Tag: pubmed

Health Res Policy Syst. 2024 Dec 24;22(1):176. doi: 10.1186/s12961-024-01268-7.

ABSTRACT

BACKGROUND: There is widespread enthusiasm for scaling interventions to strengthen health systems. However, little is known about the scalability of such interventions in Africa. In this study, we seek to assess the scalability of interventions for improving the functionality of health systems in Africa, as a key to large-scale implementation strategy of interventions with potential for impact.

METHODS: The study will deploy a multi-pronged approach, grounded in an integrated knowledge translation (iKT) approach. First, a multidisciplinary steering committee will be established, involving key female and male stakeholders in all stages of our study from its inception and as equal members of the research team for overseeing the project. Second, as part of the RAND/University of California, Los Angeles (UCLA) Appropriateness Method, evidence from a published systematic review will be used to develop the African Scalability Assessment Framework (AFROSAF), a series of multiple attributes for assessing the ability to scale a health system intervention in Africa. Third, the content of the AFROSAF will be validated using Delphi survey (within a deliberative dialogue) following the Lavis’ framework for knowledge transfer and a conceptual framework developed by Boyko et al. a multi-stakeholder consensus exercise with experts from Africa will be convened. The Likert scaled scalability attributes developed will be rated and descriptive statistics and hierarchical cluster analysis will be used to synthesize the data. Finally, document analyses will be conducted to rate to which extent each intervention has data that meet criteria responding to the essential components of scalability using the AFROSAF. We will conduct an analysis to score and rank each intervention for scalability.

DISCUSSION: This project proposes an approach aiming to catalyse the scale of interventions for effective functionality of health systems in Africa. The process will yield a scalability assessment tool for Africa and inventory scalable interventions. The findings will help African countries and policymakers understand the parameters to use and assess health system interventions for scaling.

PMID:39719642 | DOI:10.1186/s12961-024-01268-7

BMC Psychol. 2024 Dec 24;12(1):777. doi: 10.1186/s40359-024-02273-9.

ABSTRACT

OBJECTIVE: This study aimed to investigate a range of insomnia-related factors, including difficulty with sleep induction, nocturnal awakenings, early awakenings, total sleep time, overall sleep quality, well-being, functioning, and daytime drowsiness, to determine which variables were significantly associated with subsequent adolescent suicide attempts.

METHOD: A total of 782 students aged 11-16 years old from one middle school in Changsha, China completed the survey at baseline and 6 months follow-up with a prospective cohort design. The binary logistic regression models were used to analyze the associations between insomnia variables and suicide attempts during the 6 months follow-up.

RESULTS: The new incidence rate of suicide attempts was 4.60% (36/782) at 6-month follow-up. Insomnia was a significant predictor of incident suicide attempts (OR = 6.00; 95%CI, 2.47-14.60). After adjusting for age, gender, nationality, stress, anxiety and depression, insomnia was found to predict suicide attempts only among female (OR = 4.28; 95%CI, 1.41-12.98) and only nocturnal sleep disruption was significantly associated with an increased risk of suicide attempts (OR = 2.74; 95%CI, 1.32-5.71).

CONCLUSIONS: Nocturnal sleep disruption are independently associated with increased risk of suicide attempts. Intervention for nocturnal sleep disruption may be important for early identification as well as prevention of adolescent suicide, especially among adolescent girls.

PMID:39719641 | DOI:10.1186/s40359-024-02273-9

BMC Res Notes. 2024 Dec 24;17(1):383. doi: 10.1186/s13104-024-07057-3.

ABSTRACT

BACKGROUND: Measles is a very contagious illness that can be clinically diagnosed and intervened quickly. It is caused by the measles virus Morbillivirus. The disease has a case fatality rate of 5% to 10% in the sub-Saharan region. Recent information on measles forecasting is limited in this study area. Therefore, this study was aimed to assess the five-year trend and next five-year prediction of measles disease in East Gojjam zone, Amhara National Regional State (ANRS), Ethiopia, 2023.

METHODS: A descriptive study using case based surveillance data analysis in the East Gojjam zone was conducted. Five-year data (January 1/2018-December 30/2022) was extracted from the WHO database. ARIMA (3, 1, 1) model was used for disease forecasting for the next 5 years of the zone (2023-2027).

RESULTS: For the study, 1003 participants in total were enlisted. 12.3% of the subjects were IgM positive. About 59.4% and 1.2% were epidemiologically linked and died subjects, respectively. Many of the cases (54.2%) occurred in the March season and the lowest (1%) in December. For the next five years (2024-2027), it is predicted that the number of cases will rise gradually in fluctuation.

