bluuebunny/crossref_metadata_2025 huggingface dataset:
Political discussions lead to political efficacy among students in Indonesia
Authors: Mashud Mustain , Ida Rachmah , Saud Muhammad
Published: December 2022

Student unions based on religious and political affiliations are of paramount importance in political decision-making around the globe and in Indonesia particularly. The involvement of youth in political arenas and narrative building has become a debated topic among academicians, scholars and policymakers. In the context of Indonesia, the association of youth with religious groups has been seen as very important for engaging them in capacity-building initiatives (students in particular) and in political activities by mobilizing them with general communities. The present study examines the phenomenon of political efficacy through the political participation of youth associated with different religious and political groups. In consideration of the nature of the study, the present research tried to accomplish the desired outcomes by employing a quantitative research design and carrying out surveys. For that purpose, a self-administered questionnaire was developed with the help of literature for gathering data. The data were gathered from students and the general public, focusing on the premise that political discussion and religious group affiliation can be instrumental for political efficacy. The research found that the affiliation of students with religious groups has a strong impact on their involvement in political activities. Along with various political and religious factors, social media is considered a decisive factor in forming youth's political opinions and developing a sense of community engagement as well as practising their political rights. The data also show that there is a significant relationship between political efficacy and social media, highlighting that the participation of students in political discussion leads to political efficacy by mobilizing youth with general communities to create a discursive political environment.
Contraceptive Use and Missed Opportunities for Family Planning Discussions in Women Living with Human Immunodeficiency Virus at an HIV Clinic
Authors: Winters Ashley , Jakeman Bernadette , Aragon Kelsea Gallegos , Kasten Zoe , Bos Alexander , Snyder Jeremy , Herman Alexandra
Published: December 2022

The objective of this study was to examine contraception use and family planning discussions (FPD) in female people living with HIV (PLWH). A retrospective cohort study was conducted. Female PLWH were included if they were 18–44 years and received care in 2019 at an HIV clinic. 74 patients met inclusion; mean age was 35 years, 53% were white. All patients were prescribed antiretroviral therapy. 48.6% of patients had documented FPD. 64.9% of patients were using contraception; sterilization was most common (41.7%). Only five patients had a contraindication to hormonal contraception. No differences in contraception use were observed based on age, race, HIV viral load, number of visits, or past pregnancies. However, patients with documented FPD were more likely to use contraception (OR 4.55; 95% CI 1.35-15.29). Routine FPD and contraception use in female PLWH were low. Rates of sterilization were high in female PLWH. Providing quality family planning services is critical to increase contraception use and selection of the most appropriate contraception form.
Hypolipidemic effect of ethanol extract from Chimonanthus nitens Oliv. leaves in hyperlipidemia rats via activation of the leptin/JAK2/STAT3 pathway
Authors: Pan Jianping , Ouyang Xilin , Jin Qi , Wang Wei , Xie Jiali , Yu Baoming , Ling Zhijie , Wu Qizhen , Zheng Baoping
Published: December 2022

Background

This study aims to explore the protective role of ethanol extract from Chimonanthus nitens Oliv. leaf (COE) in hyperlipidemia via the leptin/Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) pathway.

Methods

Male Sprague‒Dawley rats were randomly divided into 6 groups (n = 8): normal-fat diet (NMD), high-fat diet (HFD), HFD treated with simvastatin (SIM, 5 mg/kg/day), and HFD treated with COE (40, 80, 160 mg/kg/day). Lipid parameters, oxidative stress factors, serum leptin, body weight, hepatic wet weight and liver index were measured. Proteins in the leptin/JAK2/STAT3 pathway in liver tissues were determined using western blotting. Additionally, the expression levels of cytochrome P450 family 7 subfamily A member 1 (CYP7A1) and 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) were quantified using western blotting and quantitative real-time polymerase chain reaction (qPCR).

Results

COE decreased HFD-induced increases in body weight, hepatic wet weight and the liver index. HFD-induced hyperlipidemia and oxidative stress were observed in rat serum and livers. Additionally, COE repressed these two symptoms in rats fed a HFD. Moreover, COE caused CYP7A1 upregulation and HMGCR downregulation in HFD-fed rats. Mechanistically, COE induced the expression of leptin receptor (OB-Rb) and JAK2 and STAT3 phosphorylation in HFD-treated rats.

Conclusion

COE activates the leptin/JAK2/STAT3 pathway, leading to an improvement in liver function and lipid metabolism and ultimately alleviating hyperlipidemia in rats. Therefore, COE may be a potential hypolipidemic drug for the treatment of hyperlipidemia.
Immunological pathogenesis of Bovine E. coli infection in a model of C. elegans
Authors: Peng Hao , Bai Huili , Pan Yan , Li Jun , Pei Zhe , Liao Yuying , Wu Cuilan , Li Changting , Tao Li , Zhong Shuhong , Ma Chunxia , Chen Zhongwei , Li Xiaoning , Gong Yu , Wang Leping , Li Fengsheng
Published: December 2022

Background

Cattle industry is critical for China’s livestock industry, whereas E. coli infection and relevant diseases could lead huge economic loss. Traditional mammalian models would be costly, time consuming and complicated to study pathological changes of bovine E. coli. There is an urgent need for a simple but efficient animal model to quantitatively evaluate the pathological changes of bovine-derived E. coli in vivo. Caenorhabditis elegans (C. elegans) has a broad host range of diverse E. coli strains with advantages, including a short life cycle, a simple structure, a transparent body which is easily visualized, a well-studied genetic map, an intrinsic immune system which is conservable with more complicated mammalians.

