Study Participants Research Articles

Impact of COVID-19 lockdown measures on mother and child health - the case of Ghana.

The lockdown measures in response to the coronavirus disease (COVID-19) have led to a wide range of unintended consequences for women and children. Until the outbreak of COVID-19, attention was on reducing maternal and infant mortality due to pregnancy and delivery complications. The aim of this study was to interrogate the impact of lockdown measures on women and children in two contrasting districts in Ghana - Krobo Odumase and Ayawaso West Wuogon. This study adopted the mixed-method approach using both qualitative and quantitative data. The qualitative study relied on two data collection methods to explore the impacts of COVID-19 control measures on women and children in Ghana. These were: Focus Group Discussions (FGDs; n = 12) and Key Informant Interviews (KIIs; n = 18). The study complemented the qualitative data with survey data - household surveys (n = 78) which were used to support the nutrition and school closure data; and policy data gathered from government websites consisting of government responses to COVID-19. The qualitative data was analysed using the thematic approach with codes generated apriori with the NVIVO software. The quantitative data used percentages and frequencies. Engagements with participants in the study revealed that the lockdown measures implemented in Ghana had consequences on child and maternal health, and the health care system as a whole. Our study revealed, for example, that there was a decrease in antenatal and postnatal attendance in hospitals. Childhood vaccinations also came to a halt. Obesity and malnutrition were found to be common among children depending on the location of our study participants (urban and rural areas respectively). Our study also revealed that TB, Malaria and HIV treatment seeking reduced due to the fear of going to health facilities since those ailments manifest similar symptoms as COVID 19. Government responded to COVID-19 using different strategies however the policy response resulted in both intended and unintended consequences especially for women and children in Ghana. It is recommended that national policy directions should ensure the continuous provision of child and maternal healthcare services which are essential health services during lockdowns.

Effect of a small increase in off-premises trading hours on alcohol sales in Norway: A stepped-wedge cluster-randomized controlled trial.

Evidence of the effect of limiting off-premises alcohol trading hours is still scarce. This study tested the effect of a small extension in trading hours on alcohol sales in alcohol monopoly outlets in Norway. The extension of trading hours was implemented within a stepped-wedge cluster-randomized trial design. Eligible state monopoly outlets (n = 229) were clustered into trade districts (n = 62), which were block-randomized to one of three sequences regarding date of implementation: 1 September 2020 (n = 21 districts, 82 outlets), 1 December 2020 (n = 21 districts, 73 outlets) and 1 March 2021 (n = 20 districts, 74 outlets). Outcomes were followed-up for a 1-year period. Study participants were state monopoly outlets in urban and rural trade districts in all parts of Norway. Monthly alcohol sales in litres of pure alcohol per trade district and per outlet were measured from March 2020 to March 2022 (primary outcome). We applied a linear mixed-effect model with two-way fixed effects within a difference-in-difference framework. As a robustness check we considered the effects of cross-border trade and effects in subgroups of outlets. Trading hours in monopoly outlets were extended by 1 hour on Saturdays. The extension was permanent. Pre-intervention periods and not-yet-treated units served as control conditions. We did not find a statistically significant effect of the small extension in trading hours on monthly alcohol sales (i) per trade district [average treatment effect: -185.5litres, 95% confidence interval (CI) = -1159.9, 788.9] and (ii) per outlet (-35.3litres, 95% CI = -142.1, 72.0). These findings were consistent across estimation methods and model specifications. There is no clear evidence that a small extension in off-premises trading hours affected alcohol sales in monopoly outlets in Norway.

Targeting Method for rTMS for Treating Depression in Japanese Patients: A Comparison of the Standard, F3, and Neuronavigation Approaches.

