bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic Sorrow: Lived Experiences of Family Caregivers of People With Severe Mental Illness
Authors: Claassens Hanneke , Delespaul Philippe , Feringa Dana
Published: May 2024

This study explores loss experiences and trigger events of chronic sorrow among family caregivers who support a relative with a severe mental illness. Chronic sorrow is a theoretical concept describing a normal grief response associated with an ongoing loss. A total of 39 Dutch family caregivers were interviewed. They report experiencing three kinds of loss: loss of a person, loss of the former relationship, and loss of a normal life. Seven specific trigger events were identified: (a) confrontation with symptoms, (b) comparisons with developmental, social and personal norms, (c) role change, (d) deterioration, (e) hospitalization, (f) disregard and disrespect by health professionals, and (g) worries and memories. This paper suggests that mental health professionals should realize that they can (unintentionally) trigger chronic sorrow by disregarding and/or disrespecting family caregivers. Awareness of the mechanism can lead to greater understanding within and improvement of the partnership between family caregivers and health professionals.
Unheard and Unseen: Exploring the Disenfranchisement of Perinatal Loss in North-Indian Men
Authors: Kapil Arusha , Chakraborty Rituparna
Published: May 2024

Mental distress is recognised as common following perinatal loss. But often, existing literature and bereavement care standards focus on women, leaving a gap in understanding men’s grief. This qualitative study examined the emotional experiences of males from some Northern states of India, who had experienced perinatal loss, with a focus on grief disenfranchisement. Eleven participants were interviewed using a semi-structured guide. Thematic analysis unveiled themes on the intersection of religiosity and grief, social structuring of grief patterns, gender-based grieving, inhibited expression of grief in men, disenfranchisement of grief, self-focused coping, coping with the help of others, and interpersonal barriers to emotional disclosure. The findings provide valuable insights, helping mental health practitioners better understand men’s experiences of perinatal loss and develop more effective support strategies.
Constructing Stay-at-Home Fathers’ Work-Care Identities in China
Authors: Huang Fei
Published: May 2024

This article examines how stay-at-home fathers (SAHFs) position their primary caregiving identity in relation to paid work that they either used to have or currently have part-time/freelance. The aim is to understand how their sense of masculinity is shaped by and/or rebelled against normative gender expectations. 22 Chinese SAHFs participated in this qualitative research, involving one-to-one repeat semi-structured interviews over a year. Four fathering identities emerged from the data: “Ambivalent SAHFs”, “Reluctant SAHFs”, “Proud SAHFs”, and “Reflective SAHFs”. The juxtaposition of these subject positions indicates the tensions between assuming the primary caregiving role and conforming to normative gendered expectations for men. However, the findings also demonstrate that stay-at-home fathering identity is not fixed, but subject to change over time, with spousal support being crucial to their transition. This constant evolution challenges oversimplified categorizations of SAHFs as purely choice-driven or circumstantial.
Prediction of vitreomacular traction syndrome outcomes with deep learning: A pilot study
Authors: Usmani Eiman , Bacchi Stephen , Zhang Hao , Guymer Chelsea , Kraczkowska Amber , Qinfeng Shi Javen , Gilhotra Jagjit , Chan Weng Onn
Published: May 2024

Purpose

To investigate the potential of an Optical Coherence Tomography (OCT) based Deep-Learning (DL) model in the prediction of Vitreomacular Traction (VMT) syndrome outcomes.

Design

A single-centre retrospective review.

Methods

Records of consecutive adult patients attending the Royal Adelaide Hospital vitreoretinal clinic with evidence of spontaneous VMT were reviewed from January 2019 until May 2022. All patients with evidence of causes of cystoid macular oedema or secondary causes of VMT were excluded. OCT scans and outcome data obtained from patient records was used to train, test and then validate the models.

Results

For the deep learning model, ninety-five patient files were identified from the OCT (SPECTRALIS system; Heidelberg Engineering, Heidelberg, Germany) records. 25% of the patients spontaneously improved, 48% remained stable and 27% had progression of their disease, approximately. The final longitudinal model was able to predict ‘improved’ or ‘stable’ disease with a positive predictive value of 0.72 and 0.79, respectively. The accuracy of the model was greater than 50%.

Conclusions

Deep-learning models may be utilised in real-world settings to predict outcomes of VMT. This approach requires further investigation as it may improve patient outcomes by aiding ophthalmologists in cross-checking management decisions and reduce the need for unnecessary interventions or delays.
Intralesional 5-Fluorouracil for Keloids: A Systematic Review
Authors: King Aliyah , Guirguis Marina , Satkunanathan Seyyon , Saad Mysa , Bose Reetesh
Published: May 2024

