bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptom clusters in patients with colorectal cancer after colostomy: a longitudinal study in Shanghai
Authors: Hao Jianling , Gu Liyan , Liu Peng , Zhang Lingjuan , Xu Honglian , Qiu Qun , Zhang Wei 
Published: December 2021

Objective Research is lacking regarding the experiences of patients after colostomy, which is needed so as to take necessary specific actions. In this study, we aimed to describe the trajectory of symptom clusters experienced by patients after colostomy over time. Methods This was a longitudinal observational study using data from 149 patients with colorectal cancer after colostomy. We investigated symptoms and symptom clusters at 2 weeks, 1 month, 3 months, 6 months, and 1 year after colostomy. Results Four main symptom clusters were identified, including a psychological symptom cluster, digestive and urinary symptom cluster, lack of energy symptom cluster, and pain symptom cluster in patients after colostomy in the first year after surgery. We further explored the symptom trajectory. Conclusions We explored symptom clusters and the trajectory of symptom resolution in patients after colostomy during the first year after surgery. Four stages were proposed to describe the different statuses of symptom clusters experienced by patients. Our findings may provide insight into how to improve symptom management and postoperative quality of life for patients after colostomy.
Genotype Effects on β-Carotene Conversion to Vitamin A: Implications on Reducing Vitamin A Deficiency in the Philippines
Authors: Zumaraga Mark Pretzel P. , Arquiza Jose Maria Reynaldo Apollo , Concepcion Mae Anne , Perlas Leah , Alcudia-Catalma Ma. Neda , Rodriguez Marietta 
Published: December 2021

Background: The study aimed to identify 2 beta-carotene 15,15′-monooxygenase (BCMO1) mutations, namely R267S and A379V, and determine their association with vitamin A status among Filipinos 6 to 19 years old respondents of the 2013 Philippine National Nutrition Survey living in the National Capital Region. Materials and Methods: This study followed cross-sectional design. Whole blood specimen was collected in the morning and was used as source of genomic DNA and serum for retinol concentration determination. Fisher exact test was performed to determine whether genotype frequencies were associated to retinol concentrations/vitamin A deficiency status. A level of P < .05 was identified as significant. Results: A total of 693 Filipino children and adolescents were included. Of the 693, there were at least 7.6% who bear the combined mutations for R267S + A379V. Association analysis showed that an inverse relationship exists between the A379V TT variant and vitamin A status, although the exact role of these identified polymorphisms on retinol/carotenoid metabolism need to be confirmed in dedicated functional studies. Conclusion: This study has identified for the first time the presence of 2 nonsynonymous genetic variants/mutations in the coding region of BCMO1 gene. Interestingly, one of these 2 variants, the A379V T, was found to be associated with vitamin A status. It is, therefore, warranted to investigate the role of BCMO1 variants for the success of supplementation programs and fortification efforts among vulnerable populations in this region. Genetic variability should be considered for future provitamin A supplementation recommendations among children and adolescents in the Philippines.
Fecal Bacterial Communities Differ by Lactation Status in Postpartum Women and Their Infants
Authors: Haddad Eliot N. , Ferro Lynn E. , Russell Kathleen E. B. , Sugino Kameron Y. , Kerver Jean M. , Comstock Sarah S. 
Published: December 2021