Results

Here, we considered that O126 was the dominant serotype, and a total of 19 virulence factors were identified from 41 common E. coli virulence factors. Different E. coli strains with diverse pathogenicity strengths were tested in C. elegans in E. coli with higher pathogenicity (EC3/10), Nsy-1, Sek-1 and Pmk-1 of the p38 MAPK signaling pathway cascade and the expression of the antimicrobial peptides Abf-3 and Clec-60 were significantly up-regulated comparing with other groups. E. coli with lower pathogenicity (EC5/13) only activated the expression of Nsy-1 and Sek-1 genes in the p38 MAPK signaling pathway, Additionally, both groups of E. coli strains caused significant upregulation of the antimicrobial peptide Spp-1.

Conclusion

Thirteen E. coli strains showed diverse pathogenicity in nematodes and the detection rate of virulence factors did not corresponding to the virulence in nematodes, indicating complex pathogenicity mechanisms. We approved that C. elegans is a fast and convenient detection model for pathogenic bacteria virulence examinations.
Jasmonic acid contributes to rice resistance against Magnaporthe oryzae
Authors: Ma Junning , Morel Jean-Benoît , Riemann Michael , Nick Peter
Published: December 2022

Background

The annual yield losses caused by the Rice Blast Fungus, Magnaporthe oryzae, range to the equivalent for feeding 60 million people. To ward off infection by this fungus, rice has evolved a generic basal immunity (so called compatible interaction), which acts in concert with strain-specific defence (so-called incompatible interaction). The plant-defence hormone jasmonic acid (JA) promotes the resistance to M. oryzae, but the underlying mechanisms remain elusive. To get more insight into this open question, we employ the JA-deficient mutants, cpm2 and hebiba, and dissect the JA-dependent defence signalling in rice for both, compatible and incompatible interactions.

Results

We observe that both JA-deficient mutants are more susceptible to M. oryzae as compared to their wild-type background, which holds true for both types of interactions as verified by cytological staining. Secondly, we observe that transcripts for JA biosynthesis (OsAOS2 and OsOPR7), JA signalling (OsJAZ8, OsJAZ9, OsJAZ11 and OsJAZ13), JA-dependent phytoalexin synthesis (OsNOMT), and JA-regulated defence-related genes, such as OsBBTI2 and OsPR1a, accumulate after fungal infection in a pattern that correlates with the amplitude of resistance. Thirdly, induction of defence transcripts is weaker during compatible interaction.

Conclusion

The study demonstrates the pivotal role of JA in basal immunity of rice in the resistance to M. oryzae in both, compatible and incompatible interactions.
Reconstruction of karyotypic evolution in Saccharum spontaneum species by comparative oligo-FISH mapping
Authors: Meng Zhuang , Wang Fei , Xie Quanliang , Li Rong , Shen Haitao , Li Hongbin
Published: December 2022

Background

Karyotype dynamics driven by chromosomal rearrangements has long been considered as a fundamental question in the evolutionary genetics. Saccharum spontaneum, the most primitive and complex species in the genus Saccharum, has reportedly undergone at least two major chromosomal rearrangements, however, its karyotypic evolution remains unclear.

Results

In this study, four representative accessions, i.e., hypothetical diploid sugarcane ancestor (sorghum, x = 10), Sa. spontaneum Np-X (x = 10, tetraploid), 2012–46 (x = 9, hexaploid) and AP85–441 (x = 8, tetraploid), were selected for karyotype evolution studies. A set of oligonucleotide (oligo)-based barcode probes was developed based on the sorghum genome, which allowed universal identification of all chromosomes from sorghum and Sa. spontaneum. By comparative FISH assays, we reconstructed the karyotype evolutionary history and discovered that although chromosomal rearrangements resulted in greater variation in relative lengths of some chromosomes, all chromosomes maintained a conserved metacentric structure. Additionally, we found that the barcode oligo probe was not applicable for chromosome identification in both Sa. robustum and Sa. officinarum species, suggesting that sorghum is more distantly related to Sa. robustum and Sa. officinarum compared with Sa. spontaneum species.

Conclusions

Our study demonstrated that the barcode oligo-FISH is an efficient tool for chromosome identification and karyotyping research, and expanded our understanding of the karyotypic and chromosomal evolution in the genus Saccharum.
Effect of the COVID-19 outbreak on emergency transport of children by an emergency medical service system: a population-based, ORION registry study
Authors: Ota Koshi , Nishioka Daisuke , Katayama Yusuke , Kitamura Tetsuhisa , Masui Jun , Ota Kanna , Nitta Masahiko , Matsuoka Tetsuya , Takasu Akira
Published: December 2022

Background

Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2, has spread rapidly around the world.

Objective

To assess the effect of the COVID-19 pandemic on the emergency medical service (EMS) and hospital admission course for children transported by ambulance.

Methods

This study was a retrospective, descriptive study with a study period from January 1, 2018 to December 31, 2020 using the Osaka Emergency Information Research Intelligent Operation Network (ORION) system. All children who were transported by ambulance in Osaka Prefecture were included. The main outcome of this study was the rate of difficult-to-transfer cases, which was calculated by univariate and multivariate Poisson regression analyses.