Keloids are benign, fibroproliferative dermal tumours, often arising after trauma, that are more common in darker skin types. Numerous therapeutic options have been employed for the treatment of keloids; however, there is no one gold standard approach. Five-fluorouracil, a potent chemotherapeutic agent, has emerged as a promising therapeutic option. Therefore, this systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focused on providing a broad overview of the use of 5-fluorouracil for the management of keloids. Forty studies (2325 patients) met inclusion criteria and investigated 5-fluorouracil for keloid management, with 19 studies (1043 patients) including a 5-fluorouracil monotherapy group. Five-fluorouracil monotherapy demonstrated consistent keloid improvement with >254 keloids injected across various anatomical regions. Five-fluorouracil monotherapy was most often compared to intralesional triamcinolone acetonide, utilizing the Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale. The most common keloid parameters assessed were height, size, volume, width, length, induration, pruritus, and erythema. Five-fluorouracil monotherapy exhibited substantial improvements, with weight averages of 73% of patients experiencing >25% improvement and 67% achieving >50% improvement. Relapse rate was 16% at 27 weeks after 5-fluorouracil monotherapy treatment. Limitations included potential selection bias, language restrictions, and heterogenous data analysis among studies. Overall, our findings underscore the potential effectiveness of 5-fluorouracil monotherapy in the management of keloids, with an encouraging safety profile. Larger prospective trials are needed to determine optimal therapy or combination therapy for the management of keloids. This detailed compilation of treatment protocols, outcomes, and relapse rates stand as a valuable resource for further research and clinical applications.
Impact of adverse childhood experiences and family resilience on sleep duration in autistic children
Authors: Sadikova Eleonora , Soland Jim , Menezes Michelle , Mazurek Micah
Published: May 2024

Autistic children are at higher risk of experiencing adverse childhood experiences, which lead to negative health outcomes such as sleep difficulties. In the general population, family resilience can help reduce the negative impact of adverse childhood experiences on child functioning. The aim of this study was to examine the impact of adverse childhood experiences on sleep duration, and whether family resilience moderates this impact in autistic children. With data from 2882 caregivers of children with autism from the National Survey of Children’s Health, we examined the role of family resilience on the relationship between adverse childhood experiences and sleep duration. As shown in previous findings, there was a main effect of adverse childhood experiences on sleep duration. There was no significant main effect of family resilience on sleep duration. Results also show that family resilience moderates the relationship between adverse childhood experiences and sleep duration, possibly serving as a protective factor.

Lay abstract

Autistic children are more likely to have sleep difficulties and to experience adverse childhood experiences. Adverse childhood experiences can include parental divorce, bullying, or witnessing violence. We also know that children in families who are resilient (e.g. families who are connected, work together, and help each other) are less impacted by adverse childhood experiences. Our study examined whether there was a relationship between adverse childhood experiences and sleep duration in autistic children. We also wanted to find out whether family resilience protects from the negative impact of adverse childhood experiences on sleep duration. We used data from 3247 parent surveys about their children that we got from the National Survey of Children’s Health. We found that children with adverse childhood experiences are more likely to get less sleep. We also found that children with resilient families were more likely to get more sleep. Our results show that family resilience helps weaken the relationship between adverse childhood experiences and sleep, so it is important to help families build resilience.
Multicentric Use of Commercially Available Infrarenal Endografts During Fenestrated Endovascular Aortic Repair: A Feasibility Study
Authors: Karelis Angelos , Jonsson Magnus , Budtz-Lilly Jacob , Jirström Wendela , Sonesson Björn , Dias Nuno V.
Published: May 2024

Purpose:

This study aimed to assess the feasibility and short-term outcomes of different manufactured proximal and distal stent graft components during fenestrated endovascular aortic repair (FEVAR).

Materials and methods:

A multicenter retrospective review was conducted at 3 aortic centers, involving all consecutive patients who underwent FEVAR utilizing a customized Dacron-based tubular proximal and a distal bifurcated polytetrafluoreten (PTFE)-based commercially available stent grafts. Primary outcomes were 30 day mortality, major adverse events, and technical and clinical success. Secondary outcomes assessed stent graft migration, occurrence of types I/III endoleak, and reintervention.

Results:

A total of 23 FEVAR cases across all centers were included in this study. Technical success was achieved in all cases, with a median procedure time of 183 (153–244) minutes. There were no major adverse events, except for 1 transient acute renal failure. The median follow-up period was 23 (17–28) months. All target vessels retained patent with the exception of 1 right renal fenestration that showed signs of kinking at the first follow-up, and despite secondary intervention with relining and distal extension, there was an occlusion afterward and 1 hepatic artery with a separate fenestration. This and 1 successful relining of a superior mesenteric artery kink were the only reinterventions in this cohort. One case of persistent type 1b endoleak was reported in a patient with chronic type B aortic dissection, which resolved with distal extension on the external iliac artery 5 months after the index procedure. No deaths occurred throughout the follow-up with, and there were no signs of stent graft migration or type 3 endoleak.

Conclusion:

The use of commercially available PTFE-based bifurcated stent grafts to extend distally the tubular graft appears to be a feasible approach during FEVAR, with promising short-term outcomes. Further studies are necessary to define the applicability of this solution and evaluate long-term outcomes.

