bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review and synthesis of global stroke guidelines on behalf of the World Stroke Organization
Authors: Mead Gillian E , Sposato Luciano A , Sampaio Silva Gisele , Yperzeele Laetitia , Wu Simiao , Kutlubaev Mansur , Cheyne Joshua , Wahab Kolawole , Urrutia Victor C , Sharma Vijay K , Sylaja PN , Hill Kelvin , Steiner Thorsten , Liebeskind David S , Rabinstein Alejandro A
Published: February 2023

Background:

There are multiple stroke guidelines globally. To synthesize these and summarize what existing stroke guidelines recommend about the management of people with stroke, the World Stroke Organization (WSO) Guideline committee, under the auspices of the WSO, reviewed available guidelines.

Aims:

To systematically review the literature to identify stroke guidelines (excluding primary stroke prevention and subarachnoid hemorrhage) since 1 January 2011, evaluate quality (The international Appraisal of Guidelines, Research and Evaluation (AGREE II)), tabulate strong recommendations, and judge applicability according to stroke care available (minimal, essential, advanced).

Summary of review:

Searches identified 15,400 titles; 911 texts were retrieved, 200 publications scrutinized by the three subgroups (acute, secondary prevention, rehabilitation), and recommendations extracted from most recent version of relevant guidelines. For acute treatment, there were more guidelines about ischemic stroke than intracerebral hemorrhage; recommendations addressed pre-hospital, emergency, and acute hospital care. Strong recommendations were made for reperfusion therapies for acute ischemic stroke. For secondary prevention, strong recommendations included establishing etiological diagnosis; management of hypertension, weight, diabetes, lipids, and lifestyle modification; and for ischemic stroke, management of atrial fibrillation, valvular heart disease, left ventricular and atrial thrombi, patent foramen ovale, atherosclerotic extracranial large vessel disease, intracranial atherosclerotic disease, and antithrombotics in non-cardioembolic stroke. For rehabilitation, there were strong recommendations for organized stroke unit care, multidisciplinary rehabilitation, task-specific training, fitness training, and specific interventions for post-stroke impairments. Most recommendations were from high-income countries, and most did not consider comorbidity, resource implications, and implementation. Patient and public involvement was limited.

Conclusion:

The review identified a number of areas of stroke care where there was strong consensus. However, there was extensive repetition and redundancy in guideline recommendations. Future guideline groups should consider closer collaboration to improve efficiency, include more people with lived experience in the development process, consider comorbidity, and advise on implementation.
The grounds of Gallipoli: Earthy memory and the collapse of space and time
Authors: Daugbjerg Mads , Whitehead Christopher
Published: February 2023

This article deals with the meanings and agencies of earth in the making of memory. We consider the role of the soil at the Gallipoli peninsula, in today’s Turkey, a key First World War battlefield and a nodal point of national memories, especially for Australia, New Zealand and Turkey. Informed by more-than-human approaches to heritage and memory and drawing on contemporary site visits as well as historical sources, we discuss the Gallipoli peninsula as a landscape freighted with earthy memory in multiple ways: with the bodies of the dead of 1915, the material deposits and earthworks of the conflict, the memory practices undertaken relationally between people and nation states, and the weight of international diplomacies in the making and remaking of geopolitical orders and claims. In all of this, the ground is both supremely tangible and extremely abstract, making it a most potent agent in memory practices. We are interested in how groups claim ownership of, and control over, the ground; the many ways in which the earth comes to matter, including why and how it moves, how far, and through what forms of transfer; and the scalar zoom of perception and imagination that allows memory to take different forms. We explore these interrelations through attention to processes of what we call ‘formation’ and ‘activation’ of the earth, arguing that they often work to set up mitigations or collapses of distance – geographically and temporally – through different memorial and museum practices and rituals. In our analysis, however, such attempts to create collapses, or ‘wormholes’, through which the faraway Gallipoli can somehow be felt and grasped, are ultimately doomed to fail, as spatial and temporal distances inevitably seem to re-assert themselves as brutal and unbrookable gulfs.
Spray characterization of boron-loaded slurry fuels using high-speed imaging technique
Authors: Prabhudeva P. , Ojha Pawan Kumar , Karmakar Srinibas
Published: February 2023

The characterization of atomized spray in terms of its structure, break-up, and droplet morphology is crucial to analyze an engine's performance. Therefore, in this study, the spray characteristics of boron-laden slurry fuels have been evaluated experimentally through a high-speed imaging technique. The rheological properties of the boron-loaded slurry fuels have been measured and their impact on the atomization behavior has been qualitatively analyzed. The spray cone angle, penetration length, sheet break-up length, ligament length, ligament diameter, and droplet diameter distribution are obtained by processing the time-sequences images. The experiments were performed at three atomizing air-to-liquid ratios (ALR). Spray characteristics of the fuel samples with various particle loadings (10%, 20%, and 30%) have been analyzed and compared with that of the pure Jet A-1. The obtained results were qualitatively analyzed with different non-dimensional parameters, such as Momentum flux ratio, Weber number, Ohensorge number, and Reynolds number. The results show that an increase in viscosity due to particle loading significantly affects the spray characteristics. However, a better atomization behavior of boron slurry fuel at higher ALR than low ALR, even with higher particle loading, has been observed. This is possibly due to the change in momentum flux ratio at higher atomizing air velocity.
Rural and Urban Home Modification Program Users: A Comparative Study
Authors: Semeah Luz M. , Orozco Tatiana , Wang Xinping , Ahonle Zaccheus J. , Cowper-Ripley Diane , Ganesh Shanti P. , Wilson Lauren K. , Litt Eric R. , Ahern Justin K. , Roman Leslie M. Santos , Varma Deepthi Satheesa , Lee Mi Jung , Novak Jonathan R. , Jia Huanguang
Published: February 2023

