAXQDA 2020. According to the model proposed by Strauss and Corbin, causal conditions comprised “economic challenges facing the family”, “academic apathy”, “seeking pleasure”, “self-other differentiation” and “family disorganization”, contextual conditions included “school inefficiency”, “environmental conditions” and “cultural diversity” and confounding conditions consisted of “peer pressure” and “puberty”. The strategies of adolescents with violent behaviors such as ignoring school rules and bullying can cause their humiliation, loss of ideal opportunities in life, punishment and rejection. “Violence as the collapse of individual and socio-familial capital” was labeled the core category of the present study. According to the present findings, violence in adolescents is affected by a multilevel mechanism based on social relationships. As a major obstacle to educational objectives, the violence emerging at school as a reliable and safe environment can spread to other social domains in the long run.
Pharmacokinetics of gefitinib in elderly patients with EGFR-mutated advanced non-small cell lung cancer: a prospective study
Authors: Nio Yuta , Ishida Hiroo , Matsumoto Natsumi , Kusumoto Sojiro , Kubota Yutaro , Tsunoda Takuya , Sasaki Yasutsuna , Fujita Ken-ichi
Published: November 2022

Background

Gefitinib is recommended as a first-line treatment option for elderly patients with non-small cell lung cancer (NSCLC). Because no pharmacokinetics of gefitinib have been examined, we prospectively assessed the pharmacokinetics of gefitinib in patients with epidermal growth factor receptor gene-mutated advanced NSCLC who were 75 years or older.

Methods

Gefitinib was orally administered once daily at a dose of 250 mg. The concentrations of gefitinib and its major metabolite O-desmethyl gefitinib in plasma were measured by high-performance liquid chromatography. The area under the plasma concentration–time curve from time 0 to 48 h (AUC0–48) was calculated. Polymorphisms in CYP3A5, CYP2D6, ABCG2, ABCB1, and OATP1B1 were analyzed by direct sequencing.

Results

Eighteen patients with a median age of 80.5 years (range, 75–89) with adequate liver and kidney functions were examined. AUC0–48 values of gefitinib and O-desmethyl gefitinib in this population were 9.49 ± 3.5 and 10.6 ± 14 µM h, respectively. Compared to the gefitinib pharmacokinetics observed in a previous phase I study in Japan, systemic exposure to gefitinib in elderly patients was slightly higher than that in younger patients. Three patients experienced grade 3 diarrhea, increases in alanine aminotransferase, and aspartate aminotransferase levels 30 days after starting gefitinib treatment. The CYP2D6 genotype was associated with CYP2D6-mediated metabolism of gefitinib to O-desmethyl gefitinib.

Conclusions

We demonstrated for the first time the systemic exposure to gefitinib in elderly patients with NSCLC.

Trial registration: The study was registered with the University Hospital Medical Information Network-Clinical Trials Registry Japan (UMIN000026409) on November 8, 2013.
Extraosseous Ewing's sarcoma/peripheral primitive neuroectodermal tumour of the kidney: a case report and literature review
Authors: Li Jing , Nie Fang , Li Yan
Published: November 2022

Background

Extraosseous Ewing's sarcoma/peripheral primitive neuroectodermal tumours(EWS/pPNETs) of the kidney are rare. Signs and symptoms are atypical in EWS patients. Presenting symptoms include haematuria, abdominal pain, or a palpable mass. A comprehensive review of the literature shows that it is difficult to make an accurate diagnosis based on physical examination alone. The imaging findings of EWS/pPNETs are nonspecific. We used contrast-enhanced ultrasound (CEUS) to diagnose an EWS/pPNET in our patient, which had never been reported previously to our knowledge.

Case presentation

This article reports the case of a 20-year-old female with an abdominal mass and gross haematuria for 1 month. The ultrasound revealed a hypoechoic mass with a clear margin at the lower pole in the left kidney. CEUS demonstrated signs of annular enhancement and heterogeneous enhancement of the tumour, and simultaneous wash-in was predominant. Computed tomography images showed an elliptical low-density tumour. The patient underwent a left kidney resection, and the pathological diagnosis was an EWS/pPNET. Twenty-one days after the kidney operation, the patient underwent 8 cycles of a CAV (vinorelbine, ifosfamide, epirubicin) + IE (isocyclophosphamide, etoposide) chemotherapy regimen. Subsequently, radiotherapy (dose: 45 Gy, radiation field:the tumour bed following surgical resection) was administered for nearly 30 days. The patient had no signs of local recurrence or metastasis within a follow-up of 4 years.