Clinical Impact

This multicentric study on fenestrated endovascular aortic repair (FEVAR) demonstrates the feasibility and good short-term outcomes of utilizing a PTFE-based commercially available stent graft to extend the proximal tubular custom-made fenestrated stent graft. The high technical success rate, absence of major adverse events, and low occurrence of complications such as stent graft migration and endoleaks highlight the potential clinical benefits of this approach with an off-the-shelf distal extension whose delivery system does not cross the fenestrations intraoperatively.
Access to Contraceptives among Venezuelan Migrant Women Residing in Peru: Analysis on a Population-Based Survey
Authors: Moncada-Mapelli Enrique , Roman Luz Angela , Galeas-Torre Maryorie Katteryne , Roman-Lazarte Victor
Published: May 2024

Introduction: The emigration of Venezuelans has seen a significant increase in recent years. The aim of this study was to identify factors associated with access to contraceptives in migrant women from Venezuela residing in Peru. Methods: An exploratory cross-sectional study was conducted using data from the Second Survey of the Venezuelan Population Residing in Peru. Access to contraceptives (yes/no) was established as the dependent variable. A Poisson regression model was performed for complex samples, and crude (PRc) and adjusted (PRa) prevalence ratios were reported. Results: A total of 3617 migrant women were analyzed, with 50.12% reporting access to contraceptives. Factors associated with greater access to contraceptives included being between 20 to 29 years old, having a university education, the entry period after the declaration of COVID-19 quarantine was associated with lower access to contraceptives. Conclusions: Access to contraceptives for Venezuelan migrants should be provided to all, as it is a free service in Peru. Additionally, education and family planning should be provided from the basic or middle school level to prevent unintended pregnancies in the future. Complete coverage should be provided regardless of the time of entry into Peru.
They Never Left: Drivers of Memory of Dictatorship and Impressions of Ferdinand E. Marcos as President After February 1986
Authors: Tigno Jorge V. , Ducanes Geoffrey M. , Rood Steven , Licudine Vladymir Joseph A.
Published: May 2024

Between 1972 and 1986, Ferdinand E. Marcos of the Philippines headed an autocratic system that allowed him to rule with little to no accountability. Some 36 years after FM (as he is popularly called) and family were driven from power into exile in Hawaii, his son, Ferdinand ‘Bongbong’ Marcos, Jr., was overwhelmingly elected President in the May 2022 general elections. This turnaround seemed puzzling to many, but others saw a long-term deliberate process of rehabilitation after the family returned to the Philippines. Our paper explores how Filipinos remembered FM in the years after his ouster. What drives the memory of dictatorship in the Philippines? Using time series data on public opinion about FM post-ouster, we find that a generally positive appreciation of Marcos as former president had crystallised early on across nearly all the major variables of age, sex, education, location and ethnicity.
Recurrent severe secondary haemorrhage due to facial artery pseudoaneurysm following styloidectomy via tonsillectomy approach: A case report
Authors: Rauniyar Neeraj , Phuyal Subash
Published: May 2024

A 41-year-old female who underwent right-sided styloidectomy via tonsillectomy approach experienced refractory short-lasting severe secondary haemorrhage on the third, seventh and thirteen postoperative days. On examination under general anaesthesia, no major vessel injury was noticed. Contrast-enhanced computerized tomography scan of the neck was done because no obvious bleeder was seen and refractory nature of bleeding. Contrast-enhanced computerized tomography scan neck showed pseudoaneurysm of facial artery which was managed with endovascular embolization successfully.
Pro Inflammatory Cytokines Profiles of Patients With Long COVID Differ Between Variant Epochs
Authors: Ganesh Ravindra , Yadav Siddhant , Hurt Ryan T. , Mueller Michael R. , Aakre Christopher A. , Gilman Elizabeth A. , Grach Stephanie L. , Overgaard Joshua , Snyder Melissa R. , Collins Nerissa M. , Croghan Ivana T. , Badley Andrew D. , Razonable Raymund R. , Salonen Bradley R.
Published: May 2024

Background:

Over 30% of patients with COVID-19 have persistent symptoms that last beyond 30 days and referred to as Long COVID. Long COVID has been associated with a persistent elevation in peripheral cytokines including interleukin-6, interleukin-1β, and tumor necrosis factor-α. This study reports cytokine profiles of patients in our clinic across SARS-COV-2 variant epochs.

Methods:

The clinical cytokine panel was analyzed in patients with Long COVID during periods that were stratified according to variant epoch. The 4 variant epochs were defined as: (1) wild-type through alpha, (2) alpha/beta/gamma, (3) delta, and (4) omicron variants.

Results:

A total of 390 patients had the clinical cytokine panel performed; the median age was 48 years (IQR 38-59) and 62% were female. Distribution by variant was wild-type and alpha, 50% (n = 196); alpha/beta/gamma, 7.9% (n = 31); delta, 18% (n = 72); and omicron, 23% (n = 91). Time to cytokine panel testing was significantly longer for the earlier epochs. Tumor necrosis factor-α ( P < .001) and interleukin 1β ( P < .001) were significantly more elevated in the earlier epochs (median of 558 days in wild-type through Alpha epoch vs 263 days in omicron epoch, P < .001)). Nucleocapsid antibodies were consistently detected across epochs.