CONCLUSION: The disease had an upward trend over the five-year period, and for the next consecutive years, there will be a consistent increase in the number of cases in the zone. It is recommended that the East Gojjam Zone Health Office and different stakeholders have to monitor and evaluate the vaccination status of target children and vaccination coverage and strengthen the surveillance system in the dry-hot season, which is valuable for disease control.

PMID:39719640 | DOI:10.1186/s13104-024-07057-3

BMC Psychiatry. 2024 Dec 24;24(1):947. doi: 10.1186/s12888-024-06312-y.

ABSTRACT

BACKGROUND: This study explored the relationship between Adverse Childhood Experiences (ACE), physical pain, and depressive symptoms, and examined the mediating role of pain in the correlation between ACE and depressive symptoms among middle-aged and elderly Chinese (over the age of 45).

METHODS: Cox proportional hazards regression models were used to analysis the association between ACE, physical pain, and depressive symptoms. To assess the mediating role of physical pain in the relationship between ACE and depressive symptoms, mediation analysis was conducted. Indirect, direct, and total effects were estimated by combining mediation and outcome models, adjusting for relevant covariates. Bayesian network models were used to visually demonstrate the interrelations between factors influencing depressive symptoms, further verifying the association between ACE, physical pain, and depressive symptoms.

RESULTS: In the fully adjusted model, middle-aged and elderly individuals reporting ACE had a higher risk of developing depressive symptoms (hazard ratios [HR] and 95% confidence intervals [95% CI], 1.379 [1.266-1.503]). Compared to those without physical pain, individuals reporting severe physical pain were at an increased risk of depressive symptoms (HR [95% CI], 1.438 [1.235-1.673]). The risk was even higher for those with both ACE and severe physical pain compared to those with neither (HR [95% CI], 2.020 [1.630-2.505]). The intensity of pain explained 7.48% of the association between ACE and depressive symptoms, while the number of pain sites accounted for 7.86%.

CONCLUSIONS: Physical pain partially mediated the association between ACE and depressive symptoms. The study findings highlighted the importance of early screening and intervention for physical pain in middle-aged and older adults with ACE.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:39719627 | DOI:10.1186/s12888-024-06312-y

Reprod Health. 2024 Dec 24;21(1):197. doi: 10.1186/s12978-024-01931-w.

ABSTRACT

INTRODUCTION: Although the Government of Nepal has developed strategies to integrate contraceptive services with abortion care to better meet the contraceptive needs of women, data indicate that significant gaps in services remain. This paper assessed post-abortion contraceptive use, trends over 36 -months, and factors influencing usage.

METHODS: Data from this paper came from an ongoing cohort study of 1831 women who sought an abortion from one of the sampled 22 government-approved health facilities across Nepal. Women were interviewed eight times over 36 months between April 2019 to Dec 2023. Bivariate and multivariate analysis were used to analyze the data.

RESULTS: Results show that after abortion, 59% of women used modern contraception, with injection being the most prevalent method, followed by condoms, pills, implants, and IUD. The hazard model showed that discontinuation of modern contraception was significantly higher among women desiring additional children (aHR 0.62) and lower among literate (aHR – 0.15) and those with existing children (aHR – 0.30). Women’s age, ethnicity, cohabitation with husband, household’s income and autonomy were not associated with continuation.

CONCLUSION: After having an abortion, we found that just slightly more than half of women used modern methods of contraception; this percentage did not increase significantly over the course of three years.

PMID:39719611 | DOI:10.1186/s12978-024-01931-w

J Orthop Surg Res. 2024 Dec 24;19(1):872. doi: 10.1186/s13018-024-05372-w.

ABSTRACT

AIM: To evaluate the clinical efficacy and imaging outcomes of a domestically produced orthopedic surgical robot for total knee arthroplasty and to explore its applicability in patients with varying degrees of deformity.

METHODS: This study retrospectively included 120 patients who underwent TKA at our hospital between February 2023 and June 2024. The patients were divided into a control group (conventional TKA surgery) and an observation group (robot-assisted TKA surgery), with 60 patients in each group. Based on different lower extremity alignment angles, each group was further subdivided into mild deformities (Hip knee ankle angle (HKA angle)deviation < 10°) and significant deformities (HKA angle deviation ≥ 10°). Preoperative and postoperative HKA angles, range of motion (ROM), visual analog scale (VAS) pain scores, and Knee Society (AKS) scores were recorded for both groups. Postoperative measurements included the posterior tibial slope angle (PSA), femoral coronal component angle (FFC), tibial coronal component angle (FTC), and femoral sagittal component angle (LFC), as well as the incidence of abnormal values for each angle, which were analyzed statistically.