Background: Previous research examined effects of human milk on the infant gut microbiota, but little attention has been given to the microbiota of lactating women. Research Aim: To determine associations between exclusive human milk feeding and gut microbiota characteristics in mothers and infants at 6-weeks postpartum. Methods: A sample of mother–infant dyads ( N = 24) provided fecal samples and questionnaire responses at 6-weeks postpartum as part of the Pregnancy, EAting & POstpartum Diapers study. Deoxyribonucleic acid was extracted from stool samples, followed by (V4) 16S ribosomal ribonucleic acid gene amplicon sequencing. Alpha and beta diversity, in addition to taxa differences, were compared by human milk exposure status, exclusive versus non-exclusive. A subset of dyads (those exclusively fed human milk; n = 14) was analyzed for shared bifidobacterial species using polymerase chain reaction. Results: Alpha diversity was significantly lower in exclusively human milk-fed infants. Maternal lactation status (exclusive vs. partial) and Shannon diversity were associated in univariate analysis but were no longer associated in multivariable regression including body mass index category in the model. Beta diversity (Sorensen dissimilarity) of fecal samples from women and infants was significantly associated with human milk feeding. Of six infants with Bifidobacterium longum subspecies longum in their fecal samples, all their mothers shared the same species. Conclusion: Maternal gut microbiotas differ by lactation status, a relationship potentially confounded by body mass index category. Further research is needed to identify whether lactation directly influences the maternal gut microbiota, which may be another mechanism by which lactation influences health.
Ephemeral Traces: Archaeology of a Medieval Rural Settlement
Authors: Varma Supriya , Menon Jaya , Nair Deepak 
Published: December 2021

For a considerable span of human history, following the adoption of agricultural economies but prior to the emergence of settlements that we label as ‘urban’, small permanent communities or ‘villages’ were the main types of settlements, as also were places intermittently occupied by mobile, nomadic groups. The context of these, however, differed from those small or rural settlements that existed within an integrated network of centres in urban and state societies. A third scenario is the case of small-scale rural settlements that may exist at the margins of complex societies and, hence, outside state/political control but could still be socially and economically networked with other centres. Thus, the concept of ‘rural’ needs to be situated and interrogated within specific political, social and economic contexts. While archaeological research has addressed village settlements in pre-urban periods, once urbanism and the state societies emerged, urban settlements became the focus of attention. Even though surveys have shown the distribution of settlements of varying sizes, we do not seem to know much about early historic and medieval villages, in terms of settlement layouts, domestic spaces, crafts, if any, or even subsistence practices. It is this lacuna that we are trying to address through our work at a small, rural settlement in the Upper Ganga-Yamuna Doab. Some of the questions that we raise in this article deal with terms like ‘urban’, or ‘rural’, whether these should be viewed as binaries, or whether it may be more fruitful, as others have suggested, to see settlements in a continuum.
Carfilzomib-induced thrombotic microangiopathy. A case report
Authors: Scheggi Valentina , Merilli Irene , Cesaroni Edoardo , Alterini Bruno 
Published: December 2021

Introduction Drug-induced thrombotic microangiopathy (DITMA) is an acquired condition resulting from exposure to a drug that induces the formation of platelet-rich thrombi in small arterioles or capillaries secondary to drug-dependent antibodies or direct tissue toxicity. Carfilzomib is a selective proteasome inhibitor approved to treat selected patients with Multiple Myeloma (MM). It is one of the drugs with the strongest evidence for a causal association with non-antibody-mediated DITMA. Case Report A 75-year-old man presented to the emergency department for the outbreak of vomit, asthenia, oliguria and dark stool emission. He was recently diagnosed with multiple myeloma, treated with lenalidomide, dexamethasone and carfilzomib. Laboratory exams were significant for microangiopathic haemolytic anaemia, thrombocytopenia and new-onset renal failure. ADAMTS-13 levels were in range, and no infectious signs were found both in blood nor in stool test. Management & Outcome A carfilzomib induced thrombotic microangiopathy was soon suspected. Thus, since daily haemodialysis and supportive care did not seem to get a fast enough recovery, the patient was treated with eculizumab with a good general outcome. Discussion Drug-induced thrombotic microangiopathy is a rare and often life-threatening acquired condition whose diagnosis can be challenging and whose therapy is not always limited to supportive treatment and drug avoidance. Carfilzomib, along with other proteasome inhibitors, is one of the described potential drugs which can trigger such a manifestation.
Comparison of the effect of three intramuscular sedation protocols on packed cell volume and total protein in cats
Authors: Skelding Alicia M , Valverde Alexander 
Published: December 2021