Discussion:

When stratified by variant epoch, patients with early epoch Long COVID had persistently elevated peripheral pro-inflammatory cytokine levels when compared to later epoch Long COVID. Patients with Long COVID have similar clusters of symptoms across epochs, suggesting that the underlying pathology is independent of the peripheral cytokine signature.
Pediatric Monitoring Technologies and Congenital Heart Disease: A Systematic Review
Authors: Duffy Summer S. , Lee Sharon , Gottlieb Sen Danielle
Published: May 2024

Outpatient monitoring of infants with congenital heart disease has been shown to significantly reduce rates of mortality in the single ventricle population. Despite the accelerating development of miniaturized biosensors and electronics, and a growing market demand for at-home monitoring devices, the application of these technologies to infants and children is significantly delayed compared with the development of devices for adults. This article aims to review the current landscape of available monitoring technologies and devices for pediatric patients to describe the gap between technologies and clinical needs with the goal of progressing development of clinically and scientifically validated pediatric monitoring devices.
Do Traditionally Certified Teachers Really Have Better Curriculum Leadership Than Alternatively Certified Teachers? Based on an Empirical Study in China
Authors: Xu Fenghua , Wang Xinyu , Chen Junyuan , Lin Jiamin , Wang Lei
Published: May 2024

With the gradual improvement of open teacher selection mechanisms, the comparison of traditionally and alternatively certified teachers has become one of the international focuses in teacher research. Current studies have compared teachers of different certification pathways from multidimensional perspectives; however, no study has yet compared the differences in curriculum leadership between the two types of teachers. Teacher curriculum leadership is the ability of teachers to collaborate with stakeholders in the curriculum area to promote curriculum optimization and the development of students and teachers, and it includes three dimensions: teachers’ curriculum leadership views, practices and identity. This study conducted a comparative analysis of the curriculum leadership of traditionally and alternatively certified teachers based on data from 9,068 teachers of 20 provinces in China. Independent samples t-test and multiple linear regression analysis revealed no significant differences between traditionally and alternatively certified teachers on the overall level of curriculum leadership and the three sub-dimensions of curriculum leadership views, practices, and identity. Theoretically, it provides new evidence for the debate about whether there are differences between the two types of teachers by further corroborating the conclusion that there is no significant difference in the educational effectiveness of traditionally and alternatively certified teachers. Practically, it justifies the rationality of an open teacher selection mechanism and points the way to further reforms in university teacher education.
Osteosynthesis and radial head arthroplasty achieve comparable and favorable results in terrible triad injury: a systematic review using propensity score matching
Authors: Heifner John J , Rivera Dones Asdrubal E , Wells A Laurie , Reb Christopher W , Mercer Deana M
Published: May 2024

The terrible triad literature reports data across wide ranges of patients ages and the treatment allocation for the radial head is commonly based on fracture severity. These observations raise the question of selection bias which can hinder comparative efficacy. Propensity score matching analysis may provide better control of patient variables and treatment allocation. We convey two conclusions from this analysis. Firstly, clinical outcome metrices were favorable for both radial head arthroplasty and open reduction internal fixation following terrible triad injury. This finding supports the recent literature which describe satisfactory outcomes for acute surgical management of these injuries. Secondly, the analysis suggests that revision rates may be lower for both treatment options than previously reported in the literature.
Consumer Shift from Fast Fashion  to Thrift Fashion: An Application of Goal Framing Theory
Authors: Yadav Nidhi , Sijoria Charu
Published: May 2024

Thrift fashion represents the fastest-growing trend on Instagram. Although consumers are still skeptical about thrift, its increasing popularity among young Indian consumers remains under-researched. Thus, this article analyzes the responsible factors shaping consumers’ purchase intention toward Instagram thrift stores. Responses from 206 Instagram thrift store followers were received using a self-administered questionnaire. Structural equation modeling in SPSS AMOS 21 tests the proposed research model. Six factors influencing consumers’ purchase intention were identified after reviewing relevant literature on the topic. Results indicate that the gain goal frame (economic value), hedonic goal frame (perceived concern and hedonic value), and electronic word-of-mouth significantly influence consumers’ purchase decisions. However, the impact of the normative goal frame (environmental concern) and fashion consciousness was insignificant. The findings of this study could help Instagram thrift store owners plan their communication strategies by identifying the motivating and demotivating factors of conscious consumers’ purchase intention. It is the first empirical article to understand the factors influencing the purchase intention of Indian consumers while purchasing from Instagram thrift fashion stores.
The Governance of Internal Migration: Learning from the Pre- and Post-COVID-19 Policy Responses of Indian States
Authors: Singh Priyansha , Sinha Harshita , Aggarwal Varun , Naik Mukta
Published: May 2024