Objective:

To understand the sociodemographic, geographical, and clinical characteristics of rural veterans utilizing home modification (HM) healthcare services under the Home Improvement Structural Alterations (HISA) program, to compare these characteristics between rural and urban veteran users, to estimate the costs of HMs performed, and to present distance that users traveled to HISA-prescribing medical facilities within the Veterans Health Administration (VHA).

Background:

Accessible housing is in short supply. HMs allow veterans with disabilities (VWDs) to remain living at home rather than enter institutional-type settings. HISA is associated with decreased inpatient hospitalization rates and increased use of preventative healthcare via outpatient clinic visits. Home accessibility provides psychological benefits improving social interactions and interaction with the physical environment.

Methods:

This retrospective database study analyzes data from the National Prosthetics Patient Database and other medical datasets within the VHA.

Results:

Results provide a profile of and comparison between rural and urban veteran users. HISA users are substantially older compared to younger VWDs. The frequency of bathroom, railing, and wooden ramp HMs differed significantly between rural and urban users ( p values < .001). Rural users traveled more miles than urban users to reach a prescribing facility.

Conclusions:

Older adults and individuals with disabilities have unmet housing needs since accessible housing is in short supply. This HM healthcare service is helping to meet the housing accessibility needs of older veterans, VWDs, older adults, and people with disabilities, in general.
Myelomatous pleural effusion in a cat diagnosed with multiple myeloma
Authors: Amalbert Tancrède , Canonne Aude Morgane , Béguin Jérémy
Published: February 2023

Case summary

A 10-year-old male castrated domestic shorthair cat was presented with a 3-day history of dyspnoea, chronic lethargy and inappetence. A bilateral pleural effusion was identified by thoracic ultrasound, and cytological examination revealed numerous atypical plasma cells. Biochemistry and serum protein electrophoresis revealed a severe hyperglobulinaemia associated with a monoclonal gammopathy. A moderate non-regenerative anaemia was also noted. Multiple bone lytic lesions were detected, and marked plasmacytosis was observed on bone marrow aspirates. Chemotherapy with cyclophosphamide and prednisolone was initiated but did not result in any clinical or biological response, and pleural effusion recurred. Lack of therapeutic response led to euthanasia 2 months after diagnosis.

Relevance and novel information

This is the first description of a myelomatous pleural effusion in a cat diagnosed with multiple myeloma and should be considered as one of the possible differential diagnoses for cats presented with pleural effusion and hyperglobulinaemia. The diagnostic, therapeutic and prognostic aspects of this manifestation are discussed.
Ethical considerations for the use of consumer wearables in health research
Authors: Sui Anna , Sui Wuyou , Liu Sam , Rhodes Ryan
Published: February 2023

Background

The UN's High Commissioner's request for a moratorium on the use and adoption of specific Artificial Intelligence (AI) systems that pose serious risk to human rights, this commentary explores the current environment and future implications of using third-party wearable technologies in research for participants’ data privacy and data security. While wearables have been identified as tools for improving users’ physical and mental health and wellbeing by providing users with more personalized data and tailored interventions, the use of this technology does not come without concern.

Objective

Primarily, as researchers, we are concerned with enmeshment of corporate and research interests and what this can mean for participant data.

Methods

By drawing on specific sections of the UN Report ‘The right to privacy in the digital age’, we discuss the conflicts between corporate and research agendas and point out the current and future implications of the involvement of third-party companies for participant data privacy, data security and data usage. Finally, we offer suggestions for researchers and third-party wearable developers for conducting ethical and transparent research with wearable tech.

Conclusion

We propose that this commentary be used as a foothold for further discussions about the ethical implications of using third-party wearable tech in research.
Power space and governance performance: An analysis based on the Shanghai Urban Neighborhood Survey
Authors: Sheng Zhiming , Zhou Qing
Published: February 2023

