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Background: An estimated 11 million individuals are released from U.S. jails and prisons each year. Individuals with a history of incarceration have higher rates of cardiovascular disease (CVD) events and mortality compared to the general population, especially in the weeks following release from carceral facilities. Healthy sleep, associated with cardiovascular health, is an underexplored factor in the epidemiology of CVD in this population. Incarcerated people may have unique individual, environmental, and institutional policy-level reasons for being sleep deficient. The social and physical environment within carceral facilities and post-release housing may synergistically affect sleep, creating disparities in sleep and cardiovascular health. Since carceral facilities disproportionately house poor and minoritized groups, population-specific risk factors that impact sleep may also contribute to inequities in cardiovascular outcomes. Methods: This study is ancillary to an ongoing prospective cohort recruiting 500 individuals with known cardiovascular risk factors within three months of release from incarceration, the Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE) study. The Sleep Justice study will measure sleep health among participants at baseline and six months using three validated surveys: the Pittsburgh Sleep Quality Index (PSQI), the STOP-Bang, and the Brief Index of Sleep Control. In a subsample of 100 individuals, we will assess sleep over the course of one week using wrist actigraphy, a validated objective measure of sleep that collects data on rest-activity patterns, sleep, and ambient light levels. Using this data, we will estimate and compare sleep health and its association with CVD risk factor control in individuals recently released from carceral facilities. Discussion: The incarceration of millions of poor and minoritized groups presents an urgent need to understand how incarceration affects CVD epidemiology. This study will improve our understanding of sleep health among people released from carceral facilities and its potential relationship to CVD risk factor control. Using subjective and objective measures of sleep will allow us to identify unique targets to improve sleep health and mitigate cardiovascular risk in an otherwise understudied population. [ABSTRACT FROM AUTHOR]

Background: Advances in medicine and public health mean that people are living longer; however, a significant proportion of that increased lifespan is spent in a prolonged state of declining health and wellbeing which places increasing pressure on medical, health and social services. There is a social and economic need to develop strategies to prevent or delay age-related disease and maintain lifelong health. Several studies have suggested links between the gut microbiome and age-related disease, which if confirmed would present a modifiable target for intervention development. The MOTION study aims to determine whether and how changes in the gut microbiome are associated with physical and mental capacity. A comprehensive longitudinal multiparameter study such as this has not been previously undertaken. Methods: MOTION is a longitudinal prospective cohort study with a focus on gut health and cognitive function. 360 healthy individuals aged 60 years and older, living in East Anglia, UK will be recruited to the study, stratified into one of three risk groups (cohorts) for developing dementia based on their cognitive function. Participants will attend study appointments every six months over four years, providing stool and blood samples and a health questionnaire. Participants will also undergo physical measurements and cognitive tests at alternating appointments, and undergo Optical Coherence Tomography scans at 3 timepoints. Two subgroups of participants in the study will provide colonic tissue biopsies (n = ≥30 from each cohort), and brain imaging (n = 30) at two timepoints. Discussion: This study will provide new insights into the gut-(microbiota)-brain axis and the relationship between age-associated changes in gut microbe populations and cognitive health. Such insights could help develop new microbe-based strategies to improve lifelong health and wellbeing. Trial registration: This study is registered in the ClinicalTrials.gov Database with ID: NCT04199195 Registered: May 14, 2019. [ABSTRACT FROM AUTHOR]

None of the currently available parameters allow for a direct and objective measurement of vaginal moisture. We used a calibrated filter paper strip as a measurement tool for the quantification of vaginal fluid, in a similar manner as the ophthalmic "Schirmer test" (used for eye moisture measurement). The study aimed to evaluate the validity of this new, objective tool, to measure vaginal moisture. We compared vaginal moisture measurements using the "modified Schirmer test" in symptomatic women with genitourinary syndrome of menopause to those of women without vaginal dryness. The mean "modified Schirmer test" measurement in the control group was 21.7 mm compared to 3.3 mm in the study group, yielding a statistically significant difference (p < 0.001). Strong correlations were found between "modified Schirmer test" measurements and pH (correlation coefficient −0.714), Vaginal Health Index [VHI (0.775)], and Visual Analogue Score (VAS) of dryness during intercourse (−0.821). Our findings suggest that the "modified Schirmer test" can be used as an objective measurement for the assessment of vaginal fluid level. This test may also prove useful for evaluation of non-hormonal treatments aimed to treat vaginal dryness. [ABSTRACT FROM AUTHOR]

Educational outcomes are mostly studied in the short term (i.e. during the same phase of schooling). This paper focuses on the longitudinal monitoring of the mathematical knowledge of the same generation of pupils. At the school level, this can be performed by teachers, and at the state level by relevant institutions or experts in the field. Monitoring the progress in pupils' attainments is one way of determining and assuring the school's quality educational work. At the state level, pupils in Slovenia take National Assessments of Knowledge which can be used to monitor progress within the same generation of pupils. The introduction explains the difference between internal and external assessment and presents studies that focus on comparing the attainments in both types of assessment. This study focuses on the same generation of pupils, monitoring their attainments in mathematics in the 6th and the 9th year of schooling. The aim was to determine whether there was a gap between internal and external assessment. The research into external assessment was based on the attainments on the National Assessment of Knowledge in Mathematics, while the research into internal assessment was based on the pupils' final school grades in the same subject. It has been determined that more than half of the pupils would have the same final grade in the internal and external assessment; less than a fifth of the pupils would have received a lower grade in the external assessment, and just over a quarter would have received a higher grade in the external assessment, compared to the internal assessment.

The rising costs of recruiting and hiring workers and the seismic shift of age demographics in the United States workforce has created much stir around the concept of generational cohorts. Although much has been done by researchers and practitioners alike to attempt a better understanding of each generational group's leadership preferences, confusing and contradictory results has attracted much criticism. This critique has inspired efforts to look at the concept of leadership and followership preference through an alternative lifespan developmental lens. Because leadership influences are inherently social influences, a person's overall lifespan development level may potentially provide a deeper perspicacity of the phenomenon than examining it from the more conventional generational cohort perspective. However, specific research into this area is lacking. This paper adds to the literature by uncovering what we are missing in research and practice when we look at age-related leadership phenomena solely from a generational cohort perspective. A review of the contradicting literature on generational cohorts and leadership is offered. Next, specific lifespan developmental theories are examined, and propositions and implications of such research are extended.

The author believes that the principles of statistical methods for vaccine safety can be divided into three categories: comparison of adverse event incidence rates between vaccinated and unvaccinated groups, analysis of incidentality in the vaccinated group, and a combination of both. The first category includes the cohort study; the second, the self-controlled risk interval design (SCRI); and the third, the self-controlled case series method. A single p-value alone should not determine a scientific conclusion, and analysis should be performed using multiple statistical methods with different principles. The author believes that using both the cohort study and the SCRI for analysis is the best method to assess vaccine safety. When the cohort study may not detect a significant difference owing to a low incidence rate of an adverse event in the vaccinated group or a high one in the unvaccinated group, the SCRI may detect it. Because vaccines must have a higher level of safety than the pharmaceuticals used for treatment, vaccine safety is advisable to be assessed using methods that can detect a significant difference even for any value of the incidence rate of an adverse event. The author believes that the analyses of COVID-19 vaccine safety have areas for improvement because the proportion of papers that used the cohort study and the SCRI was negligible. [ABSTRACT FROM AUTHOR]

Background: Patterns of survey response and the characteristics associated with response over time in longitudinal studies are important to discern for the development of tailored retention efforts aimed at minimizing response bias. The Millennium Cohort Study, the largest and longest running cohort study of military personnel and veterans, is designed to examine the long-term health effects of military service and experiences and thus relies on continued participant survey responses over time. Here, we describe the response rates for follow-up survey data collected over 15 years and identify characteristics associated with follow-up survey response and mode of response (paper vs. web). Method: Patterns of follow-up survey response and response mode (web, paper, none) were examined among eligible participants (n=198,833), who were initially recruited in four panels from 2001 to 2013 in the Millennium Cohort Study, for a follow-up period of 3–15 years (2004–2016). Military and sociodemographic factors (i.e., enrollment panel, sex, birth year, race and ethnicity, educational attainment, marital status, service component, service branch, pay grade, military occupation, length of service, and time deployed), life experiences and health-related factors (i.e., military deployment/combat experience, life stressors, mental health, physical health, and unhealthy behaviors) were used to examine follow-up response and survey mode over time in multivariable generalized estimating equation models. Results: Overall, an average response rate of 60% was observed across all follow-up waves. Factors associated with follow-up survey response over time included increased educational attainment, married status, female sex, older age, military deployment (regardless of combat experience), and higher number of life stressors, mental health issues, and physical health diagnoses. Conclusion: Despite the challenges associated with collecting multiple waves of follow-up survey data from members of the U.S. military during and after service, the Millennium Cohort Study has maintained a relatively robust response rate over time. The incorporation of tailored messages and outreach to those groups least likely to respond over time may improve retention and thereby increase the representativeness and generalizability of collected survey data. [ABSTRACT FROM AUTHOR]