Objectives The aim of this study was to evaluate the change in packed cell volume (PCV) and total protein following intramuscular preanesthetic sedation with one of three drug combinations in cats. Methods Thirty client-owned cats were enrolled in this prospective, randomized, blinded, clinical study. A venous blood sample was obtained prior to administration of any sedation and PCV, total protein, electrolytes (Na+, K+, Cl–, iCa2+), glucose and lactate were measured. Cats were randomly assigned to receive one of three intramuscular sedation protocols (n = 10 cats/protocol): methadone 0.2 mg/kg + acepromazine 0.02 mg/kg (MA), methadone 0.2 mg/kg + dexmedetomidine 5 µg/kg (MD) or methadone 0.2 mg/kg + midazolam 0.2 mg/kg + alfaxalone 2 mg/kg (MMA). Twenty-five minutes later, cats were assessed for level of sedation followed by another venous blood sampling to evaluate the same variables as above. Results There were no significant differences in demographics (age, weight, sex) between groups. Level of sedation was significantly higher in MMA cats. Within groups, after premedication, PCV and hemoglobin significantly decreased in all groups, total protein significantly decreased in the MA and MMA groups and glucose significantly increased in the MD group. For electrolytes, statistical changes were not clinically relevant; Cl– mean difference was significantly different between MA and MD; in the MD group Na+ and Cl– significantly decreased and in the MMA group Cl– significantly increased. Conclusions and relevance All three sedation protocols caused significant decreases in PCV and hemoglobin in healthy cats.
“If You Could Wave a Magic Wand”: Treatment Barriers in the Rural Midwest
Authors: Clark Angela , Lanzillotta-Rangeley Jennifer , Stem Jack 
Published: December 2021

Introduction: The multigenerational health considerations and negative economic impacts related to the opioid epidemic are many. Increasing numbers of opioid-related fatalities are bolstered by barriers related to access to evidence-based treatment. Ohio is ranked second in the country for number of opioid-related deaths, and for many their treatment needs remain unmet due to impaired access to effective treatment, in rural, medically underserved areas of the state. Purpose: The goal of this study was to assess opioid use disorder treatment barriers in order to increase access to evidence-based treatment, wrap around services, and harm reduction efforts to support the reintegration of persons with substance use disorder back into society and subsequently reduce opioid fatalities in a rural, medically underserved region of Ohio. Methods: As part of a larger mixed-methods study design where a community health survey was randomly distributed to residents in a rural county in Ohio, this study used qualitative methods to triangulate findings. To supplement the data received from the surveys, 20persons with a diagnosed opioid use disorder (OUD) took part in focus group sessions guided by trained researchers. The sessions were transcribed, and the data was analyzed using Braun and Clarke’s thematic analysis method. Results: Three major themes emerged from the data: epigenetics and exposure, management of disease including re-integration into society, and disease process. The participant data created insight regarding the need to recognize OUD as a chronic condition that must be addressed with integrated components of medical, behavioral, and mental health morbidities throughout the lifespan and across generations. Conclusions: Findings from this study support the need for targeted interventions for integrated care and improved wrap around services such as transportation, sober living, and employment.
Selection versus socialization effects of peer norms on adolescent cigarette use
Authors: Loan Christopher M , Khurana Atika , Wright Joanna , Romer Daniel 
Published: December 2021

Adolescent smokers tend to have friends who also smoke. This association has been attributed to peer socialization and peer selection effects. However, evidence regarding timing and relative magnitude of these effects is mixed. Using a random-intercept cross-lagged panel model, we examined the reciprocal relations between adolescent cigarette use and perceptions of friends’ cigarette use in a sample of 387 adolescents, assessed annually for 4 years. Adolescent cigarette use predicted increases in perceived friend use before the reverse effect emerged. Further, some of the effect of early adolescent cigarette use on subsequent use was mediated by changes in perceived friend use. The results support a greater role for friend selection than socialization in predicting early adolescent cigarette use.
Effects of telehealth interventions for adolescent sexual health: A systematic review and meta-analysis of randomized controlled studies
Authors: Saragih Ita Daryanti , Imanuel Tonapa Santo , Porta Carolyn M , Lee Bih-O 
Published: December 2021