Why do communities in different spatial areas display different types of governance performance? Applying the perspective of spatial theory, this paper proposes an analytical concept of “power space”. The concept refers to the distance between a community and the municipal administrative power center. Based on data drawn from the Shanghai Urban Neighborhood Survey, this study examines the variation in governance performance across communities located in different areas of the spatial structure of city power, and analyzes the causes and mechanisms underlying these differences. The study suggests that the spatial distance between the community and the center of governance power is not merely physical and geographical in nature but also social and political. We find that the distance to the center of power has a significant effect on the types of community governance performance that are easily observable, but little effect on those that are less perceptible. This reveals that power space exerts a strong effect on phenomena that can be easily recognized by higher-level officials, but not on phenomena that are less visible but nevertheless appreciated by the residents. Such a pattern can be explained by the current governance performance assessment system and incentive mechanism. Power space exerts an influence through the mechanisms of public resource allocation and governance performance benchmarks, which are equally applicable to other areas of social governance. In sum, this study contributes to the understanding of the underlying logic of grassroots social governance in contemporary China.
The impact of riboflavin on the duration of sport-related concussion: A randomized placebo-controlled trial
Authors: Kent Jeremy B. , Diduch B. Kent , Statuta Siobhan M. , Pugh Kelli , MacKnight John M.
Published: February 2023

Objectives

The objective of this study was to investigate the time to recovery after an SRC comparing riboflavin 400mg daily to placebo in a group of elite level athletes from multiple sports.

Methods

The study was a double-blind randomized placebo-controlled trial with intention to treat conducted from 2016–2020 at two different academic institutions. The study enrolled varsity student-athletes (SA) at each institution. The investigators and participants were blinded to treatment allocation. The treatment group received 14 capsules of either riboflavin 400mg or placebo to take daily until completed. The team physician made the diagnosis of an SRC within 24 h of the injury.

Results

A total of sixty participants enrolled in the study. Fifty-two participants completed the study. Subjects in the riboflavin group had a statistically significant lower number of average days to recovery of 9.92 days (CI ± 2.8) compared to placebo of 22.2 days (CI ± 11.5) (P < 0.05). Subjects matched for age, gender, history of SRCs, attention deficit hyperactivity disorder and Periodic Health Questionnaire-9 scores.

Conclusions

This is one of the first studies that documents an effective treatment option for an SRC at the time of injury. Riboflavin is safe, inexpensive, and readily available making it an ideal treatment.
The Rise of Asian Ethnoburbs: A Case of Self-Segregation?
Authors: Kye Samuel
Published: February 2023

The past several decades have seen the rise of the Asian “ethnoburb”—communities retaining a disproportionate Asian presence in middle-class and suburban settings. Recent explanations have suggested that ethnoburbs may manifest as a function of “resurgent ethnicity” that indirectly leads to Asian self-segregation. In this study, I examine whether Asian ethnoburbs can also arise as a function of stratification, where White population exodus coincides with Asian population growth. To evaluate this argument, I use census data from 2000 to 2020 to examine the history of White and Asian population change for 1,299 neighborhoods defined as Asian ethnoburbs in 2020. The results suggest, on one hand, that many ethnoburbs experienced White population exit in a fashion consistent with racial turnover. These patterns of White population decline were unexplained by socioeconomic deficits and, in fact, rose in likelihood with socioeconomic status (SES) increases. On the other hand, a near-comparable number of ethnoburbs did not experience White exit in the face of Asian in-migration. However, this tended to be the case when Asians began as a relatively small presence and White households remained the dominant group. These findings suggest that arguments of self-segregation provide a poor explanation for ethnoburb formation. Instead, Asian ethnoburbs appear to emerge as a function of spatial assimilation and ethnic stratification: though Asian households tend to grow most prominently in the Whitest neighborhoods, the prospect of racial turnover looms once Asian households start to comprise a greater share of neighborhood residents.
Political Economy of the COVID-19 Pandemic: How State Policies Shape County-Level Disparities in COVID-19 Deaths
Authors: Sun Yue , Bisesti Erin M.
Published: February 2023

The authors examine how two state-level coronavirus disease 2019 (COVID-19) policy indices (one capturing economic support and one capturing stringency measures such as stay-at-home orders) were associated with county-level COVID-19 mortality from April through December 2020 and whether the policies were more beneficial for certain counties. Using multilevel negative binominal regression models, the authors found that high scores on both policy indices were associated with lower county-level COVID-19 mortality. However, the policies appeared to be most beneficial for counties with fewer physicians and larger shares of older adults, low-educated residents, and Trump voters. They appeared to be less effective in counties with larger shares of non-Hispanic Black and Hispanic residents. These findings underscore the importance of examining how state and local factors jointly shape COVID-19 mortality and indicate that the unequal benefits of pandemic policies may have contributed to county-level disparities in COVID-19 mortality.
European Stroke Organisation (ESO) Guidelines on Moyamoya angiopathy Endorsed by Vascular European Reference Network (VASCERN)
Authors: Bersano Anna , Khan Nadia , Fuentes Blanca , Acerbi Francesco , Canavero Isabella , Tournier-Lasserve Elisabeth , Vajcoczy Peter , Zedde Maria Luisa , Hussain Salman , Lémeret Sabrina , Kraemer Markus , Herve Dominique
Published: February 2023