Aim: To assess the risks, benefits, and resource implications of home‐blended food for children with gastrostomy tubes compared with a formula diet. Method: This prospective cohort study of children (aged 0–18 years) collected baseline data on gastrointestinal symptoms, nutritional intake, anthropometric outcomes, parent and child quality of life, and resource use. A propensity score‐weighted generalized linear mixed model was used to compare children receiving a home‐blended versus formula diet. Results: Baseline data were obtained for 180 children (2019–2021; 107 males, 73 females; mean age 9 years 7 months [SD 4 years 5 months]). Children receiving a home‐blended diet (n = 104) had similar diagnoses and age but more lived in areas of lower deprivation and parental education was higher compared to the parents of children receiving a formula diet (n = 76). Children receiving home‐blended diets had significantly better gastrointestinal scores than those receiving formula diets (B = 13.8, p < 0.001). The number of gut infections and tube blockages were similar between the two groups but with fewer stoma site infections in the group receiving home‐blended food. Children receiving a home‐blended diet had more fibre in their diet compared to children receiving a formula diet. Interpretation: Home‐blended diets should be seen as a safe option for children who are gastrostomy‐fed unless clinically contraindicated. Equality of access to home‐blended diets for children with gastrostomy should be assessed by local clinical teams. What this paper adds: Children with gastrostomy receiving a home‐blended diet had fewer gastrointestinal symptoms compared to children receiving a formula diet.Children with gastrostomy receiving a home‐blended diet had no more complications than children receiving a formula diet. What this paper adds: Children with gastrostomy receiving a home‐blended diet had fewer gastrointestinal symptoms compared to children receiving a formula diet.Children with gastrostomy receiving a home‐blended diet had no more complications than children receiving a formula diet. [ABSTRACT FROM AUTHOR]

How do generational patterns affect public opinion in prolonged conflicts? While considerable research has addressed the effects of conflicts on children and adolescents, understanding the broader generational divides in public attitudes towards conflict resolution remains an area with both theoretical and empirical gaps. Such understanding is crucial, given its potential to significantly shape aggregate public opinion and the trajectory of conflicts. This paper focuses on the Israeli-Palestinian conflict, examining how support for conflict resolution varies across Israeli-Jewish cohorts. It employs longitudinal survey data (1981-2019), using both descriptive methods and age-period-cohort (APC) regression models. The findings indicate that generational differences in public opinion were relatively small until the early 2000s. Post this period, younger Israelis have increasingly displayed more hawkish attitudes than older generations, coupled with a stronger inclination towards right-wing identification. These trends pose important questions about the changing nature of support for compromise within Israeli society and its implications for the future of the Israeli-Palestinian conflict. The factors driving these emerging generational gaps are complex and merit in-depth exploration. While this article touches upon potential explanations, including demographic shifts and hope for peace, they do not entirely clarify the observed generational differences, highlighting the need for further research. [ABSTRACT FROM AUTHOR]

Objectives: The Future Proofing Study (FPS) was established to examine factors associated with the onset and course of mental health conditions during adolescence. This paper describes the design, methods, and baseline characteristics of the FPS cohort. Methods: The FPS is an Australian school‐based prospective cohort study with an embedded cluster‐randomized controlled trial examining the effects of digital prevention programs on mental health. Data sources include self‐report questionnaires, cognitive functioning, linkage to health and education records, and smartphone sensor data. Participants are assessed annually for 5 years. Results: The baseline cohort (N = 6388, M = 13.9 years) is broadly representative of the Australian adolescent population. The clinical profile of participants is comparable to other population estimates. Overall, 15.1% of the cohort met the clinical threshold for depression, 18.6% for anxiety, 31.6% for psychological distress, and 4.9% for suicidal ideation. These rates were significantly higher in adolescents who identified as female, gender diverse, sexuality diverse, or Aboriginal and/or Torres Strait Islander (all ps < 0.05). Conclusions: This paper provides current and comprehensive data about the status of adolescent mental health in Australia. The FPS cohort is expected to provide significant insights into the risk, protective, and mediating factors associated with development of mental health conditions during adolescence. [ABSTRACT FROM AUTHOR]

This paper analyses the strategy developed thus far to have Andalusian olive-growing landscapes included as a Cultural Landscape on the World Heritage List (UNESCO). The research method used is descriptive, reflexive and prospective, and seeks to achieve a systematic and holistic overview of a complex reality. In addition to the corresponding bibliographical review, the research has been nourished by qualitative information from land surveys (field visits) and interviews with experts consulted during the preparation of the two technical dossiers of the candidacy produced so far. The results include the rationale for Outstanding Universal Value and the basis of the protection and management plan for the property. Subsequently, the paper discusses the possibilities for rural development that can be derived from this initiative through the virtuous interactions between the property, the region and the food (olive oil) obtained from traditional olive groves. [ABSTRACT FROM AUTHOR]

The rising prevalence of mental health conditions among children and young adults accelerated by the COVID-19 pandemic emphasises the urgent need to address this issue effectively. A potential avenue for early diagnosis lies in physical activity patterns as individuals with mental health conditions often move less than the general population. This paper utilises Millennium Cohort Study data to investigate the relationship between childhood physical movement patterns, and mental distress and wellbeing outcomes in late adolescence. By controlling for a range of factors of both cohort members and their parents, the study employs well-adjusted logistic and linear regressions to assess the hypothesis. Objective physical movement data is collected with accelerometers, while mental distress is measured using the Kessler K6 scale and mental wellbeing using the Warwick-Edinburgh Mental Wellbeing Scale. The findings of the study suggest no significant association between raw physical movement and mental distress; however, there is suggestive evidence of a weak positive association with mental wellbeing. In addition, the study found that lower exercise levels at age 7 were associated with an increased likelihood of mental distress at age 17, highlighting the potential impact of exercise habits on mental health in adolescence. Overall, these findings suggest that raw physical activity data may be a better predictor of specific mental health outcomes, such as those assessed by the Strengths and Difficulties Questionnaire in similar studies. The paper offers recommendations for future research -- such as using self-reported questionnaires to contextualise quantitative physical movement data -- and a more comprehensive analysis of the cognitive and mental implications. [ABSTRACT FROM AUTHOR]

Background: Little is known about the publication outcomes of submissions rejected by specialty psychiatry journals. We aimed to investigate the publication fate of original research manuscripts previously rejected by the Indian Journal of Psychological Medicine (IJPM). Methods: A random sampling of manuscripts was drawn from all submissions rejected between January 1, 2018, and December 31, 2019. Using the titles of these papers and the author names, a systematic search of electronic databases was carried out to examine if these manuscripts have been published elsewhere or not. We extracted data on a range of scientific and nonscientific parameters from the journal's manuscript management portal for every rejected manuscript. Multivariable analysis was used to detect factors associated with eventual publication. Results: Out of 302 manuscripts analyzed, 139 (46.0%) were published elsewhere; of these, only 18 articles (13.0%) were published in a journal with higher standing than IJPM. Manuscripts of foreign origin (odds ratio [OR] 1.77, 95% confidence interval [CI] = 1.06–2.97) and rejection following peer review or editorial re-review (OR 2.41, 95% CI = 1.22–4.74) were significantly associated with publication. Conclusion: Nearly half of the papers rejected by IJPM were eventually published in other journals, though such papers are more often published in journals with lower standing. Manuscripts rejected following peer review were more likely to reach full publication status compared to those which were desk rejected. [ABSTRACT FROM AUTHOR]

This document is a corrigendum for an article titled "Association Between Age and the 28-Day All-Cause Mortality in Tuberculosis Complicated by Sepsis in ICU Patients: A Retrospective Cohort Study." The authors acknowledge an error in Figure 1 of the original article and provide the correct version. They apologize for the mistake and assure readers that it does not impact the findings of the paper. The authors of the article are Kunping Cui, Yi Mao, Shuang Feng, Haixia Luo, Jiao Yang, Ruyi Xu, and Lang Bai. [Extracted from the article]