The left dorsolateral prefrontal cortex (lDLPFC) is a commonly targeted brain region for repetitive transcranial magnetic stimulation (rTMS) for depression. The lDLPFC has been identified using the "5-cm rule." However, identification of the lDLPFC may deviate from the ideal stimulation site localized by neuronavigation. Therefore, we aimed to compare this method with other methods and examine the relationship between deviation from the ideal stimulation site and treatment effects. While most existing studies have focused on participants of European descent, this study focused on Japanese participants. The study participants were 16 patients who underwent rTMS and had the stimulus location identified using the 5-cm method. The lDLPFC was identified by the F3 electrode position and neuronavigation in addition to the 5-cm rule, and these locations were compared. We then performed a correlation analysis of the distance between the sites identified by the 5-cm method and by neuronavigation, as well as changes in scores on the 17-item Hamilton Depression Scale (HAMD-17). The lDLPFC identified by the F3 site and neuronavigation was approximately 3 cm more anterolateral than that identified by the 5-cm method. A significant correlation was found between the distance between the sites identified by the 5-cm method and neuronavigation and the rate of change in HAMD-17 scores. The ideal stimulation site may be approximately 3 cm anterior to the site identified by the 5-cm method, and stimulation of the F3 site may be a valid alternative to the 5-cm method.

Knowledge, attitude, and practice towards breast self-examination among women: a web based community study

BackgroundThe most common form of cancer among women is breast cancer in the Kingdom of Saudi Arabia. Thus, the purpose of this study was to evaluate women in Saudi Arabia’s Asir Region, on their knowledge, attitudes, and practices (KAP) regarding breast self-examination (BSE).MethodsThe research was carried out cross-sectional and conducted from October 2023 to June 2024 in Saudi Arabia’s Asir province.ResultsOut of 397 study participants, 89 (22.4%) had good knowledge, and 308 (77.6%) had poor knowledge; 185 (46.6%) had a positive attitude, and 212 (53.4%) had a negative attitude 24 (6%) had good practice 373 (94%) had poor practice about breast BSE. According to study participants, social media, 204 (51.4%), radio, television, and newspapers were the best places to learn about BSE. In this study, 316 (79.6%) had heard of BSE. 230 (57.9%) stated that breast cancer patient’s likelihood of survival increases with early detection. Only 231 (58.2%) and 247 (62.2%) agreed that breast cancer is indicated by changes in the color and shape of the breast and retraction/discharge of the breasts, respectively. Out of 147, 24 (16.3%) self-examined just one week after each menstruation. Single (OR = 6.259; 95% CI = 1.790–21.887, p = 0.004) and married (OR = 4.923; 95% CI = 1.509–16.056, p = 0.008), Single (OR = 2.736; 95% CI = 1.248–6.000, p = 0.012) and married (OR = 3.176; 95% CI = 1.734–5.817, p = 0.00) were significantly associated with good knowledge and attitude of BSE, respectively. Illiterates (OR = 0.233; 95% CI = 0.060–0.895, p = 0.034), pre-university (OR = 0.222; 95% CI = 0.092–0.538, p = 0.001), Illiterates (OR = 0.293; 95% CI = 0.114–0.755, p = 0.011), pre-university (OR = 0.462; 95% CI = 0.271–0.788, p = 0.005) are less likely to have good knowledge and attitude compared to college and university educated.ConclusionThe study revealed that few women have good knowledge, attitudes, and practices among BSE. In this study, attitude level is high in comparison to knowledge and practice. However, 94% never practiced at all. It is strongly advised that a focus be placed on improving women’s KAP regarding BSE, as well as BSE educational programs in universities and more community service activities such as health campaigns in public places.

An Open-Label Extension Study Assessing the Long-Term Safety and Efficacy of Viloxazine Extended-Release Capsules in Adults with Attention-Deficit/Hyperactivity Disorder.