The European Stroke Organisation (ESO) guidelines on Moyamoya Angiopathy (MMA), developed according to ESO standard operating procedure and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology, were compiled to assist clinicians in managing patients with MMA in their decision making. A working group involving neurologists, neurosurgeons, a geneticist and methodologists identified nine relevant clinical questions, performed systematic literature reviews and, whenever possible, meta-analyses. Quality assessment of the available evidence was made with specific recommendations. In the absence of sufficient evidence to provide recommendations, Expert Consensus Statements were formulated. Based on low quality evidence from one RCT, we recommend direct bypass surgery in adult patients with haemorrhagic presentation. For ischaemic adult patients and children, we suggest revascularization surgery using direct or combined technique rather than indirect, in the presence of haemodynamic impairment and with an interval of 6–12 weeks between the last cerebrovascular event and surgery. In the absence of robust trial, an Expert Consensus was reached recommending long-term antiplatelet therapy in non-haemorrhagic MMA, as it may reduce risk of embolic stroke. We also agreed on the utility of performing pre- and post- operative haemodynamic and posterior cerebral artery assessment. There were insufficient data to recommend systematic variant screening of RNF213 p.R4810K. Additionally, we suggest that long-term MMA neuroimaging follow up may guide therapeutic decision making by assessing the disease progression. We believe that this guideline, which is the first comprehensive European guideline on MMA management using GRADE methods will assist clinicians to choose the most effective management strategy for MMA.
Assessment of the prediction of ground motion parameters in 1D ground response analysis using data from seismic arrays and centrifuge experiments
Authors: Bessette Caroline , Yniesta Samuel
Published: February 2023

Peak ground acceleration (PGA), peak ground velocity (PGV), and spectral acceleration are among the most widely used metrics to represent seismic hazard characteristics in practice. Several simplified seismic design procedures to evaluate liquefaction triggering, slope stability, or structural response have also proposed other ground motion parameters (GMPs) to represent a ground motion’s intensity, duration, and frequency content. To account for soil effects, these parameters can be obtained from the results of one-dimensional (1D) ground response analyses. Few studies have systematically evaluated the prediction of these additional parameters from the results of ground response analyses. This study presents an exhaustive review of the accuracy and precision of the prediction of 19 common GMPs from the results of 1D ground response analyses using vertical seismic arrays and centrifuge tests. Total stress nonlinear analyses are conducted using the software DEEPSOIL along with equivalent-linear analysis. A reference dataset composed of 10 sites and 306 ground motion recordings representing varying conditions of seismic excitation is employed. The findings of this study showed that while the models produced a reasonable approximation of spectral accelerations, a general tendency toward the over-prediction of most parameters was revealed. The results identified that the mean period ( Tm) yielded the lowest bias, and other parameters, such as the predominant spectral period ( To), PGA, and PGV, also offered some improvements over the other parameters included in this study.
Differences in acoustic features of cough by pneumonia severity in patients with COVID-19: a cross-sectional study
Authors: Davidson Clare , Caguana Oswaldo Antonio , Lozano-García Manuel , Arita Guevara Mariela , Estrada-Petrocelli Luis , Ferrer-Lluis Ignasi , Castillo-Escario Yolanda , Ausín Pilar , Gea Joaquim , Jané Raimon
Published: February 2023

Background

Acute respiratory syndrome due to coronavirus 2 (SARS-CoV-2) is characterised by heterogeneous levels of disease severity. It is not necessarily apparent whether a patient will develop severe disease or not. This cross-sectional study explores whether acoustic properties of the cough sound of patients with coronavirus disease 2019 (COVID-19), the illness caused by SARS-CoV-2, correlate with their disease and pneumonia severity, with the aim of identifying patients with severe disease.

Methods

Voluntary cough sounds were recorded using a smartphone in 70 COVID-19 patients within the first 24 h of their hospital arrival, between April 2020 and May 2021. Based on gas exchange abnormalities, patients were classified as mild, moderate or severe. Time- and frequency-based variables were obtained from each cough effort and analysed using a linear mixed-effects modelling approach.

Results

Records from 62 patients (37% female) were eligible for inclusion in the analysis, with mild, moderate and severe groups consisting of 31, 14 and 17 patients respectively. Five of the parameters examined were found to be significantly different in the cough of patients at different disease levels of severity, with a further two parameters found to be affected differently by the disease severity in men and women.

Conclusions

We suggest that all these differences reflect the progressive pathophysiological alterations occurring in the respiratory system of COVID-19 patients, and potentially would provide an easy and cost-effective way to initially stratify patients, identifying those with more severe disease, and thereby most effectively allocate healthcare resources.
Genome-wide association study of quality traits and starch pasting properties of maize kernels
Authors: Guo Xinmei , Ge Zhaopeng , Wang Ming , Zhao Meiai , Pei Yuhe , Song Xiyun
Published: February 2023

Background

Starch are the main nutritional components of maize (Zea mays L.), and starch pasting properties are widely used as essential indicators for quality estimation. Based on the previous studies, various genes related to pasting properties have been identified in maize. However, the loci underlying variations in starch pasting properties in maize inbred lines remain to be identified.