Results

Over the 3 years between January 1, 2018 and December 31 2020, 1,436,212 patients were transported to hospitals by ambulances in Osaka Prefecture, with children accounting for 102,473 (37,064, 39,590, and 25,819, in 2018, 2019, and 2020, respectively). Poisson regression analysis showed that children were negatively associated with difficult-to-transfer cases (risk ratio (RR) 0.35, 95% CI 0.33 to 0.37). With reference to 2018, 2020 was not significantly associated with difficult-to-transfer cases in children (RR 1.14, 95% CI 0.99 to 1.32, P = 0.075), but was significantly related (RR 1.24, 95% CI 1.21 to 1.27, P < 0.001) to difficult-to-transfer cases in the general population.

Conclusion

Children were consistently associated with a reduced RR for difficult-to-transfer cases, even in the COVID-19 pandemic in 2020.
Role of metabolic equivalent between calcium intake and vertebral fractures: a cross-sectional study of NHANES 2013–2014
Authors: Yu Hecheng , Tao Zhiqiang , Luo Xiaoming , Huang Ben , Zhou Longdian
Published: December 2022

Background

This study was to analyze the association of calcium intake and metabolic equivalent (MET) with vertebral fractures, and to explore the role of MET between calcium intake and vertebral fractures.

Method

This cross-sectional study used data from the National Health and Nutrition Examination Surveys (NHANES) 2013–2014. The study involved individuals aged ≥ 50 years old with complete information on vertebral fracture, calcium intake, and physical activity. Vertebral fracture assessment is obtained using dual-energy x-ray absorptiometry to perform a lateral scan of the thoracolumbar spine. Calcium intake included total nutrient intake and total dietary supplements. The total MET is the sum of the METs for each activity (Vigorous/ moderate work-related activities, walking or bicycling for transportation and vigorous/ moderate recreational activities). Univariate and multivariate logistic regression analyses were utilized to investigate the effect of calcium intake, MET, and their combined effect on vertebral fracture.

Results

A total of 766 participants were included in the analysis, and 54 participants had vertebral fractures. The median calcium intake and MET were 8.43 mcg and 280.00, respectively. Multivariate results showed that neither calcium intake nor MET as continuous or categorical variables was significantly associated with vertebral fractures. MET < 160 and calcium intake ≥ 670 mg group was associated with the decreased risks of vertebral fracture [odds ratio (OR) = 0.47, 95% confidence interval (CI): 0.26–0.83, P = 0.032] after adjusting for age, race, energy, total femur bone mineral density (BMD), and femoral neck BMD. In the group of MET < 160, increased calcium intake was associated with a reduced risk of vertebral fracture, with a decreased OR value. In the group of MET ≥ 160, increased calcium intake was associated with an increased risk of vertebral fracture, with an increased OR value.

Conclusion

The combination of MET < 160 and calcium intake ≥ 670 mg was associated with decreased risks of vertebral fractures. There may be an interaction between calcium intake and MET on vertebral fracture risk.
Xerostomia, the perception of general and oral health and health risk behaviours in people over 65 years of age
Authors: Pérez-Jardón Alba , Pérez-Sayáns Mario , Peñamaría-Mallón Manuel , Otero-Rey Eva , Velasco-Ortega Eugenio , López-López José , Martínez-González José María , Blanco-Carrión Andrés
Published: December 2022

Background

This study investigated the association between xerostomia and health risk behaviours, general and oral health and quality of life.

Methods

A cross-sectional study involving 800 adults over 65 years of age residing in Spain using a computer-assisted telephone questionnaire. The severity of xerostomia was assessed through the Xerostomia Inventory (XI). Both univariate and adjusted multinomial logistic regression were used to determine the risk (OR) of xerostomia.

Results

The sample comprised of 492 females (61.5%) and 308 males, with a mean age of 73.7 ± 5.8 years. Some, 30.7% had xerostomia: 25.6% mild, 4.8% moderate and 0.3% severe, the majority being female (34.8% vs 24%; p = 0.003). The mean XI was 24.6 ± 6.3 (95% CI 19.2–24.8) for those with poor health, whereas it was 17.4 ± 6.3 (95%CI 16.1–18.6) in those reporting very good health (p < 0.001). This difference was also observed in terms of oral health, with the XI mean recorded as 14.7 ± 10.7 for very poor oral health and 6.4 ± 5.4 for those with very good health (p = 0.002). Logistic regression showed that the highest OR for xerostomia was observed among adults with poor general health (2.81; 95%CI 1.8–4.3; p < 0.001) and for adjusted model the OR was still significant (2.18; 95%CI 1.4–3.4; p = 0.001). Those who needed help with household chores had 2.16 higher OR (95%CI 1.4–3.4; p = 0.001) and 1.69 (95%CI 1.1–2.7; p = 0.03) in the adjusted model. Females had a higher risk of suffering from xerostomia than males.