Viloxazine ER (extended-release capsules; Qelbree®) is a nonstimulant medication that has been approved by the United States Food and Drug Administration (FDA) for treatment of attention-deficit/hyperactivity disorder (ADHD) in children (> 6 years old) and adults. This phase 3 open-label extension to a pivotal phase 3, double-blind trial evaluated the long-term safety and continued efficacy of viloxazine ER in adults with ADHD. This was a multicenter, flexible-dose, open-label extension to a phase III, double-blind, placebo-controlled trial (NCT04016779). Viloxazine ER was initiated at 200 mg/day and adjusted (between 200 and 600 mg/day) to achieve optimal efficacy and tolerability. Trial enrollment was halted temporarily (24 March 2020 to 23 July 2020) due to the coronavirus disease 2019 (COVID-19) pandemic. Participants completing double-blind treatment during that time were offered delayed enrollment upon trial requalification. Safety outcomes were the primary objectives. Secondary objectives were efficacy outcomes, including the ADHD Investigator Symptom Rating Scale (AISRS), and were assessed relative to double-blind baseline (or trial re-entry baseline for those whose enrollment was delayed by the COVID-19 pandemic). Overall, 159 participants (133 immediate and 26 delayed rollover) received viloxazine ER, with a mean exposure of 265 ± 254.9 days. Adverse events (AEs) included (> 10% incidence) insomnia (13.8%), nausea (13.8%), headache (10.7%), and fatigue (10.1%). AEs led to discontinuation for 17.6% of participants [most commonly insomnia (2.5%), nausea (2.5%), and fatigue (1.9%)]. AISRS total score [baseline mean ± standard deviation (SD): 37.9 ± 6.3] improved by the first follow-up visit (-11.4 ± 9.5; week 2) with continued improvement at subsequent visits (last on-study visit: -18.2 ± 11.54). Similar patterns of improvement were seen for other measures of efficacy, including quality of life and executive function. Following initial dose optimization, most participants (73%) used viloxazine ER doses ≥ 400 mg/day, with 36% using doses of 600 mg/day. Long-term viloxazine ER use was well tolerated, with no new long-term safety findings. Improvements in ADHD symptoms and associated measures were sustained throughout trial participation. In total, 73% percent of adult participants in this long-term study used viloxazine ER doses of 400 mg or more during maintenance treatment. Clinicaltrials.gov Identifier: NCT04143217.

Investigating the Relationship Between Metabolic Syndrome with Physical Activity and Eating Habits: The Result of the Tabari Cohort Study

Background: Metabolic syndrome (MetS) is a group of metabolic issues that increase the risk of type 2 diabetes and heart disease. Objectives: To reduce deaths from type 2 diabetes and heart disease, this study was conducted to determine the relationship between metabolic syndrome, physical activity, and eating habits in participants of the Tabari cohort study. Methods: In this descriptive cross-sectional study, data from the Tabari cohort in an urban and mountain area in Sari, Mazandaran, was utilized from June 2015 to November 2017. Background information of participants was documented, and their eating habits were assessed using a food habit questionnaire. Additionally, the physical activity levels of the participants were recorded. All individuals were assessed for metabolic syndrome according to the third Adult Treatment Panel (ATP III) guidelines. The gathered data was then inputted into SPSS V.23 software for analysis. Qualitative variables, such as demographic and epidemiological data, were compared between the two groups using the chi-square test, while quantitative variables were compared using an independent t-test. Results: A total of 10,255 adults between the ages of 35 and 70 participated in this study, and after applying entry and exit criteria, 9,976 people, including 4,083 with metabolic syndrome and 5,893 healthy individuals, were included in the final analysis. There was no significant difference in the average Body Mass Index (BMI) between individuals with metabolic syndrome (30.6 ± 4.5 kg/m²) and healthy individuals (26.8 ± 4.4 kg/m²). However, individuals with metabolic syndrome exhibited significantly higher values for height, weight, waist circumference, abdominal circumference, and wrist circumference compared to the control group (P = 0.001). The average Metabolic Equivalent of Task (MET) for the entire population was 43.03 ± 9.27, with a median of 40.68 (range: Twenty-four-one hundred three) hours/day. A greater percentage of individuals with metabolic syndrome (57.0%) and healthy individuals (45.2%) had MET values below the average (P = 0.001). Regarding energy intake, individuals with metabolic syndrome consumed an average of 2189.74 ± 721.90 calories, while healthy individuals consumed 2354.92 ± 4.04 calories, showing a significant difference (P = 0.006). Moreover, healthy individuals demonstrated significantly higher consumption of added salt in food, fried foods, fried potatoes, fried onions, fried vegetables, and various types of cooking oils compared to those with metabolic syndrome (P = 0.001). Conclusions: Based on the results of the Tabari cohort study, the prevalence of metabolic syndrome in Mazandaran was 41.10%, highlighting the need for prevention and screening programs. In this study, individuals with metabolic syndrome consumed fewer fried foods, trans fats, and daily calories compared to the healthy group. Considering that this study is cross-sectional and utilized data from the Tabari cohort, it is assumed that the difference is due to dietary compliance and lifestyle changes in patients with metabolic syndrome. It is recommended that prospective studies be designed to evaluate the causes of differences in metabolic syndrome components between the two groups.