Results

To investigate the genetic architecture of these traits, the starch pasting properties were examined based on 292 maize inbred lines, which were genotyped with the MaizeSNP50 BeadChip composed of 55,126 evenly spaced, random SNPs. A genome-wide association study (GWAS) implemented in the software package FarmCPU was employed to identify genomic loci for the starch pasting properties. 48 SNPs were found to be associated with pasting properties. Moreover, 37 candidate genes were correlated with pasting properties. Among the candidate genes, GRMZM2G143646 and GRMZM2G166407 were associated with breakdown and final viscosity significantly, and both genes encode PPR (Pentatricopeptide repeat) protein. We used GWAS to explore candidate genes of maize starch pasting properties in this study. The identified candidate genes will be useful for further understanding of the genetic architecture of starch pasting properties in maize.

Conclusion

This study showed a complex regulation network about maize quality trait and starch pasting properties. It may provide some useful markers for marker assisted selection and a basis for cloning the genes behind these SNPs.
Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis
Authors: Alexandre Wheytnie , Muhammad Haseeb , Agbalajobi Olufunso , Zhang Grace , Gmelin Theresa , Adejumo Adeyinka , Noll Alan , Jonassaint Naudia L. , DiMartini Andrea , Bataller Ramon , Rogal Shari S.
Published: February 2023

Background

Alcohol cessation is the cornerstone of treatment for alcohol-related cirrhosis. This study evaluated associations between medical conversations about alcohol use disorder (AUD) treatment, AUD treatment engagement, and mortality.

Methods

This retrospective cohort study included all patients with ICD-10 diagnosis codes for cirrhosis and AUD who were engaged in hepatology care in a single healthcare system in 2015. Baseline demographic, medical, liver disease, and AUD treatment data were assessed. AUD treatment discussions and initiation, alcohol cessation, and subsequent 5-year mortality were collected. Multivariable models were used to assess the factors associated with subsequent AUD treatment and 5-year mortality.

Results

Among 436 patients with cirrhosis due to alcohol, 65 patients (15%) received AUD treatment at baseline, including 48 (11%) receiving behavioral therapy alone, 11 (2%) receiving pharmacotherapy alone, and 6 (1%) receiving both. Over the first year after a baseline hepatology visit, 37 patients engaged in AUD treatment, 51 were retained in treatment, and 14 stopped treatment. Thirty percent of patients had hepatology-documented AUD treatment recommendations and 26% had primary care-documented AUD treatment recommendations. Most hepatology (86%) and primary care (88%) recommendations discussed behavioral therapy alone. Among patients with ongoing alcohol use at baseline, AUD treatment one year later was significantly, independently associated with AUD treatment discussions with hepatology (adjusted odds ratio (aOR): 3.23, 95% confidence interval (CI): 1.58, 6.89) or primary care (aOR: 2.95; 95% CI: 1.44, 6.15) and negatively associated with having Medicaid insurance (aOR: 0.43, 95% CI: 0.18, 0.93). When treatment was discussed in both settings, high rates of treatment ensued (aOR: 10.72, 95% CI: 3.89, 33.52). Over a 5-year follow-up period, 152 (35%) patients died. Ongoing alcohol use, age, hepatic decompensation, and hepatocellular carcinoma were significantly associated with mortality in the final survival model.

Conclusion

AUD treatment discussions were documented in less than half of hepatology and primary care encounters in patients with alcohol-related cirrhosis, though such discussions were significantly associated with receipt of AUD treatment.
Atorvastatin reduces contrast media-induced pyroptosis of renal tubular epithelial cells by inhibiting the TLR4/MyD88/NF-κB signaling pathway
Authors: Yue Rong-zheng , Li Ya-juan , Su Bai-hai , Li Cong-jun , Zeng Rui
Published: February 2023

Background

Contrast-induced acute kidney injury (CI-AKI) is the third most common cause of hospital-acquired renal failure. However, there is no effective treatment of CI-AKI, and its mechanism is unknown. Interestingly, atorvastatin has been reported to be effective in renal injury. Therefore, the aim of this study was to explore the effect and possible molecular mechanism of atorvastatin in CI-AKI.

Methods

On the CI-AKI in vitro model, rat tubular epithelial cells (NRK-52E) were treated with 18 mg I/ml meglumine diatrizoate (MEG) and then pretreated with atorvastatin. pcDNA3.1-TLR4 treatment was performed to overexpress toll-like receptor 4 (TLR4) in NRK-52E cells. Cell Counting Kit-8 (CCK-8) and lactate dehydrogenase (LDH) kits were used to detect NRK-52E cell viability as well as LDH release in each group, respectively; qRT-PCR to determine mRNA expression of TLR4 in cells; western blot to detect protein expression levels of pyroptosis-related proteins (NLRP3, caspase-1, ASC, and GSDMD) and TLR4/MyD88/NF-κB signaling pathway-related proteins (TLR4, MyD88, NF-κBp65, and p-NF-κB p65) in cells.