While the governance of global migration is a growing conversation in policy and academia, internal migration has remained under-researched and under-represented as an area of focus. The increased policy attention on internal migrants during the COVID-19 pandemic provides an opportunity for examining the governance of internal migration. Drawing on a review of literature and two consequent rounds of an ex ante policy indexing tool—the Interstate Migrant Policy Index (IMPEX) 2019 and IMPEX 2021—this article focuses on policies formulated by Indian state governments that are prominent recipients of internal migrants in the pre- and post-pandemic period. We find that while the COVID-19 pandemic revealed the vulnerability of low-income internal migrants in India, it only partially translated into long-term policy measures. This article demonstrates that the complexity of migration policymaking governance in federal democracies like India is an important aspect of global migration governance. It argues that such a focus will enable a number of developing economies to refine labour and social protection policies toward sustainable economics and human development. The article motivates a research and policy agenda that can especially help developing countries improve labour mobility patterns for economic development as well as ensure fuller coverage of social welfare measures in response to climate migration.
Descriptive Analysis of the Long Head of the Biceps Abnormalities in Distal Isolated Supraspinatus Tears Based on Video Records: A Study From the SFA Biceps Study Group Using the “Biceps Box” Concept
Authors: Barth Johannes , Berhouet Julien , Gallinet David , Antoni Maxime , Dordain Franck , Bonnevialle Nicolas , Guery Jacques , Gadea François , Jacquot Adrien , Charousset Christophe
Published: May 2024

Background:

Considering the long head of biceps (LHB) management, important cultural differences exist among the surgeons around the world, especially when repairing small isolated distal supraspinatus tears under arthroscopy. In the perspective of an international survey to analyze our practice regarding biceps management in small rotator cuff tears, the aim is to collect all the possible LHB abnormalities according to literature review, before considering that the LHB could be normal or pathologic.

Indications:

The SFA (Société Francophone d’Arthroscopie) behind its research biceps group summarized these abnormalities in a description analysis called the “biceps box” concept, which was validated with a strong inter-rater reliability. The aim is to present the description analysis using a common language with short video records for each abnormality described to reproduce “intraoperatively” the different possible scenarios the surgeon has to encounter during arthroscopic evaluation.

Technique Description:

The description of the “biceps box” concept classifies lesions of the LHB, with so-called intrinsic lesions, for which the LHB should be considered pathological: partial rupture or delamination, fissuring, lateral or medial instability or subluxation, hypertrophy with an hourglass figure; and so-called extrinsic lesions, for which the LHB should be considered healthy: damage to the pulley without bicipital instability, exposure of the articular portion of the biceps by rupture of the supraspinatus tendon, inflammation of the superficial surface of the tendon, presence of type 1 or 2 superior labral anterior to posterior (SLAP) lesions, or a chondral print.

Results:

We present the 10 possible scenarios with video records according to our description analysis.

Discussion/Conclusion:

The LHB could be considered as a pain generator in certain situations which are still not completely clear. The indication of biceps tenotomy or tenodesis depends on the interpretation of the surgeon of these abnormalities as a pathologic or a normal condition. The next step is to use these videos in an international survey to assess cultural differences regarding the management and eventually find a consensus regarding treatment options for each abnormality.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Partially phosphorylated poly(vinyl alcohol) – A promising candidate in corrosion protection of magnesium for the biomedical industry?
Authors: Michelin Beraldo Carlos Henrique , Versteg Augusto , Scharnagl Nico , da Conceição Thiago Ferreira
Published: May 2024

Partially phosphorylated poly(vinyl alcohol) (PPVA) as anticorrosive coating for AZ31 magnesium alloy was investigated in Hank’s Balanced Salt Solution (HBSS). Four phosphoric acid levels were used to modify PVA, resulting in four PPVA products. They were characterized using thermogravimetric analysis (TGA), water contact angle (WCA), and swelling test. PPVA-coated Mg alloys were evaluated using hydrogen evolution, cathodic polarization, electrochemical impedance spectroscopy (EIS), and scanning electron microscopy (SEM). TGA indirectly revealed crosslinked regions in the PPVA structure that increased with acid content. WCA and hydrogen evolution tests suggested that PPVA is a promising polymer for biomedical applications. Corrosion tests showed that the PPVA with 10% acid addition significantly improved the impedance modulus and lowered the cathodic kinetics compared to uncoated samples. The findings of the study suggested that the acid addition in PVA must be at least 10 % to guarantee improved corrosion resistance in HBSS, which indicates this material has potential for biological applications.
Neoadjuvant chemotherapy followed by surgery versus concurrent chemoradiotherapy in patients with stage IIB cervical squamous cell carcinoma: a retrospective cohort study
Authors: Pan Xin-Bin , Lu Yan , Wei You-Sheng , Yao De-Sheng
Published: May 2024

Purpose

This study aims to compare treatment outcomes between neoadjuvant chemotherapy (NACT) followed by surgery and concurrent chemoradiotherapy (CCRT) in patients with stage IIB cervical squamous cell carcinoma (CSCC).

Materials and methods

We conducted a retrospective cohort study involving patients with stage IIB CSCC treated at Guangxi Medical University Cancer Hospital between June 2012 and June 2019. We compared overall survival (OS), locoregional-free survival (LRFS), and distant metastasis-free survival (DMFS) between the NACT + surgery and CCRT groups.

Results

A total of 257 patients were enrolled: 165 underwent NACT + surgery and 92 received CCRT. Before propensity score matching, the NACT + surgery group exhibited lower 5-year OS (68.2% vs. 85.6%; hazard ratio [HR] = 2.50, 95% confidence interval [CI]: 1.26–4.96; P = 0.009), LRFS (85.2% vs. 96.9%; HR = 5.88, 95% CI: 1.33–25.94; P = 0.019), and DMFS (81.9% vs. 97.4%; HR = 6.65, 95% CI: 1.51–29.23; P = 0.012) compared to the CCRT group. After propensity score matching, OS, LRFS, and DMFS remained worse in the NACT + surgery group compared to the CCRT group.