Complementary and integrative medicine in cancer-related fatigue

The majority of cancer patients experience fatigue during the course of their illness. Fatigue should not be seen as an inevitable consequence of cancer and its treatment. Cancer-related fatigue (CRF) is amultidimensional symptom complex that is influenced by avariety of factors. Complementary medicine approaches offer potentially promising strategies to address this fatigue and can therefore be avaluable addition to conventional therapies.In this narrative review, complementary medicine treatment approaches for tumor-associated fatigue are presented according to the historical development and current scientific evidence. The focus is on methods with the highest current evidence based on the recommendations of national and international guidelines. Therapeutic approaches from mind-body medicine, such as mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), yoga, tai chi, and qigong, as well as acupuncture, acupressure, moxibustion, and phytotherapeutic treatment approaches are presented.In Germany, the complementary therapies listed here are not generally covered by health insurances. However, afew clinics have developed comprehensive programs in mind-body medicine, for which cost coverage has already been obtained. As aresult, complementary medical treatments for cancer-related fatigue that adhere to national and international guidelines are typically available only as private services or within the framework of study participation.

Parental Perceptions of Community and Professional Attitudes Toward Autism.

The purpose of this study was to examine parent perceptions of professional and community attitudes about autism through the lens of parenting their autistic children from birth through adulthood. Implications of this research may assist with future development and study of professional and community supports of individuals on the autism spectrum and their families. The study participants consisted of 51 parents who had an adult-aged child on the autism spectrum. One-on-one interviews were conducted with parents about their experiences raising a child with autism. Data were double-coded and analyzed using a qualitative, phenomenological approach to explore parents' experiences with and perceptions of society members' attitudes towards autism. Positive and negative themes were identified across parents' perceptions of professionals and of community members. Themes regarding professional attitudes included cooperating with family requests, presuming competence of individuals with autism, complacency towards the needs of families and individuals with autism, and discrimination towards the individual with autism based on age or level of need. Themes regarding community member attitudes included valuing the strengths of individuals with autism, accommodating autistic differences, intolerance of autistic traits, and prejudice towards individuals with autism. Findings indicate that professional and community members presented with both positive and negative attitudes towards autism and individuals on the autism spectrum, with negative attitudes proving more prevalent in parent recollections. Results suggest a need for further research and related training to improve interactions with and support of individuals with autism and their families.

Characterizing visual field loss from past mercury exposure in an Indigenous riverine community (Grassy Narrows First Nation, Canada): a cluster-based approach.