Results

MEG treatment significantly inhibited the viability of NRK-52E cells, increased pro-inflammatory factor levels and promoted pyroptosis, representing successful establishment of a rat tubular epithelial cell (NRK-52E) CI-AKI in vitro model. Notably, atorvastatin increased the activity of MEG-treated NRK-52E cells and alleviated cell injury in a concentration-dependent manner. In addition, atorvastatin significantly down-regulated the expression of TLR4 in MEG-treated NRK-52E cells. However, overexpression of TLR4 inhibited the effects of atorvastatin on increasing cell viability, alleviating cell injury, reducing pro-inflammatory factors (IL-1β, IL-6, and TNF-α) levels, and inhibiting apoptosis (by down-regulating the expression of NLRP3, caspase-1, ASC, and GSDMD). Furthermore, atorvastatin also inhibited the expression of TLR4/MyD88/NF-κB pathway-related proteins (TLR4, MyD88, and p-NF-κB p65).

Conclusion

Atorvastatin can attenuate CI-AKI through increasing the activity of MEG-treated renal tubular epithelial cells, relieving cell injury, as well as inhibiting pyroptosis and inflammation. More importantly, the mechanism was achieved by inhibiting the TLR4//MyD88/NF-κB signaling pathway.
Seizure control during pregnancy and postpartum period in women with epilepsy: an Egyptian prospective study
Authors: Hosny Hassan , Al Kattan Manal Mahmoud , Zaki Maha A. , Ramzy Gihan M. , Al-Azayem Salsabil Abo , Magdy Rehab
Published: February 2023

Background

Proper seizure control during pregnancy and postpartum is essential to optimize the outcome of women with epilepsy (WWE). The current work aimed to address factors related to seizure occurrence during pregnancy and postpartum.

Methods

One hundred twenty-five WWE, compliant with their anti-seizure medications (ASMs) regimen, were prospectively evaluated for seizure control and ASMs changes all through the pregnancy up to 4 weeks postpartum.

Results

Most of the patients, 73 (58.4%), completed their pregnancy without seizures, while 52 (41.6%) had seizures. Only one case developed one episode of convulsive status epilepticus in the third trimester. Due to breakthrough seizures, the ASM dose was increased from the first to the third trimester in 19.2% of pregnancies, while another ASM was added in 8 pregnancies. Uncontrolled seizures during the six months before pregnancy were associated with a four-fold increase in the risk of seizures during pregnancy (95% CI 2.476–6.695). The latter nearly doubled the risk of seizures during the postpartum period (RR 1.978) (95% CI 1.44 -2.717). Furthermore, genetic etiology would increase the risk of seizures during the postpartum period by 2.7 times more than the unknown etiology (RR 2.778, 95%CI 1.156–6.679).

Conclusion

Women with epilepsy should be counselled that proper seizure control six months before pregnancy is necessary to pass their pregnancy and the postpartum period without seizures.
The psychological burden of COVID-19 on the desire for parenthood in minoritized sexual identities: a study on depressive symptoms and family planning in Germany
Authors: Batz Falk , Lermer Eva , Lech Sonia , O’Malley Grace , Zati zehni Alaleh , Zenz-Spitzweg Davina , Mahner Sven , Behr Joachim , Thaler Christian J. , Buspavanich Pichit
Published: February 2023

Background

The COVID-19 pandemic continues to spread across the globe and is associated with significant clinical and humanitarian burden. The desire for parenthood has been described to be positively correlated with psychological well-being: An unfulfilled wish for parenthood is associated with impaired mental health, and the wish for parenthood is a predictor for the development of depressive symptoms. While higher rates of anxiety and depression have been reported in individuals with minoritized sexual identities (compared to heterosexual individuals) during the COVID-19 pandemic, the specific impact of the pandemic and its social restriction measures on this population is poorly understood.

Methods

From April to July 2020, we conducted an anonymous cross-sectional survey online among N = 2463 adults living in Germany. We screened for depressive symptoms (Patient Health Questionnaire-4; PHQ-4) and assessed individuals’ desire for parenthood during the pandemic, and motives for or against the desire for parenthood (Leipzig questionnaire on motives for having a child, Version 20; LKM-20), with the aim of identifying differences between individuals with minoritized sexual identities and heterosexual individuals.

Results

Compared to heterosexual individuals (n = 1304), individuals with minoritized sexual identities (n = 831) indicated higher levels of depressive symptoms. In our study sample the majority of all participants (81.9%) reported no change in the desire for parenthood since the COVID-19 pandemic.

Conclusion

The findings underline the unmet need for social, psychological and medical support in regard to family-planning and the desire for parenthood during a pandemic. Furthermore, future research should explore COVID-19-related psychological consequences on individuals’ desire for parenthood and building a family.
Gender and urban-rural influences on antibiotic purchasing and prescription use in retail drug shops: a one health study
Authors: Rousham Emily K. , Nahar Papreen , Uddin Mohammad Rofi , Islam Mohammad Aminul , Nizame Fosiul Alam , Khisa Nirnita , Akter S. M. Salim , Munim Mohammad Saeed , Rahman Mahbubur , Unicomb Leanne
Published: February 2023

Introduction

Few studies have reported antibiotic purchases from retail drug shops in relation to gender in low and middle-income countries (LMICs). Using a One Health approach, we aimed to examine gender dimensions of antibiotic purchases for humans and animals and use of prescriptions in retail drug shops in Bangladesh.