Conclusion

The strong association between xerostomia and the general and oral health status of older adults justifies the need for early assessment and regular follow-up.
Low LH level does not indicate poor IVF cycle outcomes with GnRh-a single trigger: a retrospective analysis
Authors: Li Xue-Fei , Wang Qiao-Feng , He Qi-Qi , Wang Xue-Jiao , LV Xing-Yu , Tang Xiao-Jun , Zhong Zhao-Hui , Ding Yu-Bin , Wan Qi
Published: December 2022

Objective

To compare the in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle outcomes between patients with low and normal serum luteinizing hormone (LH) levels on the day after a gonadotropin-releasing hormone agonist (GnRH-a) single trigger. We further investigated the efficacy of human chorionic gonadotropin (hCG) retrigger on IVF cycle outcomes in patients with low LH levels after GnRH-a single trigger.

Methods

We retrospectively analyzed 957 infertile patients (tubal factor, ovulation disorders, male sperm factor, or unexplained infertility) who were treated with IVF/ICSI at the Chengdu Xinan Gynecology Hospital from July 2017 to December 2020. Patients received sufficient GnRH-a single trigger were divided into two groups based on the serum LH levels on the next day of trigger: normal serum LH levels (≥ 10 mIU/mL) group (control group, n = 906) and low LH levels (< 10 mIU/mL) group (experimental group, n = 51). And the efficacy of hCG retrigger on IVF/ICSI cycle outcomes in 10 patients with low LH levels after GnRH-a single trigger.

Results

There were no significant differences in IVF/ICSI cycle outcomes, including egg yield, two pronuclei fertilization rate, excellent embryo rate, or live birth rate of frozen-thawed embryos between patients with low and normal LH levels after GnRH-a trigger. It showed significantly higher risk of ovarian hyperstimulation syndrome in the group of low LH levels [ 0.7%(1/137) vs. 8.5%(4/47), P = 0.016] compared with the group of normal LH levels who received GnRH-a single trigger. The hCG retrigger had no obvious efficacy on cycle outcomes in patients with low LH levels, including oocytes retrieved, fertilization rate, embryo conditions, and live birth rate of frozen-thawed cycles.

Conclusion

The IVF/ICSI cycle outcomes of patients with low LH levels on the day after GnRH-a administration were similar to those of patients with normal LH levels. Blood LH test might not be required on the day following the trigger. The hCG retrigger did not have any effect on the cycle outcomes, suggesting that immediate retriggering with hCG was unnecessary.
Self-assembled DNA nanostructure containing oncogenic miRNA-mediated cell proliferation by downregulation of FOXO1 expression
Authors: Kar Avishek , Kumari Kanchan , Mishra Sandip K. , Subudhi Umakanta
Published: December 2022

FOXO1 transcription factor not only limits the cell cycle progression but also promotes cell death as a tumor suppressor protein. Though the expression of FOXO1 is largely examined in breast cancer, the regulation of FOXO1 by miRNA is yet to be explored. In the current study, self-assembled branched DNA (bDNA) nanostructures containing oncogenic miRNAs were designed and transfected to the MCF7 cell line to decipher the FOXO1 expression. bDNA containing oncogenic miRNAs 27a, 96, and 182 synergistically downregulate the expression of FOXO1 in MCF7 cells. The down-regulation is evident both in mRNA and protein levels suggesting that bDNA having miRNA sequences can selectively bind to mRNA and inhibit translation. Secondly, the downstream gene expression of p21 and p27 was also significantly downregulated in presence of miR-bDNA nanostructures. The cell proliferation activity was progressively increased in presence of miR-bDNA nanostructures which confirms the reduced tumor suppression activity of FOXO1 and the downstream gene expression. This finding can be explored to design novel bDNA structures which can downregulate the tumor suppressor proteins in normal cells and induce cell proliferation activity to identify early-phase markers of cancer.
Determinants of cervical cancer screening utilization among women attending health facilities of Dessie town, Northeast Ethiopia
Authors: Assefa Tilahun , Arefaynie Mastewal , Mebratu Wondwosen , Mohammed Anissa , Addisu Elsabeth , Kebede Natnael
Published: December 2022

Introduction

Despite the higher burden of cervical cases, screening programs in highly affected developing countries remained low. This made the disease to be present at an advanced stage which is almost always fatal, causing enormous pain and suffering for the individual and having significant adverse effects on the welfare of their families and community. Thus, this study aimed to assess determinants of cervical cancer screening utilization among women attending health facilities in Dessie Town, Northeast Ethiopia.

Methods

An institution-based unmatched case–control study design was employed on 430 women (146 cases and 284 controls) at selected health facilities of Dessie town, South Wollo Zone, from July 1/2020 to August 30/2020. Cases were selected for all women screened for cervical cancer during the data collection period until the required sample size was attained and using a consecutive sampling technique, every 3 participants from women who come for services other than cervical cancer screening. were included as controls. Pretested and structured questionnaires were used to collect the data. Data were analyzed by SPSS version 25 software. Bivariable and multivariable logistics regression analysis was done. An adjusted odds ratio with 95% CI was estimated to measure the strength of the association. The level of statistical significance was declared at a p-value < 0.05.

Result

Age group of 35 and more [AOR = 11.52(6.09–21.77)], being a private employee [AOR = 4.67(2.41–9.03)], having symptoms of vaginal bleeding or pelvic pain or postcoital bleeding or vaginal discharge [AOR = 3.08(1.37–6.95)], being recommended by a physician for screening [[AOR = 3.07(1.45–6.49)] and positive attitude towards cervical cancer screening [AOR = 5.3(2.8–10.59)] were determinants of cervical cancer screening.