Introduction Telehealth interventions to advance adolescent sexual health have evolved and are being used to promote adolescent sexual health knowledge and healthy sexual behaviors. However, as this area of intervention modality expands, there is a need to pause and examine the effects of telehealth interventions on adolescent sexual health outcomes. Addressing this knowledge gap will inform researchers and practitioners on the current state of evidence of telehealth interventions and inform further intervention development and testing. This study aimed to explore the meta-effects of telehealth interventions on self-efficacy of using condoms, condom use practices, and sexually transmitted infection testing behaviors among adolescents. Methods A systematic review and meta-analysis of randomized controlled trials were conducted. Seven databases (Academic Search Complete, CINAHL, EMBASE, MEDLINE, PubMed, OVID (UpToDate), and Web of Science) were searched for relevant full-text articles from the inception to May 2021. The revised Cochrane risk-of-bias tool for randomized trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random effects model to calculate the pooled effects of telehealth interventions for adolescents. Stata 16.0 was used for statistical analysis. Results A total of 15 studies ( N = 5499) that used telehealth interventions with adolescents were included in the analysis. Telehealth interventions were found to increase self-efficacy for condom use (standardized mean difference: 0.22; 95% confidence interval: 0.08–0.36), practice for condom use (standardized mean difference: 0.35; 95% confidence interval: 0.23–0.47), and being screened/tested for sexual transmitted infections (standardized mean difference: 0.61; 95% confidence interval: 0.31–0.92). Discussion Telehealth interventions show promise as effective intervention delivery solutions for improving self-efficacy and certain sexual health behaviors among adolescents. These telehealth strategies could be important alternatives to in-person visits to accessing sexual health information or services near where they live. Future research should consider testing telehealth strategies where there is evidence of impact to move the field forward.
Shorter average look durations to dynamic social stimuli are associated with higher levels of autism symptoms in young autistic children
Authors: Major Samantha , Isaev Dmitry , Grapel Jordan , Calnan Todd , Tenenbaum Elena , Carpenter Kimberly , Franz Lauren , Howard Jill , Vermeer Saritha , Sapiro Guillermo , Murias Michael , Dawson Geraldine 
Published: December 2021

Prior eye-tracking studies involving autistic individuals have focused on total looking time or proportion of looking time to key regions of interest. These studies have not examined another important feature, the ability to sustain attention to stimuli. In particular, the ability to sustain attention to a dynamic social stimulus might reflect more advanced self-regulatory skills that may enhance engagement with and comprehension of social information. In a sample of 155 autistic children (2–8 years of age), we examined children’s average look duration while they viewed a complex, dynamic stimulus containing both social and nonsocial elements. After accounting for children’s age and intelligence quotient, we found that shorter average look duration was associated with increased autism spectrum disorder severity across multiple clinical measures. To calculate average look duration, we divided the length of total looking time in seconds by the total number of uninterrupted looks to the video media. Thus, the ability to sustain attention while viewing complex dynamic information could be important for comprehending dynamic social information. Lay Abstract Many studies of autism look at the differences in how autistic research participants look at certain types of images. These studies often focus on where research participants are looking within the image, but that does not tell us everything about how much they are paying attention. It could be useful to know more about how well autistic research participants can focus on an image with people in it, because those who can look at images of people for longer duration without stopping may be able to easily learn other skills that help them to interact with people. We measured how long autistic research participants watched the video without breaking their attention. The video sometimes had a person speaking, and at other times had toys moving and making sounds. We measured the typical amount of time autistic research participants could look at the video before they looked away. We found that research participants with more severe autism tended to look at the video for shorter amounts of time. The ability to focus without stopping may be related to social skills in autistic people.
Promoting health equity in the health-care system: How can we identify potentially vulnerable patients?
Authors: Johnsen Anna Thit , Flink Christine Enevoldsen , Winther Katrina Pitt , Markussen Anne-Lene Rye , Lund Line , Pedersen Isabella , Rix Bo Andreasen , Kehlet Kristine Halling 
Published: December 2021