Methods

We conducted customer observations in 20 drug shops in one rural and one urban area. Customer gender, antibiotic purchases, and prescription use were recorded during a four-hour observation (2 sessions of 2 hours) in each shop. We included drug shops selling human medicine (n = 15); animal medicine (n = 3), and shops selling both human and animal medicine (n = 2).

Results

Of 582 observations, 31.6% of drug shop customers were women. Women comprised almost half of customers (47.1%) in urban drug shops but only 17.2% of customers in rural drug shops (p < 0.001). Antibiotic purchases were more common in urban than rural shops (21.6% versus 12.2% of all transactions, p = 0.003). Only a quarter (26.0%) of customers who purchased antibiotics used a prescription. Prescription use for antibiotics was more likely among women than men (odds ratio (OR) = 4.04, 95% CI 1.55, 10.55) and more likely among urban compared to rural customers (OR = 4.31 95% CI 1.34, 13.84). After adjusting for urban-rural locality, women remained more likely to use a prescription than men (adjusted OR = 3.38, 95% CI 1.26, 9.09) but this was in part due to antibiotics bought by men for animals without prescription. Customers in drug shops selling animal medicine had the lowest use of prescriptions for antibiotics (4.8% of antibiotic purchases).

Conclusion

This study found that nearly three-quarters of all antibiotics sold were without prescription, including antibiotics on the list of critically important antimicrobials for human medicine. Men attending drug shops were more likely to purchase antibiotics without a prescription compared to women, while women customers were underrepresented in rural drug shops. Antibiotic stewardship initiatives in the community need to consider gender and urban-rural dimensions of drug shop uptake and prescription use for antibiotics in both human and animal medicine. Such initiatives could strengthen National Action Plans.
Influences and patterns of intimate partner violence among married Akha and Lahu women in northern Thailand
Authors: Singkhorn Onnalin , Apidechkul Tawatchai , Srichan Peeradone , Mulikaburt Thanatchaporn , Kitchanapaibul Siwarak , Udplong Anusorn , Upala Panupong , Chomchoei Chalitar , Yeemard Fartima , Tamornpark Ratipark , Wongnuch Pilasinee
Published: February 2023

Background

Intimate partner violence (IPV) is a major global public health problem. Women are the principal victims of IPV, and some special populations have been particularly impacted. The Akha and Lahu women are vulnerable populations for IPV due to the modernization and changes of their culture and norms. This study aimed to understand premarriage factors related to IPV, including associated factors, influencers, patterns and impacts, in Akha and Lahu women in Thailand.

Methods

A qualitative method was used to gather information among Akha and Lahu women who had experienced IPV in the previous year and were fluent in Thai. Women who had experienced IPV in the previous year and lived in the border area of Thailand and Myanmar were invited to provide information. A thematic analysis was used to extract information from the participants and develop findings.

Results

A total of fifty-two married women were recruited into the study: 46.2% were Akha and 53.8% were Lahu. Those married Akha and Lahu women younger than 39 years found their partner through social media, had conditions before getting married, had high self-confidence, and tended to marry people from different tribes. While those aged 40 years and over met their husbands in village activities, were highly compliant with the norms of their culture, and married men from the same tribe. Three factors were detected as associated factors of IPV: cultural differences between partners from different tribes, substance use, and personality. Differences in age between partners, living in poor family economic status, and poor education were also detected as influencers of IPV. Four patterns of IPV were observed among Akha and Lahu married women: neglect, emotional abuse, verbal abuse, and physical abuse. Several patterns of the impacts were presented: children were neglected, especially in the preparation of daily food, having stress, having poor family relationships, and having children with unsuccessful lives in terms of education and getting a good job. Almost all married Akha and Lahu women had no particular expectations in their lives.

Conclusion

Akha and Lahu women face IPV problems with several key influences and impacts. Effective implementations are required to monitor and reduce the problem in the Akha and Lahu families, especially where the women are younger than 40 years old and married to men from different tribes.
Study protocol of an international patient-led registry in patients with pulmonary fibrosis using online home monitoring: I-FILE
Authors: Nakshbandi Gizal , Moor Catharina C. , Antoniou Katerina , Cottin Vincent , Hoffmann-Vold Anna-Maria , Koemans Edwin A. , Kreuter Michael , Molyneaux Philip L. , Wuyts Wim A. , Wijsenbeek Marlies S.
Published: February 2023

Background

Pulmonary fibrosis (PF) is caused by a heterogeneous group of diseases, with a high inter-individual variability in disease trajectory. Identifying disease progression in patients with PF has impact on clinical management decisions. However, strategies to early identify and predict disease progression for these patients are currently lacking. In this study, we aim to assess long-term FVC change in patients with PF measured with home spirometry, and evaluate the feasibility of a multinational patient-led registry in PF. In addition, we will assess validity of patient-reported outcomes (PROMs) for the different subgroups of patients with PF.