Conclusions

As a radiation-free, inexpensive, convenient, and repeatable examination method, ultrasound was the primary choice for kidney examination. Early CEUS was helpful to make an accurate diagnosis. Surgery and adjuvant radiation or chemotherapy administered in a timely manner can prevent further deterioration.
Psychosocial factors affecting the bereavement experience of relatives of palliative-stage cancer patients: a systematic review
Authors: Hasdenteufel Marie , Quintard Bruno
Published: November 2022

Background

Cancer is one of the leading causes of death worldwide and a cancer death is a major risk factor for pathological bereavement. This systematic review of the literature aimed to identify biopsychosocial and existential determinants specific to the palliative phase of cancer that influence the grieving experience of the caregiving relative.

Method

A systematic review of the literature was conducted without language or time restrictions. The Cairn, Cochrane Library, PubMed, PsycArticle, PsychInfo, Psychology and Behavioral Sciences Collection databases were explored. All studies assessing pre- and post-death measures and focusing on friends and relatives caring for adults with cancer in palliative care services were included in the review.

Results

Out of 645 articles identified, 18 full text studies were finally included in our systematic review of the literature. Many factors specific to the cancer palliative phase were identified as influencing the bereavement experience of caregivers, with factors relating to: 1) the caregiver (e.g. social support, psychological burden, preparation for loss, action and discussion related to death); 2) the patient (e.g. denial or acceptance); 3) the interactions between patient and their caregivers (e.g. tensions, communication difficulties, and presence at the time of death); and 4) the end-of-life context. The caregiver's grief experience can be described by the following terms: typical and pathological grief, anxiety, depression, guilt, psychological distress, post-traumatic stress disorder and post-traumatic growth, and life satisfaction.

Conclusions

 Many contextual, sociodemographic, dispositional and transactional factors specific to the palliative cancer phase are involved in the caregiver's grieving experience. Avenues for reflection and recommendations are proposed including supporting communication and patient-relative relationships, evaluating the nature and degree of functionality of coping strategies, strengthening the robustness of methodologies, considering impact of COVID-19, and new lines of enquiry for research.
Minimising population health loss in times of scarce surgical capacity: a modelling study for surgical procedures performed in nonacademic hospitals
Authors: van Alphen Anouk M. I. A. , van Hof Kira S. , Gravesteijn Benjamin Y. , Krijkamp Eline M. , Bakx Pieter A. G. M. , Langenbach Peter , Busschbach Jan J. , Lingsma Hester F. , Baatenburg de Jong Robert J. ,   Value Based Operation Room Triage team collaborators, Arends Arend , Haberkorn Brigitte , van Rossem Charles , van Ramshorst Gabrielle H. , de Graaff Han , Sleeboom Harm , Postema Jonne , van Scheltinga Josien Terwisscha , Valk-Kleibreuker Linda , Hoedt Marco , Baartmans Martin , Nieboer Mike , Faes Miriam , Oversier Nieke , Schep Niels , Schuitema Onno , MacLean Patricia , Schouwenberg Patrick , Koppel Paul ten , Bakx Pieter , Pouwels Sjaak , Raaff Suze , Nieboer Taco , van Dorp Tietse , Bosman Willem Maarten
Published: November 2022

Background

The burden of the COVID-19 pandemic resulted in a reduction of available health care capacity for regular care. To guide prioritisation of semielective surgery in times of scarcity, we previously developed a decision model to quantify the expected health loss due to delay of surgery, in an academic hospital setting. The aim of this study is to validate our decision model in a nonacademic setting and include additional elective surgical procedures.

Methods

In this study, we used the previously published three-state cohort state-transition model, to evaluate the health effects of surgery postponement for 28 surgical procedures commonly performed in nonacademic hospitals. Scientific literature and national registries yielded nearly all input parameters, except for the quality of life (QoL) estimates which were obtained from experts using the Delphi method. Two expert panels, one from a single nonacademic hospital and one from different nonacademic hospitals in the Netherlands, were invited to estimate QoL weights. We compared estimated model results (disability adjusted life years (DALY)/month of surgical delay) based on the QoL estimates from the two panels by calculating the mean difference and the correlation between the ranks of the different surgical procedures. The eventual model was based on the combined QoL estimates from both panels.

Results

Pacemaker implantation was associated with the most DALY/month of surgical delay (0.054 DALY/month, 95% CI: 0.025–0.103) and hemithyreoidectomy with the least DALY/month (0.006 DALY/month, 95% CI: 0.002–0.009). The overall mean difference of QoL estimates between the two panels was 0.005 (95% CI -0.014–0.004). The correlation between ranks was 0.983 (p < 0.001).