Conclusion

Age group of 35 and more, current occupation as a private employee, having symptoms of cervical cancer, being recommended by a physician for screening, and positive attitude towards cervical cancer screening were determinants of cervical cancer screening utilization.
Analysis of macular blood flow changes in thyroid associated ophthalmopathy
Authors: Zhang Xiaohan , Liu Wangyuan , Zhang Zhaode , Dai Jinhui , Zhang Jinfeng , Lin Lingli
Published: December 2022

Background

To evaluate the changes in macular superficial retinal vessel density and their relation with visual acuity in thyroid-associated ophthalmopathy (TAO) patients with different severity.

Methods

This cross-sectional observational study included 70 TAO patients and 70 healthy controls. Only data from the right eyes were analyzed. TAO patients were divided into 7 subgroups according to the NOSPECS score. Foveal avascular zone (FAZ), vascular density (VD), and perfusion density (PD) of macular 1 mm diameter and 6 mm diameter areas were measured by optical coherence tomography angiography (OCTA).

Results

In TAO patients, significant increases were found in macular and foveal vascular densities (FVD) and perfusion densities (FPD) while a significant decrease was found in the FAZ area when compared with the control group (p < 0.05). Spearman correlation analysis and multiple linear regression analysis showed that TAO severity grade was negatively correlated with FVD (β = -1.150, p = 0.032), FPD (β = -0.024, p = 0.042), MVD (β = -0.583, p = 0.020) and MPD (β = -0.011, p = 0.010). Clinical activity score (CAS) score showed positive correlation with FVD (β = 0.794, p = 0.035) and FPD(β = 0.017, p = 0.041). FVD (β = -0.009, p = 0.033), MVD(β = -0.034, p < 0.001), FPD(β = -0.416, p = 0.039) and MPD(β = -2.428, p < 0.001) all showed negative correlation with best corrected visual acuity (BCVA).

Conclusions

There was an overall increase in superficial macular blood flow in TAO patients compared with healthy controls and the blood flow decreased as TAO got worse. Superficial macular flow density was negatively correlated with BCVA.
Histopathological dimensions differ between aganglionic and ganglionic bowel wall in children with Hirschsprung’s disease
Authors: Graneli Christina , Patarroyo Sofia , Mitev Rodrigo Munoz , Gisselsson David , Gottberg Emilia , Erlöv Tobias , Jansson Tomas , Hagelsteen Kristine , Cinthio Magnus , Stenström Pernilla
Published: December 2022

Background

In the validation of new imaging technology for children with Hirschsprung’s disease (HSCR), basic anatomical parameters of the bowel wall must be established specifically for this patient group.

Aim

To explore differences in histoanatomical layers of bowel wall, comparing ganglionic and aganglionic bowel walls, and to examine if the bowel wall thickness is linked to patient weight.

Methods

This was an observational study of bowel specimens from children weighing 0–10 kg, operated on consecutively during 2018–2020. Ganglionic and aganglionic bowel walls were measured in digitalized microscopy images from 10 sites per trans-sectional specimen and compared regarding the thickness of their histoanatomical layers.

Results

Bowel walls were measured in 21 children. Full bowel wall thickness did not differ between aganglionic and ganglionic bowel (2.20 vs 2.04; p = 0.802) while weight at surgery correlated positively with both ganglionic and aganglionic bowel wall thickness (r = 0.688 and 0.849, respectively), and age at surgery with ganglionic bowel wall thickness (r = 0.517). In aganglionic segments, the muscularis externa layer was thicker compared to that in ganglionosis (0.45 vs 0.31 mm, p = 0.012) whereas the muscularis interna was thinner (0.45 vs 0.62 mm, p < 0.001). A diagnostic index was identified whereby a lower ratio of muscularis interna/externa thickness followed by a thinner muscularis interna differed between aganglionic and ganglionic bowel in all specimens.

Conclusion

Thicknesses of the bowel wall’s muscle layers differ between aganglionic and ganglionic bowel walls in children with HSCR. These findings support a diagnostic index that could be validated for transfer to instant diagnostic imaging techniques.

Level of evidence

Diagnostic: 3
Postpartum depression crisis since the second lockdown and ‘screening paradox’: many women identified, very few treated
Authors: Chrzan-Dętkoś Magdalena , Walczak-Kozłowska Tamara
Published: December 2022

Objective

Exposure to stressful situations, such as emergencies, infectious diseases, and natural disasters, may lead to a heightened risk of perinatal mental health problems. Declared on March 11th, 2020, the global COVID-19 pandemic triggered an additional burden on women in the perinatal period. Safety recommendations, such as social distancing and isolation, were opposite to the usual advice given to new mothers. Besides fear, changes in financial stability and daily life reorganization contributed to increased depressive symptoms. As the periods of epidemic waves and lockdowns were associated with a more significant burden for young families, we aimed to assess the intensification of depressive and anxiety symptoms during the pandemic concerning the time intervals of the three lockdowns introduced in Poland. Methods: 1588 postpartum women took part in the online self-assessment with the Edinburgh Postnatal Depression Scale (EPDS) and General Anxiety Disorder 2 (GAD-2) questionnaire between January 1, 2020, and March 31, 2021. This self-screening is a part of a prevention program The Next Stop: Mum, implemented in the North of Poland.