Between 1962 and 1975, a chlor-alkali plant in Canada discharged approximately 9 metric tons of mercury (Hg) into the Wabigoon River. Over the following decades, biomarkers of Hg exposure of persons from Grassy Narrows First Nation (Asubpeeschoseewagong Anishinabek), located downriver from the discharge, reflected Hg concentrations in fish. Hg exposure is known to target the calcarine fissure, resulting in visual field (VF) loss. Most studies and clinical reports focus solely on peripheral VF loss; little is known about the impact of Hg on the central and paracentral portions. The present study sought to characterize the patterns of VF loss with respect to past and current Hg. A 28-year hair-Hg (HHg) database, created from a 1970-97 government biomonitoring program, served to select study participants with ≥ 4year-based HHg measurements (n = 81). Blood-Hg was assessed for current exposure. Light sensitivity thresholds across the VF were analyzed monocularly, using a Humphrey Field Analyzer (HFA). Following post-hoc exclusions, based on HFA interpretation indices, 65 participants were retained. Both eyes were combined for analyses (n = 130 eyes). Unsupervised hierarchical clustering of HFA plot data was used to identify patterns of VF loss. A series of mixed effects models (MEM) were performed to test the associations for current Hg exposure with respect to HFA interpretation indices and clusters, as well as for longitudinal past Hg exposure. The clustering approach decomposed the light sensitivity deficits into 5 concentric clusters, with greatest loss in the peripheral clusters. No relation was observed between any of the cluster scores and current blood-Hg. VF deficits increased with past Hg exposure. Longitudinal MEM showed that HHg was significantly (p < 0.05) associated with all peripheral, paracentral, and central cluster scores, as well as with HFA interpretation indices. Past Hg exposure in Grassy Narrows First Nation was associated with present day VF loss. The cluster-based location-specific approach identified patterns of VF loss associated with long-term Hg exposure, in both the peripheral and the central areas. The functional implications of this type of visual loss should be investigated.

Implementation study of the CARRA Uveitis Consensus Treatment Plans: feasibility for clinical practice and applicability for research.

Chronic anterior uveitis (CAU) carries a significant risk for eye complications and vision loss. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) introduced consensus treatment plans (CTPs) to standardize treatment for CAU and facilitate future comparative effectiveness studies. Two CTPs were developed to address: 1) initiation of methotrexate (MTX) in patients with CAU naïve to steroid-sparing therapy, and 2) initiation of a TNF inhibitor (TNFi) in patients with severe uveitis or uveitis refractory to MTX. We evaluated implementation of the uveitis CTPs using existing CARRA Registry infrastructure and assessed feasibility of the CTPs for comparative effectiveness research. This prospective observational cohort study was conducted at nine pilot sites between February 2020 and August 2022. Patients with JIA-associated CAU (JIA-U) were treated according to either the MTX or TNFi CTP. Uveitis activity and medication use were recorded at 0, 3, and 6months. We assessed patient enrollment rates, CTP arm selection, uveitis control, and quality of data collection. We also evaluated CTP arm selection in a retrospective cohort of similar JIA-U patients enrolled in the CARRA Registry during the same study period. Seventeen patients were included in the pilot cohort. Eight were treated with the MTX CTP (4 oral MTX, 4 subcutaneous MTX), and 9 with the TNFi CTP (9 received standard-dose adalimumab, none selected high-dose adalimumab or infliximab). Uveitis was controlled in 13 of 17 patients by 6months. Query of the CARRA-wide Registry identified 42 patients with JIA-U who were treated according to the MTX or TNFi CTPs. Among these, 26 were treated with MTX (8 oral, 18 subcutaneous) and 16 with TNFi (12 standard dose adalimumab, 2 high dose adalimumab, and 2 infliximab). Both the MTX and TNFi uveitis CTPs can practically be implemented in clinical settings and are currently being utilized across Registry sites. However, in patients starting TNFi therapy, all pilot study participants and most patients across the CARRA Registry were treated with a standard dose of adalimumab. This consensus on the treatment approach underscores its broad acceptance but also limits the applicability of the uveitis TNFi CTP for comparative effectiveness research.

Audiometric Profiles Across a Clinical Population of Children With Hyperacusis.

Hyperacusis (sound sensitivity) is well documented among adults, but little is known about hyperacusis in children. Here, we assess relationships among the presence of hyperacusis, audiometric profiles, and nonauditory factors in a pediatric clinical population. A retrospective review of clinical records from 329 children, ages 2-17 years, was performed to assess the prevalence of hyperacusis and correlations among hearing status, behavioral or communication concerns, and the presence of hyperacusis. In 329 study participants, 18% reported hyperacusis (58% male and 42% female). No significant sex or age differences were found. Hyperacusis was more likely to occur alongside normal hearing or with unilateral hearing loss relative to bilateral hearing loss. Among children with hyperacusis, there was a high prevalence of audiovestibular problems, mental health concerns, speech and language delays, difficulty in school, and behavioral problems. Tinnitus was also found to be comorbid with hyperacusis, but the comorbidity was less than that reported in adults. This study identified common hearing profiles and critical comorbidities in a large clinical cohort of children with hyperacusis. These results demonstrate the urgent need for standardized multidisciplinary assessment and treatment protocols for pediatric hyperacusis.