Background: Women with mental illness experience an increased risk of cervical cancer. The excess risk is partly due to low participation in cervical screening; however, it remains unknown whether it is also attributable to an increased risk of infection with human papillomavirus (HPV). We aimed to examine whether women with mental illness had an increased infection rate of HPV compared to women without mental illness. Methods and findings: Using a cohort design, we analyzed all 337,116 women aged 30 to 64 and living in Stockholm, who had a negative test result of 14 high-risk HPV subtypes in HPV-based screening, during August 2014 to December 2019. We defined women as exposed to mental illness if they had a specialist diagnosis of mental disorder or had a filled prescription of psychotropic medication. We identified incident infection of any high-risk HPV during follow-up and fitted multivariable Cox models to estimate hazard ratios (HR) with 95% confidence intervals (CI) for HPV infection. A total of 3,263 women were tested positive for high-risk HPV during follow-up (median: 2.21 years; range: 0 to 5.42 years). The absolute infection rate of HPV was higher among women with a specialist diagnosis of mental disorder (HR = 1.45; 95% CI [1.34, 1.57]; p < 0.001) or a filled prescription of psychotropic medication (HR = 1.67; 95% CI [1.55, 1.79]; p < 0.001), compared to women without such. The increment in absolute infection rate was noted for depression, anxiety, stress-related disorder, substance-related disorder, and ADHD, and for use of antidepressants, anxiolytics, sedatives, and hypnotics, and was consistent across age groups. The main limitations included selection of the female population in Stockholm as they must have at least 1 negative test result of HPV, and relatively short follow-up as HPV-based screening was only introduced in 2014 in Stockholm. Conclusions: Mental illness is associated with an increased infection rate of high-risk HPV in women. Our findings motivate refined approaches to facilitate the WHO elimination agenda of cervical cancer among these marginalized women worldwide. Author summary: Why was this study done?: Mental illness has been associated with a higher risk of cervical cancer and precancerous lesions as well as a lower degree of participation in cervical screening. Little is known, however, regarding disparities in HPV infection between women with and without mental illness. What did the researchers do and find?: In a cohort study, we followed all 337,116 women who were at age 30 to 64, living in Stockholm, and had a negative test result of high-risk HPV during August 2014 to December 2019, to assess the link between mental illness and risk of infection with high-risk HPV. The absolute infection rate of HPV was 45% higher among women with a specialist diagnosis of mental disorder and 67% higher among women with a filled prescription of psychotropic medications, compared to women without such. What do these findings mean?: Mental illness is associated with an increased infection rate of oncogenic HPV in women. Refined approaches are needed to facilitate the elimination agenda of cervical cancer among women with mental illness. [ABSTRACT FROM AUTHOR]

Background: Recruiting large cohorts efficiently can speed the translation of findings into care across a range of scientific disciplines and medical specialties. Recruitment can be hampered by factors such as financial barriers, logistical concerns, and lack of resources for patients and clinicians. These and other challenges can lead to underrepresentation in groups such as rural residents and racial and ethnic minorities. Here we discuss the implementation of various recruitment strategies for enrolling participants into a large, prospective cohort study, assessing the need for adaptations and making them in real-time, while maintaining high adherence to the protocol and high participant satisfaction. Methods: While conducting a large, prospective trial of a multi-cancer early detection blood test at Geisinger, an integrated health system in central Pennsylvania, we monitored recruitment progress, adherence to the protocol, and participants' satisfaction. Tracking mechanisms such as paper records, electronic health records, research databases, dashboards, and electronic files were utilized to measure each outcome. We then reviewed study procedures and timelines to list the implementation strategies that were used to address barriers to recruitment, protocol adherence and participant satisfaction. Results: Adaptations to methods that contributed to achieving the enrollment goal included offering multiple recruitment options, adopting group consenting, improving visit convenience, increasing the use of electronic capture and the tracking of data and source documents, staffing optimization via leveraging resources external to the study team when appropriate, and integrating the disclosure of study results into routine clinical care without adding unfunded work for clinicians. We maintained high protocol adherence and positive participant experience as exhibited by a very low rate of protocol deviations and participant complaints. Conclusion: Recruiting rapidly for large studies – and thereby facilitating clinical translation – requires a nimble, creative approach that marshals available resources and changes course according to data. Planning a rigorous assessment of a study's implementation outcomes prior to study recruitment can further ground study adaptations and facilitate translation into practice. This can be accomplished by proactively and continuously assessing and revising implementation strategies. [ABSTRACT FROM AUTHOR]

Background: This study explored the specific relationship between different lipid indicators and cognitive impairment and aimed to provide a reference for implementing targeted lipid regulation measures to prevent and alleviate cognitive impairment. Methods: We searched three databases (PubMed, Embase, and Web of Science) for literature related to hyperlipidaemia, lipid levels, and cognitive impairment, and used the Newcastle-Ottawa Scale to evaluate the quality of the identified literature. A meta-analysis was performed using RevMan 5.4, and the combined effect size ratio using a random-effects model (odds ratio [OR] and 95% confidence interval [CI]) was used to evaluate the association between dyslipidaemia and cognitive impairment. Results: Among initially identified 2247 papers, we ultimately included 18 studies involving a total of 758,074 patients. The results of the meta-analysis revealed that patients with hyperlipidaemia had a 1.23-fold higher risk of cognitive impairment than those with normal lipid levels (OR = 1.23, 95% CI: 1.04-1.47, p = 0.02). Further subgroup analysis showed that elevated total cholesterol (TC) levels increased the risk of cognitive impairment by 1.59-fold (OR = 1.59, 95% CI: 1.27-2.01, p < 0.0001) and were more significant in older or male patients. Moreover, elevated triglyceride levels were inversely correlated with cognitive disorders, whereas elevated low-density lipoprotein cholesterol levels were unrelated to cognitive impairment risk. Conclusions: Dyslipidaemia was strongly associated with cognitive impairment, and elevated TC levels were a risk factor for cognitive impairment. Furthermore, the damaging effects of elevated TC levels on cognition were more pronounced in older and male populations. [ABSTRACT FROM AUTHOR]

In India, the incidence of mucormycosis reached high levels during 2021–2022, coinciding with the COVID-19 pandemic. In response to this, we established a multicentric ambispective cohort of patients hospitalised with mucormycosis across India. In this paper, we report their baseline profile, clinical characteristics and outcomes at discharge. Patients hospitalized for mucormycosis during March–July 2021 were included. Mucormycosis was diagnosed based on mycological confirmation on direct microscopy (KOH/Calcofluor white stain), culture, histopathology, or supportive evidence from endoscopy or imaging. After consent, trained data collectors used medical records and telephonic interviews to capture data in a pre-tested structured questionnaire. At baseline, we recruited 686 patients from 26 study hospitals, of whom 72.3% were males, 78% had a prior history of diabetes, 53.2% had a history of corticosteroid treatment, and 80% were associated with COVID-19. Pain, numbness or swelling of the face were the commonest symptoms (73.3%). Liposomal Amphotericin B was the commonest drug formulation used (67.1%), and endoscopic sinus surgery was the most common surgical procedure (73.6%). At discharge, the disease was stable in 43.3%, in regression for 29.9% but 9.6% died during hospitalization. Among survivors, commonly reported disabilities included facial disfigurement (18.4%) and difficulties in chewing/swallowing (17.8%). Though the risk of mortality was only 1 in 10, the disability due to the disease was very high. This cohort study could enhance our understanding of the disease's clinical progression and help frame standard treatment guidelines. [ABSTRACT FROM AUTHOR]

Background: Osteogenesis Imperfecta (OI) is characterised by bone fragility. Among several features, easy bruising and multiple case reports on haemorrhagic events have been reported. This paper describes the diverse manifestations of bleeding and bruising in a large cohort of 328 OI patients. The aim of this study is to provide insight in the diverse aspects and therapeutic considerations of bleedings in OI. Methods: This descriptive cohort study was conducted at the National Expert Center for adults with OI in the Netherlands. Bleeding was assessed by the validated self-bleeding assessment tool (Self-BAT) The tool was distributed among 328 adults with different clinically confirmed types of OI. Results: 195 of 328 invited patients (completion rate 60%) with OI type 1 (n = 144), OI type 3 (n = 17) and OI type 4 (n = 34), aged between 18 and 82 years, completed the tool. Self-BAT scores were above the normal range in 42% of all patients. For males Self-BAT scores were increased in 37% with a mean score of 3.7, ranged between 0 and 18. For females the Self-BAT scores were increased in 44% with a mean of 5.4 and a range of 0–24. No statistical differences in OI subtypes were found. Conclusions: Bleeding tendency appears to be a relevant complication in OI patients as this study confirms the presumption of bleeding tendency. There are specific recommendations to clinicians who treat OI patients to consider an assessment of bleeding tendency and use potential interventions to reduce haemorrhagic complications and improve quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Adverse drug reactions (ADRs) are harmful and unintended reactions to medicines given at standard doses through a proper route of administration for the purpose of prophylaxis, diagnosis, or treatment. Objective: The objective of this research paper was to assess median time to development of ADRs and associated factors among children HIV positive patients on antiretroviral treatment (ART) in North West Amhara Specialized Hospitals. Methods: The adverse drug effect survival time was estimated using the Kaplan–Meier survival method and log‐rank test curves was applied for analyze "time‐to‐event" data. Cox regression model was used to identify the associated factors. Adjusted hazard ratios with their respective 95% confidence intervals (CIs) were estimated and a value of p less than 0.05 was used to declare the presence of a significant association. Result: The overall incidence of ADRs was 0.67 (95% CI: 3.74–4.44) per 10,000 person‐year observation, with a median of 57 months. Adults are presenting with opportunistic Infections (OIs) experiences, baseline CD4 < 200 cells/µL counts, 1e, tenofovir disoproxil fumarate–lamivudine–efavirenz ART regimen, bedridden baseline functional status, World Health Organization (WHO) clinical stage II and III were notably associated with the incidence of ADRs development. Conclusion: ADRs were uncommon in this study. predictors, such as OIs experiences, a low CD4 count, ART regimen, an advanced WHO stage, and bedridden functional status were significantly associated with ADRs. [ABSTRACT FROM AUTHOR]