Methods

In this international, prospective, multicenter, observational study, we aim to include 700 patients across seven European countries. Patients will monitor their disease course for a period of two years using an online home monitoring program (I-FILE), which includes home spirometry, pulse oximetry, and PROMs. Results will be directly sent to the hospital via the online application. Patients will be asked to perform daily home spirometry and pulse oximetry in the first three months, followed by once weekly measurements for a period of two years. PROMs will be completed in the online I-FILE application every six months, including the King’s brief Interstitial Lung Disease Health Status, The EuroQol five dimensions five-level, Visual Analogue Scales on cough, dyspnea, fatigue and general complaints, Leicester Cough Questionnaire, Fatigue Assessment Scale, Work Productivity and Activity Impairment Questionnaire, Global Rating of Change Scale, and Living with Pulmonary Fibrosis questionnaire.

Discussion

This study will provide much needed insights in disease trajectories of the different subgroups of patients with PF. Simultaneously, the I-FILE study will yield valuable information on the use and feasibility of home-based data collection. This international patient-led registry will facilitate trans-border collaboration to further optimize care and research for patients with PF.

Trial registration: The study was registered on the 12th of March 2020 in the International Clinical Trial Registry, www.clinicaltrials.gov; Identifier: NCT04304898.
Eleven years of data on the Jefferson Scale of Empathy – medical student version: Japanese norm data and tentative cutoff scores
Authors: Kataoka Hitomi U. , Tokinobu Akiko , Fujii Chikako , Watanabe Mayu , Obika Mikako
Published: February 2023

Background

More and more studies investigate medical students’ empathy using the Jefferson Scale of Empathy (JSE). However, no norm data or cutoff scores of the JSE for Japanese medical students are available. This study therefore explored Japanese norm data and tentative cutoff scores for the Japanese translation of the JSE-medical student version (JSE-S) using 11 years of data obtained from matriculants from a medical school in Japan.

Methods

Participants were 1,216 students (836 men and 380 women) who matriculated at a medical school in Japan from 2011 to 2021. The JSE-S questionnaire was administered to participants prior to the start of the program. Data were summarized using descriptive statistics and statistical tests were performed to show the norm data and tentative cutoff scores for male and female students separately.

Results

The score distributions of the JSE-S were moderately skewed and leptokurtic for the entire sample, with indices -0.75 and 4.78, respectively. The mean score (standard deviation) for all participants was 110.8 (11.8). Women had a significantly higher mean score (112.6) than men (110.0; p < 0.01). The effect size estimate of gender difference was 0.22, indicating a small effect size. The low and high cutoff scores for men were ≤ 91 and ≥ 126, respectively, and the corresponding scores for women were ≤ 97 and ≥ 128, respectively.

Conclusions

This study provides JSE-S norm data and tentative cutoff scores for Japanese medical school matriculants, which would be helpful in identifying those who may need further training to enhance their empathy.
Women empowerment indices and utilization of health facilities during childbirth: evidence from the 2019 Sierra Leone demographic health survey
Authors: Sserwanja Quraish , Mukunya David , Musaba Milton W. , Mutisya Linet M. , Kamara Kassim , Ziaei Shirin
Published: February 2023

Background

Women empowerment is recognized as a potential enabling factor to the utilization of health facilities during childbirth. However, the association between women empowerment and utilization of health facilities is poorly studied, especially in counties with high maternal mortality. Therefore, we investigated the association between women empowerment indices and the utilization of health facilities during childbirth in Sierra Leone.

Methods

We analyzed secondary data from the 2019 Sierra Leone Demographic and Health Survey (SLDHS). We included 5,997 married women who had given birth in the five years before the survey, and had been sampled for the women empowerment questionnaire. The study employed the gender roles framework developed by the Harvard Institute for International Development in the selection and classification of women empowerment indices, which include influencing, resource and decision-making factors. We conducted logistic regression analyses using SPSS version 25.0 complex samples package to determine the association between women empowerment indices and utilization of health facilities.

Results

The overall prevalence of health facility utilization during childbirth was 84.1% (5,042/5,997): 95% CI: 83.6 to 85.4. Among the influencer domain variables, women from the southern (aOR = 2.25, 95% CI: 1.34–3.78), northern (aOR = 1.69,95% CI: 1.01–2.82) and eastern regions (aOR = 3.71, 95% CI: 2.03–6.77) had higher odds of health facility utilization compared to women in the western region, while women in polygamous marriages (aOR = 0.82, 95% CI: 0.69–0.98) had lower odds of utilizing health facilities compared to their counterparts in monogamous marriages. Furthermore, women who had their first birth when they were less than 18 years, had higher odds of utilizing health facilities (aOR = 1.22, 95% CI: 1.02–1.45) compared to those who were 18 years and above. Among the resource domain variables, women with post-primary education (aOR = 1.58, 95% CI: 1.21–2.06) had higher odds of utilizing health facilities compared to their counterparts with no education and women who belonged to the richest wealth quintile (aOR = 2.42, 95% CI: 1.31–4.46) had higher odds of utilizing health facilities compared to their counterparts belonging in the poorest quintile. None of the variables in the decision making domain was significantly associated with health facility utilization.

Conclusion

These findings emphasize that, successful implementation of health facility utilization interventions should prioritize women empowerment with more pragmatic efforts. Policies and programme should aim at all women with more focus on those having lower education (primary and below), belonging to the poorest wealth quintile, give birth before reaching18 years and in polygamous marriages.