Background: There is documented social inequality in cancer. The health-care system may contribute to health equity by targeting interventions to potentially vulnerable patients who may be at risk of not receiving optimal treatment and care. Aim: This study aimed to develop and pilot test a tool to identify patients who may need additional support. Method: The study took place in a department of palliative medicine and in a team for head and neck cancer within an oncology department. The tool to identify potentially vulnerable patients was developed based on literature reviews and interviews with patients and health-care personnel. It was pilot tested in a six-month period, with subsequent interviews with health-care personnel. Results: In total, 212 consecutive patients referred to the departments were systematically screened with the tool by health-care personnel. Of these, 74 (35%) patients were considered potentially vulnerable. The most frequently reported sign of vulnerability was ‘few supportive relations’ (47% of the vulnerable patients). Most health-care personnel found it relevant to focus systematically on these patients. However, some were concerned that using the tool could prove to be stigmatising and were critical of attributing the vulnerability to the individual. Conclusions: Most patients were considered in need of additional support because they lacked a social network or had difficulties communicating with health-care personnel. Applying a tool to identify potentially vulnerable patients was feasible and increased attention to this group of patients. However, the screening procedure was also questioned.
Total patient load, regional disparities and in-hospital mortality of intubated COVID-19 patients in Greece, from September 2020 to May 2021
Authors: Lytras Theodore , Tsiodras Sotirios 
Published: December 2021

Aims: While healthcare services have been expanding capacity during the COVID-19 pandemic, quality of care under increasing patient loads has received less attention. We examined in-hospital mortality of intubated COVID-19 patients in Greece, in relation to total intubated patient load, intensive care unit (ICU) availability and hospital region. Methods: Anonymized surveillance data were analyzed from all intubated COVID-19 patients in Greece between 1 September 2020 and 6 May 2021. Poisson regression was used to estimate the hazard of dying as a function of fixed and time-varying covariates. Results: Mortality was significantly increased above 400 patients, with an adjusted hazard ratio of 1.25 (95% confidence interval (CI): 1.03–1.51), rising progressively up to 1.57 (95% CI: 1.22–2.02) for 800+ patients. Hospitalization outside an ICU or away from the capital region of Attica were also independently associated with significantly increased mortality. Conclusions: Our results indicate that in-hospital mortality of severely ill COVID-19 patients is adversely affected by high patient load even without exceeding capacity, as well as by regional disparities. This highlights the need for more substantial strengthening of healthcare services, focusing on equity and quality of care besides just expanding capacity.
Projections for obesity, smoking and hypertension based on multiple imputation
Authors: Reinikainen Jaakko , Härkänen Tommi , Tolonen Hanna 
Published: December 2021

Aims: Information on the future development of prevalences of risk factors and health indicators is needed to prepare for the forthcoming burden of disease in the population and to allocate resources properly for prevention. We aim to present how multiple imputation can be used flexibly to project future prevalences. Methods: The proposed approach uses data on repeated cross-sectional surveys from different years. We create future samples with age and sex distributions corresponding to the official national population forecasts. Then, the risk factors are simulated using multiple imputation by chained equations. Finally, the imputations are pooled to obtain the prevalences of interest. Covariates, such as sociodemographic variables as well as their possible interactions and non-linear terms, can be included in the modelling. The future development of these covariates is also projected simultaneously. We apply the procedure to data from five Finnish health examination surveys conducted between 1997 and 2017, and project the prevalences of obesity, smoking and hypertension to 2020 and 2025. Results: The prevalence of obesity is projected to increase to 24% for both men and women in 2025. The prevalences of hypertension and smoking are expected to continue decreasing, and the differences between men and women are projected to remain so that men will have higher prevalences. Conclusions: Simulation of future observations by multiple imputation can be used as a flexible yet relatively easy-to-use projection method.