Background A paucity of evidence exists regarding the optimal management for abdominal aortic graft infection. The aim of this paper was to assess short- and long-term outcomes following different surgical options in aortic graft infection patients. Methods Medline, Embase and the Cochrane Library were searched from inception to February 2023. Network meta-analysis was performed using a frequentist method. Patients were divided into four treatment groups: complete graft removal with in situ repair, complete graft removal with extra-anatomic repair, partial graft removal with in situ repair and partial graft removal with extra-anatomic repair. The mortality rate at 30-days and 1-year was the primary outcome. Secondary outcomes were longer-term mortality rate, primary patency and reinfections. For included RCTs, the Cochrane risk-of-bias tool was utilized to assess the risk of bias. The methodological quality of cohort studies was evaluated using the Newcastle–Ottawa scale. Results Among 4559 retrieved studies, 22 studies with 1118 patients (11 multi-arm and 11 single-arm studies) were included. Patients received complete graft removal with in situ repair (N = 852), partial graft removal with in situ repair (N = 36), complete graft removal with extra-anatomic repair (N = 228) and partial graft removal with extra-anatomic repair (N = 2). Both network meta-analysis results and pooled results of multi- and single-arm cohorts indicated that partial graft removal with in situ repair has the lowest 30-day and 1-year mortality rates (0% and 6.1% respectively), followed by complete graft removal with in situ repair (11.9% and 23.8% respectively) and complete graft removal with extra-anatomic repair (16.6% and 41.4% respectively). In addition, complete graft removal with in situ repair had a lower 3-year (complete graft removal with in situ repair versus complete graft removal with extra-anatomic repair: 32.1% versus 90%) and 5-year (complete graft removal with in situ repair versus complete graft removal with extra-anatomic repair: 45.6% versus 67.9%) mortality rate when compared with complete graft removal with extra-anatomic repair. Patients in the complete graft removal with in situ repair group had the lowest reinfections (8%), followed by partial graft removal with in situ repair (9.3%) and complete graft removal with extra-anatomic repair (22.4%). Conclusion Partial graft removal with in situ repair was associated with lower 30-day and 1-year mortality rates when compared with complete graft removal with in situ repair and complete graft removal with extra-anatomic repair. Partial graft removal with in situ repair might be a feasible treatment for specific aortic graft infection patients. [ABSTRACT FROM AUTHOR]

Background: Evaluating the effectiveness of early years parenting interventions provides evidence to improve the development and wellbeing of children. This protocol paper describes a study to explore the feasibility of evaluating the Incredible Years Toddler early life intervention programme, which is offered to parents of 1–3-year-olds via the Better Start Bradford programme. The study aims to use a Trial within a Cohort Study (TwiCS) design that randomly selects individuals participating in a cohort to be offered an intervention. The TwiCS information and consent process is person-centred and aims to replicate real-world practice whereby only those who are offered the intervention are given information about the intervention. The cohort is the Born in Bradford's Better Start (BiBBS) cohort, an interventional birth cohort recruiting expectant parents in three areas of Bradford, UK. The study will assess the feasibility of TwiCS procedures, staged consent, and intervention take-up. Methods: We will conduct a feasibility TwiCS to test study procedures. We aim to establish the following: (1) whether TwiCS methodology can be implemented to create control and intervention arms, whilst documenting any incidences of contamination within the cohort; (2) whether satisfactory rates of intervention uptake are achieved among participants allocated to the intervention; and (3) whether satisfactory rates of retention of participants in the intervention can be achieved. A Red Amber Green (RAG) rating system has been applied to support the feasibility assessment of each objective: to be rated red (not achieved), amber (partly achieved), and green (achieved). Eligible participants in the BiBBS cohort will be individually randomised 1:1 to the intervention or control arms, with stratification by child age (1 or 2 years old at the time of randomisation) and ethnicity (White British, South Asian, or other). BiBBS researchers will seek consent from participants randomised to the intervention to pass their contact details onto Incredible Years' delivery agents. Discussion: This feasibility study will inform the utility of the TwiCs approach within an experimental birth cohort to evaluate interventions for infants, toddlers, and their families. Trial registration: The study was prospectively registered on ISRCTN (ISRCTN16150114). [ABSTRACT FROM AUTHOR]

Introduction In this paper, we aim to present an analysis of the diagnostic, therapeutic, and rehabilitation procedures in a 23-year-old athlete with an anterior cruciate ligament (ACL) injury. The study includes the patient's medical history, circumstances of the injury, diagnostic and therapeutic procedures applied, as well as the course of postoperative rehabilitation. Objective The objective of our study is to present the anatomy of the ACL, the typical mechanism of injury, and diagnostic and therapeutic possibilities. Methods This is a retrospective study. The medical documentation and imaging studies were subjected to analysis. The analysis was complemented by a literature review based on publications in the English-language PubMed database. Results The case involves a 23-year-old soccer player with an isolated ACL injury in the right knee joint. The case analysis highlights the challenges related to diagnosis and decision-making regarding therapeutic procedures. ACL reconstruction using the STG method and lateral tenodesis with the iliotibial band in combination with postoperative rehabilitation resulted in a positive outcome in terms of knee joint stability and return to sports. Conclusions The review of this medical case underscores the importance of a personalized approach to each patient with an ACL injury, taking into account age, level of physical activity, and coexisting injuries within the knee joint. This allows for the correct decision on the best treatment method for the patient, facilitating a return to sports and minimizing the risk of complications. [ABSTRACT FROM AUTHOR]

Aim: To investigate spoken language comprehension (SLC), single‐word comprehension (SWC), functional communication development, and their determinants, in children with cerebral palsy. Method: This was a prospective cohort study in the Netherlands spanning 2 years 6 months. The main outcomes were SLC and SWC, assessed by the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT) and the Peabody Picture Vocabulary Test‐III‐NL (PPVT‐III‐NL) respectively; and functional communication, measured by a subscale of the Focus on the Outcomes of Communication Under Six‐34 (FOCUS‐34). Linear mixed models were used to determine developmental trajectories, which were compared with norm and reference data. Potential determinants, for example intellectual functions, speech production, functional communication level (classified with the Communication Function Classification System, CFCS), and functional mobility, were added to assess their effects. Results: Children with cerebral palsy (n = 188; mean age 59 months, range 17–110) were monitored for 2 years 6 months. Developmental trajectories for SLC (C‐BiLLT) and SWC (PPVT‐III‐NL) were nonlinear; those for functional communication (FOCUS‐34) were linear. Compared with norm and reference groups, significantly delayed SLC, SWC, and functional communication development were found. Determinants for SLC and SWC were intellectual functions and functional communication level (CFCS); and for functional communication development (FOCUS‐34), speech production and arm–hand functioning. Interpretation: Children with cerebral palsy showed delayed SLC, SWC, and functional communication development compared with norm and reference groups. Remarkably, functional mobility was not associated with the development of SLC, SWC, or functional communication. What this paper adds: Children with cerebral palsy have delayed spoken language comprehension (SLC), single‐word comprehension (SWC), and functional communication development, compared to norm and reference data.Determinants for SLC and SWC development are intellectual functions and functional communication level.Determinants for functional communication development are speech production and arm–hand functioning.Functional mobility is not associated with SLC, SWC, or functional communication. What this paper adds: Children with cerebral palsy have delayed spoken language comprehension (SLC), single‐word comprehension (SWC), and functional communication development, compared to norm and reference data.Determinants for SLC and SWC development are intellectual functions and functional communication level.Determinants for functional communication development are speech production and arm–hand functioning.Functional mobility is not associated with SLC, SWC, or functional communication. Video Podcast: https://youtu.be/x09Tac7tsz0 [ABSTRACT FROM AUTHOR]