Results

The highest severity of PPD symptoms and anxiety were observed during the second lockdown in Poland: the mean score in the EPDS and anxiety assessment was significantly higher than the mean scores from previous pandemic periods. Since the second lockdown, the average EPDS and GAD-2 scores remained similarly high. Moreover, with the duration of the COVID-19 pandemic, the percentage of women with elevated symptoms of postpartum depression and anxiety began to increase. However, the Polish National Health Fund data indicate that only 0,7% of women giving birth in the northern macro-region of Poland received diagnosis and help from public funds. In The Next Stop: Mum project, 250 women benefited from psychological consultations.

Conclusion

Increased severity of depression and anxiety symptoms during the pandemic indicates the need for additional psychological support for postpartum women. However, very few women are diagnosed in health facilities in the first year postpartum and thus are rarely referred for further treatment. The study shows that the availability of services and the focus on social and individual barriers may be critical factors in implementing perinatal mental health programs and practices. This may be especially needed in a country where the screening obligation is new. In case of a further pandemic, policymakers and health care professionals should be aware that the duration of the restrictions and the repetition of lockdowns are associated with the aggravation of symptoms. The online screening without the possibility to discuss the results is only partially effective in increasing referrals for possibly affected women.
Modelling population responses to workplace minimum dietary standards introduced as workers return after social lockdowns
Authors: McCormick Benjamin J. J. , Scalco Andrea , Craig Tony , Whybrow Stephen , Horgan Graham. W. , Macdiarmid Jennie I.
Published: December 2022

Background

Diet norms are the shared social behaviours and beliefs about diets. In many societies, including the UK, these norms are typically linked to unhealthy diets and impede efforts to improve food choices. Social interactions that could influence one another’s food choices, were highly disrupted during the lockdowns in response to the COVID-19 pandemic. A return to workplaces and re-establishment of eating networks may present an opportunity to influence dietary norms by introducing minimum dietary standards to in workplaces, which could then spread through wider home and workplace networks.

Methods

An agent-based model was constructed to simulate a society reflecting the structure of a city population (1000 households) to explore changes in personal and social diet-related norms. The model tracked individual meal choices as agents interact in home, work or school settings and recorded changes in diet quality (range 1 to 100). Scenarios were run to compare individuals’ diet quality with the introduction of minimum dietary standards with degrees of working from home.

Results

The more people mixed at work the greater the impact of minimum standards on improving diet norms. Socially isolated households remained unaffected by minimum standards, whereas household members exposed directly, in workplaces or schools, or indirectly, influenced by others in the household, had a large and linear increase in diet quality in relation to minimum standards (0.48 [95% CI 0.34, 0.62] per unit increase in minimum standards). Since individuals regressed to the new population mean, a small proportion of diets decreased toward lower population norms. The degree of return to work influenced the rate and magnitude of change cross the population (-2.4 points [-2.40, -2.34] in mean diet quality per 20% of workers isolating).

Conclusions

These model results illustrate the qualitative impact social connectivity could have on changing diets through interventions. Norms can be changed more in a more connected population, and social interactions spread norms between contexts and amplified the influence of, for example, workplace minimum standards beyond those directly exposed. However, implementation of minimum standards in a single type of setting would not reach the whole population and in some cases may decrease diet quality. Any non-zero standard could yield improvements beyond the immediate adult workforce and this could spill between social contexts, but would be contingent on population connectivity.
“When people see me, they know me; they trust what I say”: characterizing the role of trusted sources for smoke risk communication in the Okanogan River Airshed Emphasis Area
Authors: Wood Leah M , D’Evelyn Savannah M , Errett Nicole A , Bostrom Ann , Desautel Cody , Alvarado Ernesto , Ray Kris , Spector June T
Published: December 2022

Introduction

As wildfire smoke events increase in intensity and frequency in the Pacific Northwest, there is a growing need for effective communication on the health risks of smoke exposure. Delivery through a trusted source or intermediary has been shown to improve reception of risk communication messages. This is especially salient in rural and tribal communities who may be hesitant to trust information from state and federal agency sources. This study aims to identify and characterize trusted sources for smoke risk information in the Okanogan River Airshed Emphasis Area (ORAEA), a rural region of North Central Washington state that is heavily impacted by smoke from wildfires and prescribed fire.

Methods

The research team conducted a qualitative study using data collected through key informant interviews and focus groups to assess the role of various sources and intermediaries in disseminating smoke risk information. We used a consensual coding approach in NVivo Qualitative Analysis Software to sort data into preliminary categories, which were grouped into themes using a thematic analysis approach. We used member checking and iterative feedback processes with local project partners throughout the project to ensure credibility of results.

Results

Through the analysis, we identified three themes characterizing trusted sources for smoke risk communication in the ORAEA. These themes were: (1) local and tribal sources of information are perceived as more trustworthy than state and federal government sources, (2) trustworthiness is determined by an evaluation of multiple factors, in particular, perceived credibility, quality of information, and relationship with the source, and (3) conservative political ideology and perceived parallels with COVID-19 communication influence perception of trust. Within each theme, we identified several sub-themes, which contributed additional nuance to our analysis.