Conclusion

NACT followed by surgery is associated with decreased OS, LRFS, and DMFS compared to CCRT among patients with stage IIB CSCC.
Integrating classification and regression learners with bioimpedance methods for estimating weight status in infants and juveniles from the southern Cuba region
Authors: Luna Taira Batista , Bello Jose Luis García , Carbonell Agustín Garzón , Montoya Ana de la Caridad Román , Lafargue Alcibíades Lara , Ciria Héctor Manuel Camué , Zulueta Yohandys A.
Published: May 2024

Objective

The search for other indicators to assess the weight and nutritional status of individuals is important as it may provide more accurate information and assist in personalized medicine. This work is aimed to develop a machine learning predictions of weigh status derived from bioimpedance measurements and other physical parameters of healthy younger volunteers from Southern Cuba Region.

Methods

A pilot random study at the Pediatrics Hospital was conducted. The volunteers were selected between 2002 and 2008, ranging in age between 2 and 18 years old. In total, 776 female and male volunteers are studied. Along the age and sex in the cohort, volunteers with class I obesity, overweight, underweight and with normal weight are considered. The bioimpedance parameters are obtained by measuring standard tetrapolar whole-body configuration. The bioimpedance analyser is used, collecting fundamental bioelectrical and other parameters of interest. A classification model are performed, followed by a prediction of the body mass index.

Results

The results derived from the classification leaner reveal that the size, body density, phase angle, body mass index, fat-free mass, total body water volume according to Kotler, body surface area, extracellular water according to Kotler and sex largely govern the weight status of this population. In particular, the regression model shows that other bioparameters derived from impedance measurements can be associated with weight status estimation with high accuracy.

Conclusion

The classification and regression predictive models developed in this work are of the great importance to assist the diagnosis of weigh status with high accuracy. These models can be used for prompt weight status evaluation of younger individuals at the Pediatrics Hospital in Santiago de Cuba, Cuba.
Prevalence of autism spectrum disorder in mainland china over the past 6 years: a systematic review and meta-analysis
Authors: Jiang Xinhong , Chen Xianrui , Su Jingying , Liu Nan
Published: May 2024

Background

Coupled with its rising prevalence, Autism spectrum disorder (ASD) has become a globally recognized public health concern. Nevertheless, large-scale, multicenter studies that analyze the epidemiology of ASD in China are relatively scarce.

Methods

Literature searches were conducted in PubMed/Medline, Embase, the Cochrane Library, Wanfang Data Knowledge Service Platform, China Biology Medicine database (CBM), China Science and Technology Journal Database (CSTJ), and China National Knowledge Infrastructure (CNKI) to retrieve studies published before April 8, 2023, related to ASD prevalence among children aged 0 to 14 years in mainland China. Meta-analysis was conducted using RevMan 5.2 and Stata 14.0.

Results

Twenty-one articles were included. The ASD prevalence among children in mainland China has been 0.7% (95% confidence interval(CI): 0.006–0.008) since 2017. The prevalence of ASD among boys was 1.0% (95% CI: 0.008–0.011), which was significantly higher than that among girls at 0.2% (95% CI: 0.002–0.003), with a statistically significant difference (OR = 3.198, 95% CI: 2.489–4.109, P = 0.000). Among the included studies, 18 reported an ASD prevalence of 0.8% (95% CI: 0.007–0.010), while 3 studies reported an autistic disorder (AD) prevalence of 0.7% (95% CI: 0.006–0.008). The prevalence of autism among urban children was 23.9% (95% CI: 0.149–0.328), and in rural areas, it was 0.7% (95% CI: 0.002–0.013), with no statistically significant difference (OR = 1.342, 95% CI: 0.258–6.975, P = 0.727). Regression analysis showed that factors such as region (P = 0.000), age (P = 0.000), study period (P = 0.000), sample size (P = 0.000), sampling method (P = 0.002), population source (P = 0.000), disease type (P = 0.000), quality score of the study (P = 0.000), and diagnostic criteria (P = 0.000) might have contributed to the heterogeneity in ASD prevalence.

Conclusion

The prevalence of ASD in China from 2017 to 2023 was 7/1000, showing an upward trend compared to that before 2017 (26.50/10,000). The male-to-female prevalence ratio was 5:1.The overall prevalence remained significantly lower than that reported in foreign countries.
Causal relationship between resting-state networks and depression: a bidirectional two-sample mendelian randomization study
Authors: Huang Dongmiao , Wu Yuelin , Yue Jihui , Wang Xianglan
Published: May 2024

Background

Cerebral resting-state networks were suggested to be strongly associated with depressive disorders. However, the causal relationship between cerebral networks and depressive disorders remains controversial. In this study, we aimed to investigate the effect of resting-state networks on depressive disorders using a bidirectional Mendelian randomization (MR) design.