This paper studies intergenerational links in home ownership, an increasingly important wealth marker and a measure of economic status in itself. Repeated cross sectional UK data show that home ownership rates have fallen rapidly over time, most markedly amongst younger people in more recent birth cohorts. Evidence from British birth cohorts data supplemented by the Wealth and Assets Survey show a significant rise through time in the intergenerational persistence of home ownership, as home ownership rates shrank disproportionately among those whose parents did not own their own home. Given the close connection between home ownership and wealth, these results on strengthening intergenerational persistence in home ownership are therefore also suggestive of a fall in intergenerational housing wealth mobility over time. [ABSTRACT FROM AUTHOR]

Never in recent history has mankind been so severely and diversely affected by any disease like the COVID-19 infection. Many post-COVID complications have been mentioned in the literature and other platforms, of which post-COVID Dysphagia is a very distressing complaint. The severity of dysphagia may range from mild discomfort in swallowing to life-threatening aspiration. This paper aims to study post-COVID dysphagia, its various presentations, possible causative factors and diagnosis. Like any other new disease on the block, continuous study and research is the need of the hour, for us to be able to mitigate the damage already inflicted by this pandemic. [ABSTRACT FROM AUTHOR]

The purpose of this paper of practice is to explore the use of a "Conference as Curriculum" model to develop student understanding of critical approaches and challenges and opportunities in the field of community-engaged research (CER). Two higher education institutions in California's Monterey County sent 22 students to the "All-In: Co-Creating Knowledge for Justice" Conference in Santa Cruz, California USA in October 2022. The undergraduate and graduate students were funded through their academic institutions and accompanied by faculty and staff working on community-engaged research. Participation in the conference involved a pre- and post-conference convening to prepare students for the conference and then guide students through reflections on their learning and future work. The experiential learning activities offered in conjunction with the students' conference attendance were designed to: (1) foster students' connection to the community and each other; (2) develop students' understanding of community-engaged research; and (3) build students' professional acumen through attending a professional conference. Two authors of this article share their experience as student attendees at the conference. The student vignettes provide insight on the authors' learning experiences and offer design implications for the use of cohort conference attendance as an experiential learning activity. The article presents a conference experiential learning model that could be replicated and modified by other higher education institutions. We also place the project within a greater inter-institutional initiative to build a model for community-driven collaborations that seeks to address challenges surrounding higher education engagement with local nonprofits and governments. [ABSTRACT FROM AUTHOR]

Introduction Practising health professionals, driven by a desire to see the translation of research knowledge into improved patient outcomes, may wish to improve their research skills via part-time doctoral studies (D'Arrietta et al., 2022). To do so, they must maintain demanding careers within the health sector while studying part-time and externally. Parttime, external research candidates have notoriously poor success rates. To address this issue, a new and innovative program--the Cohort Doctoral Studies Program (CDSP)--was designed for higher degree by research (HDR) candidates studying in a health discipline at a mid-sized, research-intensive Australian university. This paper describes the CDSP and the associated outcomes. Innovation The CDSP is a multifaceted program that supports HDR students from pre-enrolment through to completion. Places are prioritised for Australian candidates who are employed in the health sector, but international applicants are also accepted. Each year the CDSP accepts two cohorts of 12-18 students, who remain as an interacting group throughout their candidature. Thereafter, cohorts amalgamate for stage-of-candidature training. Students can attend two intensive "block weeks" each year, where they engage in core and elective training workshops. Each student is assigned a mentor, external to the candidate's supervisory panel, to provide ongoing in-person or online writing, administrative and pastoral support. The key features of the program are summarised in Figure 1 and described below. [ABSTRACT FROM AUTHOR]

Objectives: Systemic sclerosis (SSc) is a disease characterized by diffuse sclerosis of skin and organs and small vessel vasculopathy. Despite it, large vessels can also be involved with ulnar artery vasculopathy, revealing as a more frequent feature of SSc. The aim of this paper is to assess the macrovascular involvement of SSc patients through an ultrasound (US) evaluation of radial and ulnar arteries. Methods: Radial and ulnar resistance indices (RIs) and peak systolic velocity (PV) (cm/s) together with clinical features of SSc patients were evaluated. Raynaud phenomenon (RP) and healthy control (HC) groups were used for comparison. Results: Forty-three SSc patients were evaluated. Twelve patients (28%) had ulnar artery occlusions (UAOs). In nine cases (75%), UAOs were bilateral. A high UAO prevalence (42%) was found in SSc patients with late nailfold-video-capillaroscopy (NVC) pattern (p = 0.0264). Patients with UAOs had digital ulcers (DUs) in 10 cases (83.3%). Radial and ulnar PVs were lower in SSc and RP patients than the HC group. Radial and ulnar RIs were higher in SSc and RP patients than the HC group. A decision tree analysis led to the classification of 70% of SSc patients with an ulnar RI > 0.82 and ulnar PV > 2.8 cm/s. The most influential variables on UAO development were interstitial lung disease (ILD) (p = 0.002) and NVC pattern (p = 0.002). A positive correlation was shown between modified Rodnan skin score (mRSS) and ILD (p = 0.283; r = 0.033), mRSS and DU (r = 0.344; p = 0.012) and DU and ILD (r = 0.303; p = 0.024). Male sex was associated with increased UAO frequency (p = 0.042). Conclusions: UAO is a peculiar feature of severe SSc present in 28% of the cases, particularly associated with the presence of ILD and late NVC pattern. In 75% of the cases, UAOs are bilateral. DUs are very frequent in patients with UAOs (83%). The RI evaluated by US could be useful to distinguish SSc from HC patients. US could be a useful tool for assessing high-risk DU development in patients. [ABSTRACT FROM AUTHOR]

Background: Data-driven process analysis is an important area that relies on software support. Process variant analysis is a sort of analysis technique in which analysts compare executed process variants, a.k.a. process cohorts. This comparison can help to identify insights for improving processes. There are a few software supports to enable process cohort comparison based on the frequencies of process activities and performance metrics. These metrics are effective in cohort analysis, but they cannot support cohort comparison based on the probability of transitions among states, which is an important enabler for cohort analysis in healthcare.Results: This paper defines an approach to compare process cohorts using Markov models. The approach is formalized, and it is implemented as an open-source python library, named dfgcompare. This library can be used by other researchers to compare process cohorts. The implementation is also used to compare caregivers' behavior when prescribing drugs in the Stockholm Region. The result shows that the approach enables the comparison of process cohorts in practice.Conclusions: We conclude that dfgcompare supports identifying differences among process cohorts. [ABSTRACT FROM AUTHOR]

Background and objectives: This paper aimed to analyze the relationship between baseline prolactin (PRL) levels and live birth rates (LBRs) in patients undergoing embryo transfer who did not have polycystic ovarian syndrome (PCOS) using a retrospective design. Patient(s): A total of 20,877 patients who had undergone IVF/intracytoplasmic sperm injection (ICSI) between December 2014 and December 2019. Materials and methods: We examined the association between PRL concentrations and LBRs using multivariate regression analysis. In addition, a model for nonlinear relationships based on a two-part linear regression was developed. Results: Following adjustment for confounding factors, multivariate regression analysis confirmed a statistically significant correlation between serum PRL and LBR. Particularly, when blood PRL content was less than 14.8 ng/mL, there exists a positive relation between serum PRL and LBRs. In contrast, once PRL concentrations surpassed the inflection point at 14.8 ng/mL, a meaningful relationship could no longer be inferred between serum PRL and LBR. Conclusions: Basal serum PRL levels were segmentally connected with LBRs. [ABSTRACT FROM AUTHOR]