RESULTS: The operation time in the observation group was longer than that in the control group, but intraoperative blood loss was significantly lower in the observation group (P < 0.05). Postoperatively, the differences in the HKA and PSA angles and the incidence of abnormal values were significantly better in the robot-assisted group than in the control group (P < 0.05). The other indicators did not significantly differ between the two groups. (P > 0.05). For patients with mild preoperative deformities, those in the robot-assisted group had significantly better postoperative HKA angle deviations and rates of postoperative HKA angle outliers than those in the conventional group. For patients with significant deformities, the robot-assisted group presented greater postoperative HKA and PSA angle deviations than the control group; the postoperative HKA and PSA angle outlier rates were significantly lower in the robot-assisted group (P < 0.05).

CONCLUSION: The TINAVI robotic system demonstrated superior safety and efficacy in TKA surgery. Compared with conventional TKA, the robot-assisted system achieved significantly better outcomes regarding prosthesis implantation accuracy and lower extremity alignment, with a particular advantage in patients with severe limb alignment deformities.

PMID:39719605 | DOI:10.1186/s13018-024-05372-w

Acta Neuropathol Commun. 2024 Dec 24;12(1):202. doi: 10.1186/s40478-024-01898-6.

ABSTRACT

Alzheimer’s Disease (AD) is a debilitating neurodegenerative disease that affects 47.5 million people worldwide. AD is characterised by the formation of plaques containing extracellular amyloid-β (Aβ) and neurofibrillary tangles composed of hyper-phosphorylated tau proteins (pTau). Aβ gradually accumulates in the brain up to 20 years before the clinical onset of dementia, making it a compelling candidate for early detection of AD. It has been shown that there is increased deposition of Aβs in AD patients’ retinas. However, little is known about microglia’s ability to function and clear Aβ within the retina of AD and control eyes. We labelled microglia with ionised calcium-binding adaptor molecule 1 (IBA-1) in AD and age-matched control donor retinas. We then used interactive machine learning to segment individual microglia in 3D. In the temporal mid-peripheral region, we found that the number of microglia was significantly lower in AD retinas compared to controls. Unexpectedly, the size of the microglia was significantly larger in the AD retinas compared to controls. We also labelled retinal microglia for Cluster of Differentiation 68 (CD68), a transmembrane glycoprotein expressed by cells in the monocyte lineage and a marker of phagocytic activity and activated microglia. The size of CD68 + cells was statistically different between AD and control microglial, with CD68 + cells being larger in AD. In contrast, there was no difference in either size or shape for CD68- microglia between the two groups, suggesting an important difference in the active states of CD68 + microglia in AD retina. There was also significantly increased CD68 immunoreactivity in individual microglia within the AD group. Overall, this study reveals unique differences in the size and activity of the retinal microglia, which may relate to their potential chronic activation due to increased levels of Aβs in the AD retina.

PMID:39719599 | DOI:10.1186/s40478-024-01898-6

BMC Genomics. 2024 Dec 24;25(1):1242. doi: 10.1186/s12864-024-11159-4.

ABSTRACT

BACKGROUND: Fat traits in cattle are considered important due to their contribution to beef eating quality and carcass economic value. Discovering the genes controlling fat traits in cattle will enable better selection of these traits, but identifying these genes in individual experiments has proven difficult. Compared to individual experiments, meta-analyses allow greater statistical power for detecting quantitative trait loci and identifying genes that influence single and multiple economically important fat traits.

RESULTS: This meta-analysis study focussed on fat traits related to the major adipose depots in cattle (namely, carcass fat, intramuscular fat, internal fat, intermuscular fat, and subcutaneous fat) and was conducted using data from the Animal Quantitative Trait Loci (QTL) database. There were more Meta-QTL regions for intramuscular fat and subcutaneous fat (n = 158 and n = 55 regions, respectively) and far fewer for carcass fat and internal fat (n = 2 regions each). There were no Meta-QTL regions found for intermuscular fat. Of these 216 Meta-QTL regions, only 16 regions overlapped and affected two or more fat depots. The number of genes found for the fat depots was reflected in the size and number of the Meta-QTL regions (n = 20, 84, 1336 and 3853 genes for the carcass, internal, subcutaneous and intramuscular fat, respectively). The identification of these QTL allowed a more refined search for candidate genes. For example, the 232 genes in the Meta-QTL regions for carcass fat on BTA2, for intramuscular fat on BTA12, and the overlapping Meta-QTL regions on BTA2, BTA5, and BTA6 were readily screened, and 26 candidate genes were nominated based on their physiological roles using the GeneCards and DAVID databases.