Conclusion

This study provides insights into which sources of information are trusted by rural and tribal community members in the ORAEA and why. Results from our study emphasize the importance of relationships and collaboration with local and tribal partners in smoke risk communication. In this paper, we discuss implications for state and federal agency practitioners and present recommendations for how to work with local and tribal partners on smoke risk communication.
Inequalities in mortality associated with housing conditions in Belgium between 1991 and 2020
Authors: Otavova Martina , Faes Christel , Bouland Catherine , De Clercq Eva , Vandeninden Bram , Eggerickx Thierry , Sanderson Jean-Paul , Devleesschauwer Brecht , Masquelier Bruno
Published: December 2022

Background

Poor housing conditions have been associated with increased mortality. Our objective is to investigate the association between housing inequality and increased mortality in Belgium and to estimate the number of deaths that could be prevented if the population of the whole country faced the mortality rates experienced in areas that are least deprived in terms of housing.

Methods

We used individual-level mortality data extracted from the National Register in Belgium and relative to deaths that occurred between Jan. 1, 1991, and Dec. 31, 2020. Spatial and time-specific housing deprivation indices (1991, 2001, and 2011) were created at the level of the smallest geographical unit in Belgium, with these units assigned into deciles from the most to the least deprived. We calculated mortality associated with housing inequality as the difference between observed and expected deaths by applying mortality rates of the least deprived decile to other deciles. We also used standard life table calculations to estimate the potential years of life lost due housing inequality.

Results

Up to 18.5% (95% CI 17.7–19.3) of all deaths between 1991 and 2020 may be associated with housing inequality, corresponding to 584,875 deaths. Over time, life expectancy at birth increased for the most and least deprived deciles by about 3.5 years. The gap in life expectancy between the two deciles remained high, on average 4.6 years. Life expectancy in Belgium would increase by approximately 3 years if all deciles had the mortality rates of the least deprived decile.

Conclusions

Thousands of deaths in Belgium could be avoided if all Belgian neighborhoods had the mortality rates of the least deprived areas in terms of housing. Hotspots of housing inequalities need to be located and targeted with tailored public actions.
Association of duration of undernutrition with occurrence of tuberculosis
Authors: Park Jiho , Yoon Ji Hyun , Ki Hyun Kyun , Eun Yeonghee , Han Kyungdo , Kim Hyungjin
Published: December 2022

Undernutrition is a risk factor of tuberculosis (TB), but the association between duration of undernutrition and occurrence of TB is inconclusive. The objective of this study was to determine whether there is a difference in occurrence of TB according to the duration of undernutrition expressed as accumulated number of underweight in Republic of Korea, an intermediate TB burden country. The National Health Insurance database was used.

Eligible subjects were individuals who received a national health examination between 1 and 2009 and 31 December 2010, and who also had received health examinations for four consecutive years prior to 2009.

Finally included individuals in the analysis were followed until 31 December 2017. Accumulated number of underweight was defined as the number of times recorded as underweight over four consecutive years. The outcome of the study was newly diagnosed TB according to accumulated number of underweight. Among a study population of 2,396,434, TB was identified in 9,322 (3.89%) cases. The highest accumulated number of underweight was significantly associated with occurrence of TB (adjusted hazard ratio [aHR] 2.563, 95% CI 2.319–2.833). This association remained consistent after adjusting for demographic factors and underlying diseases (aHR 3.326, 95% CI 3.004–3.84). In stratified analysis based on age, sex, diabetes (DM), hypertension (HTN), and waist circumference (WC) in metabolic syndrome (MS), age and sex were identified as effect modifiers. Occurrence of TB was significantly higher in the group with the highest accumulated number of underweight under 65 years of age.
Accelerated tibia fracture healing in traumatic brain injury in accordance with increased hematoma formation
Authors: Shim Dong Woo , Hong Hyunjoo , Cho Kwang-Chun , Kim Se Hwa , Lee Jin Woo , Sung Seung-Yong
Published: December 2022

Background

Traumatic brain injury (TBI) has been known to accelerate bone healing. Many cells and molecules have been investigated but the exact mechanism is still unknown. The neuroinflammatory state of TBI has been reported recently. We aimed to investigate the effect of TBI on fracture healing in patients with tibia fractures and assess whether the factors associated with hematoma formation changed more significantly in the laboratory tests in the fractures accompanied with TBI.

Methods

We retrospectively investigated patients who were surgically treated for tibia fractures and who showed secondary bone healing. Patients with and without TBI were divided for comparative analyses. Radiological parameters were time to callus formation and the largest callus ratio during follow-up. Preoperative levels of complete blood count and chemical battery on admission were measured in all patients. Subgroup division regarding age, gender, open fracture, concomitant fracture and severity of TBI were compared.

Results

We included 48 patients with a mean age of 44.9 (range, 17–78), of whom 35 patients (72.9%) were male. There were 12 patients with TBI (Group 1) and 36 patients without TBI (Group 2). Group 1 showed shorter time to callus formation (P <  0.001), thicker callus ratio (P = 0.015), leukocytosis and lymphocytosis (P ≤ 0.028), and lower red blood cell counts (RBCs), hemoglobin, and hematocrit (P <  0.001). Aging and severity of TBI were correlated with time to callus formation and callus ratio (P ≤ 0.003) while gender, open fracture, and concomitant fracture were unremarkable.

Conclusion

Tibia fractures with TBI showed accelerated bone healing and superior measurements associated with hematoma formation (lymphocytes, RBCs, hemoglobin, hematocrit). Promoted fracture healing in TBI was correlated with the enhanced proinflammatory state.