Accurate and efficient diagnosis of acute coronary syndrome (ACS)-related cardiac diseases is crucial for optimizing medical resources and enhancing clinical treatment efficiency. In this paper, we construct two distinct ECG datasets: a clinical 12-lead original ECG dataset and a clinical 12-lead standard ECG dataset. Our focus is on the automatic diagnosis of diseases clinically associated with acute coronary syndrome, specifically T wave changes, ST-T segment changes, and pathological Q waves. We propose a fine-tuned EfficientNet-based network for model construction and conduct comparative experiments using various state-of-the-art networks. Our experiments demonstrate satisfactory results in the classification of four types of ECGs: normal ECGs and three types of abnormal ECGs, with an overall classification accuracy of 73.333%. Notably, the model achieves a classification precision of 0.963 for pathological Q wave types and a classification specificity of 0.877, 0.859, 0.911, and 0.993 for the four types of models. To evaluate the model's performance, we randomly select a subset of ECGs and invite two groups of doctors, each with 4–5 years of experience in ECG interpretation, to determine the gold standard. A comparison of the proposed model's classification performance with the doctors' annotations reveals that for T wave changes and ST-T segment changes, the individual doctors' accuracy is 70.115%, while the proposed fine-tuning model achieves an accuracy of 71.111%. Thus, the performance of our model matches that of experienced doctors. Furthermore, we apply transfer learning to generalize the model trained on the original 12-lead ECG dataset to the new standard 12-lead ECG dataset. The experimental results demonstrate that the transferred model achieves a classification accuracy of 71.066% on the standard dataset, equivalent to the accuracy obtained on the original ECG dataset. Notably, for the normal sinus rhythm type, the precision and sensitivity of the transferred model improved by 7.4% and 1.8%, respectively. Additionally, the ROC AUC values for normal sinus rhythm, T wave changes, and ST-T segment changes after transfer are 0.857, 0.714, and 0.770, respectively. Moreover, we utilize Grad-CAM technology to provide network interpretability, offering theoretical support for clinical electrocardiogram diagnosis based on ECG records and classification results. Regarding network model efficiency, the average classification time for the transferred learning network on each ECG is approximately 0.0035 s, indicating the model's suitability for clinical practice and its potential to enhance clinical diagnosis efficiency. [ABSTRACT FROM AUTHOR]

Background: "CoviSainik Program" was implemented in collaboration with the Ambuja Cement Foundation and Community Medicine Department in rural districts of eight states of India from May to December 2021 to create a cadre of volunteers. The aim of the present paper is to describe the program and evaluate it so that the findings can be the guiding tool for policymakers to replicate a similar program. Material and Method: A cross-sectional, mixed-method – concurrent study design was adopted to evaluate the program for its short-term outcomes such as gain in the basic knowledge of COVID-19 amongst master trainers and their feedback and program output viz – the proportion of volunteers trained and their profile by census sampling. Motivational factors, experiences of volunteers, and outcomes of COVID-19 work in their villages were explored by purposive with maximum diversity sampling with 62 online in-depth interviews and 8 online focus group discussions (FGDs). Results: There was a statistically significant difference in the pre-test (12.8 ± 5.6) and post-test (25.9 ± 9.3) scores of the Master Training Program evaluation test. Out of 6534 trained volunteers, 5901 worked as volunteers, and amongst those, 47.1%, 35.1%, and 17.8% worked for ≤3 months, 3 to 6 months, and ≥6 months, respectively, in their villages. The major themes generated for motivational factors to join the program were altruism, savior nature, generating awareness, and concern for others. The major outcomes generated by trained volunteers COVID-19 vaccination were in raising awareness on COVID-19 appropriate behavior and early identification of COVID-19 cases in their villages. Conclusion: The "CoviSainik Program" was successful in creating cadres of trained volunteers. [ABSTRACT FROM AUTHOR]

Modern science is frequently based on the exploitation of large volumes of information storage in datasets and involving complex computational architectures. The statistical analyses of these datasets have to cope with specific challenges and frequently involve making informed but arbitrary decisions. Epidemiological papers have to be concise and focused on the underlying clinical or epidemiological results, not reporting the details behind relevant methodological decisions. In this work, we used an analysis of the cardiovascular-related measures tracked in 4–8-year-old children, using data from the INMA-Asturias cohort for illustrating how the decision-making process was performed and its potential impact on the obtained results. We focused on two particular aspects of the problem: how to deal with missing data and which regression model to use to evaluate tracking when there are no defined thresholds to categorize variables into risk groups. As a spoiler, we analyzed the impact on our results of using multiple imputation and the advantage of using quantile regression models in this context. [ABSTRACT FROM AUTHOR]

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The Queensland Family Cohort Pilot Study follows 450 women over the course of their pregnancy and after giving birth, collecting a wealth of information on socioeconomic characteristics, health, healthcare use and biological samples. The focus of this paper is to demonstrate how these data may be used to measure inequality of opportunity, between advantaged and disadvantaged populations, for mothers, partners and babies, in terms of their mental health and use of scarce health care resources. This paper provides the foundation for future analyses when a wider Queensland study is proposed to collect data from 12,500 families. [ABSTRACT FROM AUTHOR]

Background: Preclinical animal studies have suggested that myeloid cell–synthesized coagulation factor X dampens antitumor immunity and that rivaroxaban, a direct factor Xa inhibitor, can be used to promote tumor immunity. This study was aimed at assessing whether patients with atrial fibrillation taking direct factor Xa inhibitors have lower risk of cancer and cancer-related mortality than patients taking the direct thrombin inhibitor dabigatran. Methods and findings: This nationwide population-based cohort study in Denmark included adult patients with atrial fibrillation and without a history of cancer, who started taking a factor Xa inhibitor or dabigatran between 2011 and 2015. Data on medical history, outcomes, and drug use were acquired through Danish healthcare registries. The primary outcome was any cancer. Secondary outcomes were cancer-related mortality and all-cause mortality. Outcome events were assessed during 5 years of follow-up in an intention-to-treat analysis. The propensity score-based inverse probability of treatment weighting was used to compute cumulative incidence and subdistribution hazard ratios (SHRs) and corresponding 95% confidence intervals (CIs), with death as a competing event. Propensity scores were estimated using logistic regression and including in the model sex, age group at index date, comorbidities, and use of comedications. A total of 11,742 patients with atrial fibrillation starting a factor Xa inhibitor and 11,970 patients starting dabigatran were included. Mean age was 75.2 years (standard deviation [SD] 11.2) in the factor Xa cohort and 71.7 years (SD 11.1) in the dabigatran cohort. On the basis of the propensity score-weighted models, after 5 years of follow-up, no substantial difference in the cumulative incidence of cancer was observed between the factor Xa inhibitor (2,157/23,711; 9.11%, 95% CI [8.61%,9.63%]) and dabigatran (2,294/23,715; 9.68%, 95% CI [9.14%,10.25%]) groups (SHR 0.94, 95% CI [0.89,1.00], P value 0.0357). We observed no difference in cancer-related mortality (factor Xa inhibitors cohort 1,028/23,711; 4.33%, 95% CI [4.02%,4.68%]. Dabigatran cohort 1,001/23,715; 4.22%, 95% CI [3.83%,4.66%]; SHR 1.03, 95% CI [0.94,1.12]), but all-cause mortality was higher in the factor Xa inhibitor cohort (factor Xa inhibitors cohort 7,416/23,711; 31.31%, 95% CI [30.37%,32.29%]. Dabigatran cohort 6,531/23,715; 27.56%, 95% CI [26.69%,28.45%]; HR 1.17, 95% CI [1.13,1.21]). The main limitations of the study were the possibility of residual confounding and the short follow-up period. Conclusions: In this population based cohort study, factor Xa inhibitor use was not associated with an overall lower incidence of cancer or cancer-related mortality when compared to dabigatran. We did observe an increase in all-cause mortality in the factor Xa inhibitor cohort. Floris Bosch and colleagues investigate whether patients with atrial fibrillation taking direct Factor Xa inhibitors have a lower risk of cancer and cancer-related mortality than patients taking dabigatran. Author summary: Why was this study done?: A preclinical study in mice with breast cancer and fibrosarcoma showed that factor X dampens antitumor immunity and that factor Xa inhibitor promote tumor immunity. Whether factor Xa inhibition is associated with decreased cancer incidence and cancer-related mortality in humans is unknown. What did the researchers do and find?: We assessed cancer incidence during 5 years of follow-up in patients with atrial fibrillation in Denmark using a factor Xa inhibitor (n = 11,742) or a thrombin inhibitor (dabigatran) (n = 11,970) for stroke prevention. No substantial difference in the cumulative incidence of cancer was observed between the factor Xa inhibitor (9.11%, 95% CI [8.61%,9.63%]) and dabigatran (9.68%, 95% CI [9.14%,10.25%]) groups (SHR 0.94, 95% CI [0.89,1.00]. No difference in cancer-related mortality (SHR 1.03, 95% CI [0.94,1.12]) was observed, but all-cause mortality was higher in the factor Xa inhibitor cohort (HR 1.17, 95% CI [1.13,1.21]). What do these findings mean?: Factor Xa inhibitor use for atrial fibrillation did not appear to significantly reduce cancer risk compared to dabigatran use. The main limitations of the study were the possibility of residual confounding and the short follow-up period. [ABSTRACT FROM AUTHOR]