CONCLUSIONS: The number of Meta-QTL regions for the various fat depots was relative to the number of associations in the database. However, the scarcity of overlapping Meta-QTL regions suggests that pleiotropic gene variants, which control multiple fat depots in cattle, are rare. The identification of candidate genes in the Meta-QTL regions will improve our knowledge of the genes with regulatory functions in adipose metabolism affecting meat quality and carcass economic value.

PMID:39719593 | DOI:10.1186/s12864-024-11159-4

BMC Pregnancy Childbirth. 2024 Dec 24;24(1):859. doi: 10.1186/s12884-024-07092-9.

ABSTRACT

BACKGROUND: This study aims to determine the impact of a childbirth educational intervention, based on empowerment theory, on childbirth experience and empowerment in women with fetal occiput posterior and occiput transverse malpositions.

METHODS: A randomized controlled trial was conducted from February 2022 to December 2022 involving pregnant women with fetal occiput posterior and occiput transverse malpositions. Eligible women were randomly assigned to either the control or study group. The control group received routine care during childbirth, while the study group received routine care and a childbirth-empowering educational intervention delivered by midwives. Primary outcomes assessed were childbirth experience and patient perceptions of patient-empowering nurse behaviors in pregnant women. Secondary outcomes included pregnancy outcomes, delivery support and control, maternal coping behavior during delivery, maternal participation in delivery decisions, and perception of empowerment.

RESULTS: A total of 137 pregnant women were enrolled, with 69 and 68 in the control and study groups, respectively. The study group showed significantly higher levels of childbirth experience and reported better patient perceptions of patient-empowering nurse behaviors than the control group. Additionally, the study group demonstrated higher levels of delivery support and control, maternal coping behavior, and specific aspects of perceived participation and patient perception of empowerment compared to the control group. There were no statistically significant differences in pregnancy outcomes between the two groups.

CONCLUSION: The childbirth empowering educational intervention effectively improved the childbirth experience and empowerment of women with fetal occiput posterior and occiput transverse malpositions. However, further studies are required to investigate its impact on pregnancy outcomes.

TRIAL REGISTRATION: The study protocol was approved by the hospital ethics committee (approval number:2020140A01) and registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2300070915; date of first registration: 26/04/2023).

PMID:39719592 | DOI:10.1186/s12884-024-07092-9

BMC Gastroenterol. 2024 Dec 24;24(1):475. doi: 10.1186/s12876-024-03458-7.

ABSTRACT

BACKGROUND: This study aimed to investigate the association between Metabolic-dysfunction-associated steatotic liver disease(MASLD)and C-reactive protein/lymphocyte ratio (CLR).

METHODS: MASLD was defined as a Controlled Attenuation Parameter (CAP ≥ 274dB/m) and CLR = C-reactive protein/lymphocyte. A multifactor linear regression model was used to test the relationship between MASLD and CLR. Smoothed curves and threshold effects analyses were fitted to describe nonlinear relationships. Subgroup analyses and interaction tests were then performed according to gender, prevalence of diabetes, ethnicity, and smoking status.

RESULTS: A total of 1846 participants from the NHANES database were included in this study. In the unadjusted model and model 1 (adjusted for age, sex, and race), CLR was positively associated with MASLD pathogenicity. Unadjusted model (OR = 1.04, 95% CI: 1.02-1.07, P = 0.0017), model 1 (OR = 1.04, 95% CI: 1.01-1.07, P = 0.0056). The results of the fitted smoothed curves showed that CLR and the risk of developing MASLD were nonlinear. Interaction tests and subgroup analyses confirmed that there were no significant interactions between CLR and MASLD causation with gender, race, prevalence of diabetes mellitus, and smoking status(P interaction>0.05).

CONCLUSIONS: This study shows that CLR is positively associated with the risk of developing MASLD Targeting CLR levels may be a new approach to treating MASLD.

PMID:39719591 | DOI:10.1186/s12876-024-03458-7