Game-based Training of Cognitive Functions: An Exploratory Study Involving Seniors in Switzerland

The aging population is resulting in a worldwide rising prevalence of individuals experiencing cognitive decline, whether it be normal age-related changes or pathological conditions. Game-based training in the form of serious games represents an alternative way to enhance cognitive functions among older people. We developed a set of games to train multiple cognitive functions of seniors, considering that their level of digital literacy can vary greatly. A participatory approach has been applied to the development process, involving a multidisciplinary research team and older people. Interviews, usability tests, and a workshop were run with ten seniors (70+) in Southern Switzerland to explore accessibility, usability, and preferences. This paper presents the development process and the games created. Six different games were designed to stimulate multiple cognitive functionalities (e.g., cognitive flexibility, attentiveness, and memory). The serious games run on a tablet. Following Laamarti’s classification, we developed the games to be applied in well-being and health areas, requiring mainly mental activities through visual modalities, played through a touchscreen in a 2D digital environment. Participants appreciated the experience and the challenges provided by the games, understanding the broader aim (cognitive functions training) and the rules, and could complete the required tasks. Feedback was provided on graphical elements (icons and colours), as well as with suggestions for improvements. The tablet appeared to be functional and relatively easy to use, even for first timers. The promising results of this participatory study pave the way for the follow-up phase of the project, which will gather data on the usage of the application and its effectiveness with a greater number of subjects.

European Nurses’ Burnout before and during the COVID-19 Pandemic and Its Impact on Patient Safety: A Scoping Review

Health systems around the world continue to experience healthcare workforce shortages, including shortages of nurses. This results in staff experiencing prolonged shifts and other stressors, which are linked to burnout, yet burned-out staff are then entrusted with the provision of patient care, despite healthcare facilities being regarded as safety-critical areas. It is assumed that the situation may have been worsened by the COVID-19 pandemic. This scoping review aims to identify the prevalence of burnout among nurses in Europe before and during the pandemic, the factors associated with this burnout, and its impact on patient safety. A literature search was conducted in the MEDLINE database; search terms included Nurse and Burnout and Patient Safety and their synonyms. The search limits used were English language, 2013 to 2023 publication years, original published research only (excluding review papers, dissertations, and unpublished reports), and studies conducted in European countries. A total of 16 papers were included for analysis: four indicated burnout levels of study participants, while 11 gave scores for individual burnout symptoms. Almost all studies indicated factors that were linked to burnout or individual dimensions of burnout. A few papers touched on the implications of these factors on patient safety. The review findings concluded that the few studies providing burnout levels on study participants could not give a clear picture of the burnout prevalence among nurses across Europe, either in general, before, or during the pandemic; therefore, this objective was not achieved and more research is required to establish this. Several factors thematically classified as sociodemographic, personal, organizational, and patient/client-related were linked to burnout. However, there were some contradictions in sociodemographic factors. Low personal accomplishment was the most common symptom of burnout before the pandemic, followed by emotional exhaustion and lastly depersonalization. Emotional exhaustion took the lead during the COVID-19 pandemic, followed by low personal accomplishment, and depersonalization remained the least common. More research is needed to establish the relationship between burnout and these factors.

Similar, not universal: the cognitive dimensions of conceptual prototypes of basic emotions in English and in Polish.