This paper examines the feasibility of ex-post harmonisation strategies using European Values Study (EVS) Wave 5 (2017–2020) and European Social Survey (ESS) Round 9 (2018–2019) data across 17 countries. The study shows an empirical assessment of the comparability of four items measuring religious behaviours (belonging to a religious denomination at present/in the past, religious services attendance, and praying), captured in both surveys. The novelty of this paper lies in the analytical comparison of religiosity indicators that are rarely assessed from a comparative perspective. The harmonisation strategy was based upon several analytical techniques that seek to determine similarities and differences between the selected items in terms of (a) their validity, by examining their correlations with a set of sociodemographic and substantive correlates, (b) their distributions, supplemented by visual comparisons and relevant statistical tests, and (c) item non-substantive shares. The findings pointed to the most consistency among the partial correlations, where individual religiosity produced the most differences between the surveys. Distributions produced the most discrepancies that also corresponded to less similarity across variable categories as gauged by Duncan's index. This paper is descriptive and exploratory in its aim. It can be taken as a jumping-off point for future research where the time series of these two surveys, and potentially others, can be examined across aggregate levels (e.g. birth cohorts, countries). [ABSTRACT FROM AUTHOR]

Background and Objectives: Iron is an essential micronutrient for many biological functions and has been found to be intimately linked to cancer biology. Although the effects of increased dietary iron consumption in the development of CRC have been previously investigated in several cohort studies, the available evidence on the involvement of iron deficiency in this process is relatively scarce. Previously published papers did not analyze specific outcomes, such as the presence of biologically aggressive histopathological characteristics, that are associated with the subtypes of iron deficiency. The purpose of this study was to investigate the connection between the development of colorectal cancer and the presence of functional iron deficiency (FID), which is defined as insufficient biological availability of iron in the presence of adequate storage reserves, or absolute iron deficiency (AID), which is defined as severely depleted iron storage levels. Materials and Methods: Our paper represents a single center registry-based cohort study. Iron levels were routinely evaluated upon diagnosis of CRC and the collected data were coupled with patient- and tumor-specific data (2018–2022). Spearman's correlation coefficient and the chi-squared test were used to analyze the association. Results: Out of 129 patients, 75 (58.13%) were anemic. AID was identified in 26.35% of cases and FID was encountered in 51.16% of cases. A statistically significant association between FID and lymphatic invasion was encountered. An analysis of the correlation demonstrated a significant association between anemia and right-sided tumor location. Conclusions: Functional iron deficiency seems to be independently associated with lymphatic invasion. Although a statistically significant correlation with the T or N stage was not demonstrated, the analysis suggested a potential positive relationship between the presence of FID and more aggressive tumor characteristics. [ABSTRACT FROM AUTHOR]

Objectives: There is conflicting evidence around the role of sex hormones with cardiovascular outcomes. The aim of this study was to examine the association of sex hormones with the risk of myocardial infarction (MI) in pre- and post-menopausal women, and men in the UK Biobank. Methods: The UK Biobank is a prospective population-based cohort study, that recruited over 500,000 (aged 40–69 years) women and men between 2006 and 2010. Sex specific cox regression models, estimating hazard ratios (HRs) and women to men ratio of HRs (RHR) with respective 95% confidence intervals (CI), were used to model the association of sex hormones [oestrogen, testosterone, oestrogen: testosterone (O/T) ratio, sex hormone–binding globulin (SHBG) and the free androgen index (FAI)], measured at study baseline, with incident MI for women and men. Results: Data were from 479,797 participants [264,282 (55.1%) women] without a history of MI at study baseline. Over 12.5 years of follow-up, there were 4,908 MI events in women and 10,517 in men. Neither oestrogen nor testosterone were associated with MI in women and men after multiple adjustment. For men, but not women, a unit higher log-transformed O/T ratio was associated with a lower risk of MI 0.79 (0.65, 0.95) after adjustment for traditional CVD risk factors. The corresponding women to men RHR (95% CI) was 1.24 (0.99, 1.56). Higher SHBG (per unit) was also associated with a lower risk of MI in men 0.94 (0.89, 0.99), and not in women 1.02 (0.95, 1.09) after multiple adjustment, the corresponding women to men RHR (95% CI) was 1.09 (1.00, 1.18). Higher FAI was associated with a higher risk of MI in men 1.09 (1.02, 1.15), though not in women 0.97 (0.92, 1.02), the corresponding women to men RHR was 0.89 (0.82, 0.97). Finally, there were differential effects in the association of SHBG and FAI between pre- and post-menopausal women. Conclusions: A higher O/T ratio was associated with a lower risk of MI, and a higher FAI with a higher risk of MI after adjustment for CVD risk factors in men, but not in women. Thus, hormone ratios, rather than each alone, may play an important role in modulating the effect of MI. Plain Language Summary: There are conflicting findings surrounding the association of sex hormones and myocardial infarction (MI) (heart disease). In particular, high oestradiol levels in women are often thought to be protective and explain why the rates of heart disease are lower in women than men. For men, those with low levels of testosterone are often thought to be more prone to develop heart disease in their lifetimes. Our study presents a comprehensive analysis of the association of sex hormones (in isolation and also together via their ratios), in women and men using the large-scale UK Biobank. We found that neither oestrogen nor testosterone alone were associated with heart disease in women and men after accounting for cardiovascular risk factors, but the ratio of testosterone and oestrogen was associated with a lower risk of heart disease in men, though not in women. We also saw the association of sex hormone–binding globulin (SHBG), and free androgen index (FAI) (calculated by the ratio of total testosterone level to SHBG) with heart disease was different between women and men, and between pre- and post-menopausal women. This paper highlights the complex interplay between sex hormones with heart disease in the presence of age and cardiovascular risk factors. In particular the balance (ratio) of sex hormones maybe more important, rather than each in isolation, when exploring their association with heart disease. Highlights: Neither oestrogen nor testosterone were associated with MI in women and men after multiple adjustment. For men, but not women, higher oestrogen/testosterone ratio was associated with a lower risk of MI after adjustment for traditional CVD risk factors. Higher SHBG was associated with a lower risk of MI in men, but not women overall. Higher FAI was associated with a higher risk of MI in men but not women overall. There were differential effects in SHBG and FAI between pre- and post-menopausal women. [ABSTRACT FROM AUTHOR]

Executive functions (EF) can be measured by tests assessing accuracy, reaction times and by computing scores which combine these two components. Interpretation issues can arise from the use of different scoring methods across studies. Given that EF measures and their scoring methods are predominantly developed and validated in high income countries, little is known about the generalisability of such methods cross- culturally. The current paper compares two different established scoring approaches for measures of inhibition and cognitive flexibility: difference scores (which utilise reaction time only) and computed scores (combining accuracy and reaction time). We utilised data collected in adulthood from three low- and middle-income birth cohorts (Guatemala, Philippines, South Africa). Non-normal distributions were observed for both scoring methods in all three samples; however, this was more pronounced for the difference score method. Differing distribution patterns were observed across the three cohorts, which was especially evident in the Guatemala cohort, highlighting potential issues with using these methods across diverse populations. The data suggest that the computed scores may be a reliable measure of EF. However, the different ways of scoring and interpreting EF instruments need to be considered carefully for each population before use. [ABSTRACT FROM AUTHOR]

Because fascial entrapment neuropathy can occur in multiple locations, ultrasound-guided nerve hydrodissection has become a key component of the treatment of cervical radicular pain. In this paper, we propose a combination of injectates used for nerve hydrodissection of the cervical nerve roots and compare the clinical outcomes of this treatment among patients with different severities of stenosis. This is a retrospective cohort study designed to compare outcomes between patients with mild stenosis and moderate to severe stenosis. Forty-four patients with mild cervical stenosis and 30 patients with moderate to severe cervical stenosis were consecutively enrolled into two groups. A 10-mL mixture in a single level consisting of 5% in Dextrose, 0.2% lidocaine (Xylocaine), and 4 mg betamethasone (Rinderon) was used for nerve roots hydrodissection. The two groups were compared with regard to their numeric rating scales (NRS) of pain, proportion of patients who exhibited a favorable outcome (a reduction of pain ≥ 50%), duration of patient exhibited a favorable outcome, and occurrence of serious complications and minor side effects. The follow-up period ranged from 3 to 20 months. The NRS of both groups improved significantly by 1 week, 1 month, 3 months, and final follow-up after the initial injection. Differences in the groups' NRS, proportion of patients who exhibited a favorable outcome, duration of patient exhibited a favorable outcome, and occurrence of serious complications and minor side effects were nonsignificant. There were 4 patients (5.4%) experienced dizziness in that resolved without further treatment. Ultrasound-guided nerve hydrodissection of cervical nerve roots is a safe procedure that reduces pain associated with cervical radicular pain, even in patients with moderate to severe stenosis. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, a great number of patients required Mechanical Ventilation (MV). Tracheostomy is the preferred procedure when difficult weaning is presented. Surgical techniques available for performing tracheostomy are open and percutaneous, with contradictory reports on the right choice. This paper aims to describe the clinical results after performing a tracheostomy in patients with COVID-19, regarding both surgical techniques. Methods: An observational, analytical study of a retrospective cohort was designed. All patients admitted to the Hospital Universitario Mayor Méderi, between March 2020 and April 2021 who presented COVID-19 requiring MV and who underwent tracheostomy were reviewed. Open versus percutaneous tracheostomy groups were compared and the primary outcome evaluated was in-hospital mortality. Results: A total of 113 patients were included in the final analysis. The median age was 66.0 (IQR: 57.2 – 72.0) years old and 77 (68.14%) were male. Open tracheostomy was performed in 64.6% (n = 73) of the patients and percutaneous tracheostomy in 35.4% (n = 40) with an in-hospital mortality of 65.7% (n = 48) and 25% (n = 10), respectively (p < 0.001). In a multivariate analysis, open tracheostomy technique [OR 9.45 (95% CI 3.20–27.92)], older age [OR 1.05 (95% CI 1.01–1.09)] and APACHE II score [OR 1.10 (95% CI 1.02–1.19)] were identified as independent risk factors for in-hospital mortality. Late tracheostomy (after 14 days) [OR 0.31 (95% CI 0.09–1.02)] and tracheostomy day PaO2/FiO2 [OR 1.10 (95% CI 1.02–1.19)] were not associated to in-hospital mortality. Conclusions: Percutaneous tracheostomy was independently associated with lower in-hospital mortality and should be considered the first option to perform this type of surgery in patients with COVID-19 in extended MV or difficulty weaning. [ABSTRACT FROM AUTHOR]