Level of evidence

III, case control study.
Walking speed is associated with postoperative pain catastrophizing in patients with lumbar spinal stenosis: a prospective observational study
Authors: Wada Takashi , Tanishima Shinji , Kitsuda Yuki , Osaki Mari , Nagashima Hideki , Noma Hisashi , Hagino Hiroshi
Published: December 2022

Background

The purpose of this study was to investigate whether walking speed is associated with postoperative pain catastrophizing in patients with lumbar spinal stenosis.

Methods

In this prospective observational study, consecutive patients with clinically and radiologically defined lumbar spinal stenosis underwent surgical treatment (decompression, or posterolateral or transforaminal lumbar interbody fusion) at Tottori University Hospital, between October 2015 and April 2018. The pain catastrophizing scale, walking speed, leg and back pain (numerical rating scale), and Japanese Orthopaedic Association score were evaluated preoperatively and at 3, 6, and 12 months postoperatively. Correlations between the pain catastrophizing scale and each variable were analyzed at each evaluation time point. The effect of walking speed on the pain catastrophizing scale was analyzed using mixed-effect models for repeated measurements.

Results

Ninety-four patients were included at baseline, and 83, 88, and 82 patients were analyzed at 3, 6, and 12 months postoperatively, respectively. The pain catastrophizing scale was significantly correlated with walking speed, leg pain, back pain, and the Japanese Orthopaedic Association score at all evaluation time points. The pain catastrophizing scale was associated with walking speed at all evaluation time points.

Conclusions

Our results suggest that changes in postoperative pain catastrophizing after lumbar spine surgery are associated with walking speed. Thus, walking speed is a necessary assessment for the management of pain catastrophizing and associated pain and disability in patients after lumbar spine surgery.
Diagnostic errors in Dentistry, opinions of egyptian dental teaching staff, a cross-sectional study
Authors: El-Wakeel Naglaa , Ezzeldin Naglaa
Published: December 2022

Background

Diagnostic errors is a known problem in healthcare practice. Data on diagnostic errors in the dental field are extremely lacking. The objective of the study is to explore the perception of dental teaching staff about the prevalence of dental diagnostic errors in Egypt, identify the most commonly misdiagnosed dental conditions and point out the contributing factors and levels of patient harm.

Methods

A cross-sectional questionnaire-based study was conducted on 151 dental teaching staff of Egyptian governmental and private universities. The questionnaire was distributed electronically via social media and messaging apps to dental staff members with at least five years of clinical experience to assess their opinion regarding the study objectives. Results were collected and statistically analyzed.

Results

94.7% of participants believed that diagnostic errors represent an urgent problem, lecturers believed by 2.703 folds more than professors that diagnostic errors are an urgent problem The percentage of diagnostic errors was estimated to be < 20% and 20–40% by more than 90% of participants. The most commonly misdiagnosed conditions were oral mucosal lesions (83.4%), followed by temporomandibular joint and periodontal conditions (58.9%) for each. More than half of the participants (60.9%) believe that medical education methodology is one of the factors that lead to dental diagnosis errors. For the impact of errors on patients, 53% of participants reported moderate impacts followed by minor impact (37.7%) while 4.6% reported no impact and the same percentage reported major impact.

Conclusion

This study with statistically significant results reported that dental diagnostic errors are frequent and need to be approached. Oral mucosal lesions, periodontal and temporomandibular joint diseases represent areas that include the most commonly seen errors. Further, besides the lack of resources, the dental education system and lack of proper training are the main causes of this problem.
The analysis of National Health Accounts and financial communications network in Iran health insurance ecosystem
Authors: Rahimisadegh Rohaneh , Mehrolhassani Mohammad Hossein , Jafari Sirizi Mohammad , Noori Hekmat Somayeh
Published: December 2022

Background

One of the major reforms in the health system of any country is the financing reform. Network analysis as a practical method for investigating complex systems allows distinguishing prominent actors in the relation networks. Leading to the identification of the effective actors and key links between them, the analysis of financial networks helps policymakers to implement reformations by providing appropriate evidence. This study aimed to design and analyze the network of National Health Accounts (NHA) and the cost network in the Iran health insurance ecosystem.

Methods

The present study is a network analysis study based on the data from NHA, and both cost and referral rates that was conducted in 2021. Data, which was for the years 2014 to 2018 and related to NHA, was collected from the Statistical Center of Iran, and cost data and referral rates, which were both related to Basic Insurance Organizations (BIOs), were collected from statistical yearbooks. To analyze the network and identify the key actors, macro indicators, such as network size and density, and micro indicators, such as centrality indicators and the combined importance index, were used.

Results

In the financing of the health system in Iran, insurance organizations, as agents and sources of financing, do not have a very good position, so direct payments have become a key element in the network of NHA. Providing treatment-oriented services is quite prior. Regarded to health services, hospitals and outpatient services, such as pharmacies and physicians are the key elements of cost and referral rates respectively.

Conclusion

Consisting of several organizations with different insurance policies and being supervised under different ministries, Iran's health financing system lacks a coherent structure. It is suggested to create a coherent insurance system by creating a single governance system and paying more attention to health-oriented instead of treatment-oriented services. The health insurance ecosystem has become a health-oriented system to reduce the direct payments as well as cost management.