Methods

Updated summary-level genome-wide association study (GWAS) data correlated with resting-state networks were obtained from a meta-analysis of European-descent GWAS from the Complex Trait Genetics Lab. Depression-related GWAS data were obtained from the FinnGen study involving participants with European ancestry. Resting-state functional magnetic resonance imaging and multiband diffusion imaging of the brain were performed to measure functional and structural connectivity in seven well-known networks. Inverse-variance weighting was used as the primary estimate, whereas the MR-Pleiotropy RESidual Sum and Outliers (PRESSO), MR-Egger, and weighted median were used to detect heterogeneity, sensitivity, and pleiotropy.

Results

In total, 20,928 functional and 20,573 structural connectivity data as well as depression-related GWAS data from 48,847 patients and 225,483 controls were analyzed. Evidence for a causal effect of the structural limbic network on depressive disorders was found in the inverse variance–weighted limbic network (odds ratio, $$28.21$$; 95% confidence interval, $$3.32-239.54$$; $$\text{P}=0.002$$), whereas the causal effect of depressive disorders on SC LN was not found(OR=1.0025; CI,1.0005-1.0046; P=0.012). No significant associations between functional connectivity of the resting-state networks and depressive disorders were found in this MR study.

Conclusions

These results suggest that genetically determined structural connectivity of the limbic network has a causal effect on depressive disorders and may play a critical role in its neuropathology.
The associations of psychopathology and metabolic parameters with serum bilirubin levels in patients with acute-episode and drug-free schizophrenia: a 5-year retrospective study using an electronic medical record system
Authors: Tian Yinghan , Yang Cheng , Liu Lewei , Zhao Xin , Fan Haojie , Xia Lei , Liu Huanzhong
Published: May 2024

Background

The oxidative system plays an important role in the pathogenesis of schizophrenia. Inconsistent associations were found between hyperbilirubinemia and psychopathology as well as glycolipid metabolism in patients with schizophrenia at different episodes. This current study aimed to examine these associations in patients with acute-episode and drug-free (AEDF) schizophrenia.

Methods

This is a retrospective study using 5 years of data from May 2017 to May 2022 extracted from the electronic medical record system of Chaohu Hospital of Anhui Medical University. Healthy controls (HCs) from the local medical screening center during the same period were also included. Participants’ data of the bilirubin levels [total bilirubin (TB), conjugated bilirubin (CB), unconjugated bilirubin (UCB)], glycolipid metabolic parameters and the score of the Brief Psychiatric Rating Scale (BPRS) were collected.

Results

A total of 1468 case records were identified through the initial search. After screening, 89 AEDF patients and 100 HCs were included. Compared with HCs, patients had a higher CB level, and lower levels of glycolipid metabolic parameters excluding high density lipoprotein-cholesterol (HDL-C) (all P < 0.001). Binary logistic regression analyses revealed that high bilirubin levels in the patients were independently associated with higher total and resistance subscale scores of BPRS, a higher HDL-C level, and lower total cholesterol and triglyceride levels (all P < 0.05).

Conclusion

Bilirubin levels are elevated in patients with AEDF schizophrenia. Patients with high bilirubin levels have more severe psychopathology and relatively optimized glycolipid metabolism. In clinical practice, regular monitoring of bilirubin levels in this patient population should be carried out.
Retrospective analysis of mortality among children under 5 years of age in Huangshi over the period 2002–2022, China
Authors: Xie Jumin , Hong Yihan , Yang Jianlin , Yan Yueming , Fei Shinuan
Published: May 2024

Background

The United Nations’ Millennium Development Goals and Sustainable Development Goals both underscore the critical need to reduce the under-five mortality rate globally. China has made remarkable progress in decreasing the mortality rate of children under five. This study aims to examine the trends in child mortality rates from 2002 to 2022 and the causes of deaths among neonates, infants, and children under 5 years of age from 2013 to 2022 in Huangshi.

Methods

The data resource was supported and provided by the Huangshi Health Commission, Huangshi Maternal and Child Health Hospital, and the Huangshi Statistics Bureau. Figures were drawn using Origin 2021.

Results

The mortality rate among children under 5 years old significantly decreased, from 21.38 per 1,000 live births in 2002 to 3.53 per 1,000 live births in 2022. The infant mortality rate also saw a significant decline, to 15.06 per 1,000 live births. Among the 1,929 recorded child deaths from 2013 to 2022, the top three causes were: F2 (Disorders related to short gestation and low birth weight), accounting for 17.26% (333 deaths); I1 (Accidental drowning and submersion), for 14.83% (286 deaths); and I3 (Other accidental threats to breathing), for 12.29% (237 deaths). Of the 1,929 deaths, 1,117 were male children, representing 57.91%. The gender disparity in the Under-5 Mortality Rate (U5MR) was calculated to be 1.38 (boys to girls). The leading causes of death under the age of five shifted from F2 (Disorders related to short gestation and low birth weight) to I1 (Accidental drowning and submersion) as children aged, highlighting the need for policymakers and parents to intensify care and vigilance for children.