Introduction: Emerging evidence have suggested a potential relationship between hysterectomy and risk of kidney cancer with inconsistent results. We aimed to investigate the association of hysterectomy with kidney cancer risk based on a meta-analysis of all available cohort studies. Methods: A comprehensive literature search was performed in the PubMed and Embase database, covering all the papers published by September 2022. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were estimated using a DerSimonian and Laird random effects model. Results: Overall, our meta-analysis included 10 cohorts from 9 studies with approximately 240 million participants. The pooled RR with its 95% CI showed a significantly positive association between hysterectomy and risk of kidney cancer (RR 1.30, 95% CI 1.19-1.41). No obvious heterogeneity was observed across the studies (P = 0.206 for heterogeneity; I² = 25.9%). Conclusion: Findings from this meta-analysis of cohort studies indicated that hysterectomy was positively associated with subsequent kidney cancer risk. Further large prospective studies with long-term follow-up are warranted to verify these findings. [ABSTRACT FROM AUTHOR]

Introduction: In Saudi Arabia, limited studies have evaluated factors including epidemiologic, clinical, and laboratory findings that are associated with COVID-19 disease. The aim of this paper was to identify laboratory parameters used in King Abdulaziz University Hospital which show an association with disease severity and patient outcome in the form of mortality. Methods: Age, gender, medical history, and laboratory parameters were all retrospectively assessed concerning disease severity and disease outcome in a total of 111 COVID-19 patients at King Abdulaziz University Hospital between July 2020 and August 2020. Patients were categorized into mild disease if they did not require ward admission, moderate if they met the Ministry of Health criteria for isolation ward admition, and severe if they were admitted to the ICU. Results: Age but not gender was associated with the disease severity X2 (4, N = 110) = 27.2, p <0.001. Of all laboratory parameters on admission, only the levels of Albumin appeared to be significantly associated X2 (2, N =70) = 6.6, p <0.05 with disease severity. Age but not gender was also significantly associated with disease outcome X2 (2, N = 110) = 12.8, p < 0.01. Interestingly, RBC count also showed a significant relation with disease outcome X2 (2, N = 71) = 6.1, p <0.05. Discussion: This study provides more understanding of the laboratory characteristics in our part of the world to efficiently manage the disease. [ABSTRACT FROM AUTHOR]

Objective(s): To estimate continuation rates for postpartum intrauterine contraceptive device (PPIUD) at 6 weeks, 6 months and 1-year within existing programs in an under-resourced setting, and to identify determinants of discontinuation, removal and expulsion. Study design: We used a prospective cohort design and enrolled recent PPIUD adopter women across 100 public healthcare facilities in Odisha and Chhattisgarh, India. We collected their socio-demographic information and followed them up telephonically at 6 weeks, 6 months and 1 year for complications and continuation status. We assessed PPIUD continuation rates and factors associated with PPIUD discontinuation, removal, and expulsion using Cox proportional hazards modelling. Results: We enrolled 916 participants (579 (63.2%) from Odisha and 337 (36.8%) from Chhattisgarh). The continuation rate of PPIUD was 88.7% at 6 weeks, 74.8% at 6 months 60.1% at one year. Once discontinued, chances of not opting for any family planning method was high (up to 81.2%). Participants with education of 6th to 12th class and those experiencing complications (pain abdomen, bleeding and discharge per vaginum) were more likely to remove the IUD with adjusted hazard ratio of 1.82 (95% CI: 1.18–2.79) and 4.39 (95% CI: 3.25–5.93) respectively. For expulsion, we did not find any factor that was statistically significant. Conclusion(s): PPIUD continuation rates declined considerably after the initial 6 weeks. Counselling and follow-up services for managing complications must be strengthened, especially in the first 6 weeks of PPIUD insertion, to enhance and sustain programmatic impact. Implications: Our findings emphasize on the need to strengthen client counseling and follow-up for management of complications, especially in the first 6 weeks of insertion of PPIUDs. Ongoing programs need to address comprehensive capacity building efforts in this regard. [ABSTRACT FROM AUTHOR]

Aim: To investigate the seizure course of PCDH19 clustering epilepsy (PCDH19‐CE) in a cohort of female children in China. Method: This ambidirectional cohort study examined 113 female patients with PCDH19‐CE through multicentre collaboration. Prognostic factors for seizure freedom were evaluated by multivariate Cox regression analysis. Results: The median seizure course period from seizure onset was 6 years 6 months. Of 113 patients, 78% and 56% experienced seizure freedom for at least 1 year and at least 2 years respectively. In patients younger than 5 years (n = 30), 5 to 10 years (n = 52), and older than 10 years (n = 31), 57%, 81%, and 94% experienced at least 1 year of seizure freedom, and 32%, 52%, and 84% experienced at least 2 years of seizure freedom, respectively. However, 58% (65 out of 113) relapsed at least once after more than 1 year of seizure freedom without trigger exposure (40%) or because of common triggers, including fever (43%) and antiseizure medication (ASM) reduction (29%). There was an 84% risk of seizure relapse after ASM reduction attempts. The likelihood of seizure freedom decreased with early age at seizure onset and developmental delay. Interpretation: Patients with PCDH19‐CE exhibit increasing seizure freedom with age, but there is a risk of relapse. ASM reduction in children younger than 10 years old requires caution. Patients with early seizure onset and developmental delay have a reduced chance of seizure freedom. What this paper adds: The seizure freedom rate in PCDH19 clustering epilepsy gradually increases with age.The disease course is characterized by relapsing–remitting seizures.Antiseizure medication reduction requires caution for patients younger than 10 years of age.Patients with early seizure onset and developmental delay are less likely to achieve seizure freedom. [ABSTRACT FROM AUTHOR]

This paper assesses the effects of adverse economic shocks on children's mental health. We rely on the Brazilian High-Risk Cohort Study for mental conditions, which provides an unprecedented array of data on psychopathology, life events, family medical history as well as parental behaviour and polygenic scores for mental disorders over a ten-year period. Our empirical strategy exploits parental job loss events over time in a difference-in-differences framework. We document that parental job loss significantly worsens children's mental health, resulting in increased clinical diagnoses of mental disorders. These results are robust to several specifications and pre-trends. Heterogeneous results and mechanism analysis indicate that psychological distress in the household brought about by job loss events may be a key mechanism affecting children's mental health. [ABSTRACT FROM AUTHOR]

This document is a response to a letter regarding a study on the relationship between screening history and survival in colorectal cancer patients. The authors of the study acknowledge the importance of considering various factors such as patient demographics, lifestyle factors, comorbidities, and treatment approaches in understanding this relationship. They conducted a comprehensive analysis, adjusting for factors such as age, sex, urbanization, hospital levels, cancer stage and site, treatment, and other clinicopathological variables. Despite these adjustments, the association between screening history and colorectal cancer mortality remained consistent. The authors note that their adjustments were not exhaustive due to limitations in the available data. The document includes tables presenting hazard ratios for death due to colorectal cancer with additional adjustments for body mass index, cigarette smoking, alcohol consumption, and family history of colorectal cancer. The authors disclose no conflicts of interest. [Extracted from the article]