Conclusions

Our study provides an overview of incurred health loss due to surgical delay for surgeries frequently performed in nonacademic hospitals. The quality of life estimates currently used in our model are robust and validate towards a different group of experts. These results enrich our earlier published results on academic surgeries and contribute to prioritising a more complete set of surgeries.
Identification of herbal teas and their compounds eliciting antiviral activity against SARS-CoV-2 in vitro
Authors: Le-Trilling Vu Thuy Khanh , Mennerich Denise , Schuler Corinna , Sakson Roman , Lill Julia K. , Kasarla Siva Swapna , Kopczynski Dominik , Loroch Stefan , Flores-Martinez Yulia , Katschinski Benjamin , Wohlgemuth Kerstin , Gunzer Matthias , Meyer Folker , Phapale Prasad , Dittmer Ulf , Sickmann Albert , Trilling Mirko
Published: November 2022

Background

The SARS-CoV-2/COVID-19 pandemic has inflicted medical and socioeconomic havoc, and despite the current availability of vaccines and broad implementation of vaccination programs, more easily accessible and cost-effective acute treatment options preventing morbidity and mortality are urgently needed. Herbal teas have historically and recurrently been applied as self-medication for prophylaxis, therapy, and symptom alleviation in diverse diseases, including those caused by respiratory viruses, and have provided sources of natural products as basis for the development of therapeutic agents. To identify affordable, ubiquitously available, and effective treatments, we tested herbs consumed worldwide as herbal teas regarding their antiviral activity against SARS-CoV-2.

Results

Aqueous infusions prepared by boiling leaves of the Lamiaceae perilla and sage elicit potent and sustained antiviral activity against SARS-CoV-2 when applied after infection as well as prior to infection of cells. The herbal infusions exerted in vitro antiviral effects comparable to interferon-β and remdesivir but outperformed convalescent sera and interferon-α2 upon short-term treatment early after infection. Based on protein fractionation analyses, we identified caffeic acid, perilla aldehyde, and perillyl alcohol as antiviral compounds. Global mass spectrometry (MS) analyses performed comparatively in two different cell culture infection models revealed changes of the proteome upon treatment with herbal infusions and provided insights into the mode of action. As inferred by the MS data, induction of heme oxygenase 1 (HMOX-1) was confirmed as effector mechanism by the antiviral activity of the HMOX-1-inducing compounds sulforaphane and fraxetin.

Conclusions

In conclusion, herbal teas based on perilla and sage exhibit antiviral activity against SARS-CoV-2 including variants of concern such as Alpha, Beta, Delta, and Omicron, and we identified HMOX-1 as potential therapeutic target. Given that perilla and sage have been suggested as treatment options for various diseases, our dataset may constitute a valuable resource also for future research beyond virology.
Predictive model for long COVID in children 3 months after a SARS-CoV-2 PCR test
Authors: Nugawela Manjula D. , Stephenson Terence , Shafran Roz , De Stavola Bianca L. , Ladhani Shamez N. , Simmons Ruth , McOwat Kelsey , Rojas Natalia , Dalrymple Emma , Cheung Emily Y. , Ford Tamsin , Heyman Isobel , Crawley Esther , Pinto Pereira Snehal M.
Published: November 2022

Background

To update and internally validate a model to predict children and young people (CYP) most likely to experience long COVID (i.e. at least one impairing symptom) 3 months after SARS-CoV-2 PCR testing and to determine whether the impact of predictors differed by SARS-CoV-2 status.

Methods

Data from a nationally matched cohort of SARS-CoV-2 test-positive and test-negative CYP aged 11–17 years was used. The main outcome measure, long COVID, was defined as one or more impairing symptoms 3 months after PCR testing. Potential pre-specified predictors included SARS-CoV-2 status, sex, age, ethnicity, deprivation, quality of life/functioning (five EQ-5D-Y items), physical and mental health and loneliness (prior to testing) and number of symptoms at testing. The model was developed using logistic regression; performance was assessed using calibration and discrimination measures; internal validation was performed via bootstrapping and the final model was adjusted for overfitting.

Results

A total of 7139 (3246 test-positives, 3893 test-negatives) completing a questionnaire 3 months post-test were included. 25.2% (817/3246) of SARS-CoV-2 PCR-positives and 18.5% (719/3893) of SARS-CoV-2 PCR-negatives had one or more impairing symptoms 3 months post-test. The final model contained SARS-CoV-2 status, number of symptoms at testing, sex, age, ethnicity, physical and mental health, loneliness and four EQ-5D-Y items before testing. Internal validation showed minimal overfitting with excellent calibration and discrimination measures (optimism-adjusted calibration slope: 0.96575; C-statistic: 0.83130).

Conclusions

We updated a risk prediction equation to identify those most at risk of long COVID 3 months after a SARS-CoV-2 PCR test which could serve as a useful triage and management tool for CYP during the ongoing pandemic. External validation is required before large-scale implementation.