Conclusions

Huangshi has achieved significant progress in lowering child mortality rates over the past two decades. The study calls for policymakers to enact more effective measures to further reduce the mortality rate among children under 5 years of age in Huangshi. Furthermore, it advises parents to dedicate more time and effort to supervising and nurturing their children, promoting a safer and healthier development.
Heterotopic ossification following COVID-19 infections: systematic literature review of case reports and case series
Authors: Chaitani Hachem , Fabeck Laurent , Koulischer Simon
Published: May 2024

Background

This review aims to study the clinical characteristics, diagnostic results, treatments, and outcomes in patients with heterotopic ossification following COVID-19 infection.

Methods

A literature search for eligible articles was conducted using MEDLINE/Pubmed, Global Health, and Scopus databases (January 12th, 2023), including all case reports and case series from any country and language. The criteria for inclusion in this review were cases of COVID-19 infection subsequently developing heterotopic ossification.

Results

This systematic review analysed 15 reports (n = 20 patients) documenting cases of heterotopic ossification following COVID-19 infection. 80% of the patients were male, with a median age of 59 years. All patients required intensive care unit stay with an average duration of 48.5 days. Mechanical ventilation was necessary for all patients and 30% of them underwent tracheostomy. Common symptoms included stiffness and pain, most frequently affecting multiple locations (70%), with the hips and shoulders being predominantly involved. X-rays were the most commonly used imaging modality, followed by computed tomography. Although treatment was given, some of the patients continued to experience symptoms, particularly stiffness.

Conclusion

20 patients who developed heterotopic ossification after COVID-19 have been reported, the majority of which had at least two independent risk factors for this condition. The link between those two clinical entities is therefore uncertain, requiring further investigation. It is nonetheless important to suspect heterotopic ossification in patients with severe COVID-19 infection, prolonged immobilisation, mechanical ventilation, who develop joint pain and stiffness, as this condition can significantly impact patients’ quality of life.

Protocol registration

CRD42023393516.
Effect of simethicone for the management of early abdominal distension after laparoscopic cholecystectomy: a multicenter retrospective propensity score matching study
Authors: Zhu Yi , Li Jinjie , Gao Ji , Bai Dousheng , Yu Zhengping , Jin Shengjie , Chen Jianfei , Li Shuang , Jiang Ping , Ge Zhong , Liu Minchao , Sun Chuandong , Su Yongjie , Zhang Yubin , Zhang Yong
Published: May 2024

Objective

To investigate whether simethicone expediates the remission of abdominal distension after laparoscopic cholecystectomy (LC).

Methods

This retrospective study involved LC patients who either received perioperative simethicone treatment or not. Propensity score matching (PSM) was employed to minimize bias. The primary endpoint was the remission rate of abdominal distension within 24 h after LC. Univariable and multivariable logistic regression analyses were conducted to identify independent risk factors affecting the early remission of abdominal distension after LC. Subsequently, a prediction model was established and validated.

Results

A total of 1,286 patients were divided into simethicone (n = 811) and non-simethicone groups (n = 475) as 2:1 PSM. The patients receiving simethicone had better remission rates of abdominal distension at both 24 h and 48 h after LC (49.2% vs. 34.7%, 83.9% vs. 74.8%, respectively), along with shorter time to the first flatus (14.6 ± 11.1 h vs. 17.2 ± 9.1 h, P < 0.001) compared to those without. Multiple logistic regression identified gallstone (OR = 0.33, P = 0.001), cholecystic polyp (OR = 0.53, P = 0.050), preoperative abdominal distention (OR = 0.63, P = 0.002) and simethicone use (OR = 1.89, P < 0.001) as independent factors contributing to the early remission of abdominal distension following LC. The prognosis model developed for predicting remission rates of abdominal distension within 24 h after LC yielded an area under the curve of 0.643 and internal validation a value of 0.644.

Conclusions

Simethicone administration significantly enhanced the early remission of post-LC abdominal distension, particularly for patients who had gallstones, cholecystic polyp, prolonged anesthesia or preoperative abdominal distention.

Trial registration

ChiCTR2200064964 (24/10/2022).
How the mapping of threshold concepts across a master’s programme in health professions education could support the development of mastersness
Authors: Archer E. , Schmutz A. M. S. , Volschenk M. , Jacobs C.
Published: May 2024

Introduction

Global trends towards the professionalization of Health Professions Education (HPE) have catalyzed the proliferation of degree-awarding programmes in HPE. We apply the theoretical lens of threshold concepts to explore the required levels of Master’s in HPE (MHPE) learning and teaching, with a view to determining how students might be supported to engage meaningfully with learning.

Methods

Qualitative data were collected with a series of nominal group discussions. The methodology and data analysis followed a consensus building approach.

Results

Four threshold concepts were identified: Being in the HPE world, the nature of HPE knowledge, the nature of HPE practice and the nature of HPE scholarship. We also mapped the threshold concepts to the World Federation for Medical Education (WFME) master’s level academic skills and the Scottish Quality Assurance Agency (QAA) facets of mastersness.

Conclusion

It is envisaged that our findings will enhance alignment between the outcomes and assessment in an MHPE programme, form the basis of understanding feedback received from students, and inform teaching and supervisory practices. The findings also complement the WFME and QAA frameworks by clarifying the depth and complexity of academic skills expected at master’s level and informing teaching and learning approaches to support the development of the identified threshold concepts.