The current study explores the differences in conceptualisation of the prototypical basic emotion lexicalisations (anger, disgust, fear, joy, sadness, surprise) in English and in Polish. Measures of concreteness, imageability and context availability were collected and analysed across the six semantic categories of basic emotions, across different parts of speech and between the self-determined genders of the study participants. The initial results indicate that within these cognitive dimensions the conceptualisations of basic emotions in English and in Polish are only similar on the more general but not the higher levels of conceptualisation. The folk-psychological division between positive and negative emotions and the grammatical parts of speech reveal similar patterns in basic emotion concepts in both Polish and in English. However, on the higher levels of conceptualisations that include specific basic emotion semantic categories and self-identified gender, marked language-specific differences become apparent. Different negative emotions drive the statistical differences in Polish and in English, and the gender effects on the measures of concreteness, imageability and context availability are opposite from one language to the other. In other words, basic emotions may be broadly mutually intelligible, but not exactly the same when communicated across languages and cultures.

Bots and fake participants: ensuring valid and reliable data collection using online participant recruitment methods

ABSTRACT Recruitment for successful health sciences research requires balancing efficiency, cost, accessibility, and reliability of available recruitment methods. Our case-control study used online recruitment methods, which broadened our reach to potential participants across the United States. However, this approach also exposed us to challenges associated with bot interference and fraudulent participation. This paper focuses on maintaining data integrity, specifically when utilizing online participant recruitment methods. Drawing from our experience, we propose The Swiss Cheese Model of Study Participant Fraud Prevention, adapted from Reason’s Swiss Cheese Model, and illustrate 10 prevention and verification measures that can be taken to minimize fraud in research studies that rely on online recruitment. We emphasize the importance of a layered approach, including carefully designed recruitment media and compensation protocols, vetting of participant eligibility, and data verification protocols to ensure the validity and reliability of research findings in the digital age.

Comparative study of microneedling monotherapy versus microneedling with autologous platelet-rich plasma for the treatment of stretch marks (striae distensae) and post-surgical scars: Clinical and dermoscopy outcomes

Objectives: Stretch marks and post-surgical scar marks may have negative cosmetic and psychological impacts.. Thus, this study aimed to compare the efficacy and safety of microneedling monotherapy versus microneedling in combination with autologous platelet-rich plasma (PRP) for the treatment of stretch marks and post-surgical scars. Material and Methods: This was a prospective randomized non-controlled study. A total of 30 study participants with stretch marks and post-surgery scars were enrolled and randomly divided into two groups, each with 15 study participants. All received three treatment sessions using microneedling monotherapy (Group A) or autologous PRP with microneedling (Group B) at 4-week intervals. Clinical response to treatment was assessed at the end of 20 weeks by comparing clinical photographs, Manchester Scar scale (MSS) score, dermoscopy images, and patient satisfaction scores. Results: At the end of the study, statistically significant esthetic improvement in terms of MSS scores was seen in Group B when compared to Group A. In Group A, 73.3% of the study participants were satisfied while in Group B, 86.6% were very satisfied with the results. Dermoscopy pictures substantiated the findings of clinical improvement. No major side effects were documented. Conclusion: PRP in combination with microneedling has a better outcome as compared to microneedling monotherapy. Furthermore, dermoscopy is a non-invasive tool that can be used to evaluate therapeutic response.

Understanding Ethical Concerns Involving Vulnerable Human Participant Populations in Medical Research: Mixed-Method Analysis of Liberian Ebola Survivors’ Experiences in PREVAIL I–VII

Background: As the number of large-scale outbreaks continues to rise worldwide, clinical trials are increasingly engaging disease-affected peoples within the Minority World (nations with over 80% poverty rates). Yet global health research inadequately addresses potential ethical issues of including impoverished, disease-affected populations and their contextual vulnerabilities in medical research. Objective: This paper presents a mixed-method analysis from our 2022 semi-structured survey capturing the experiences of Liberian Ebola Virus Disease (EVD) survivors serving as study participants in the Partnership for Research on Ebola Virus in Liberia (PREVAIL) clinical trials. Methods: Firstly, we conducted an extensive literature review of the scholarship related to biomedical research and ethical standards protecting study participants to inform our survey method and design. Applying a theoretical framework on vulnerability, we then qualitatively explored the survey responses of 19 EVD survivors’ perceptions and experiences taking part in PREVAIL, including their expectations, treatment, delivered benefits, and quality of care. We further quantitatively codified their statements for underlying themes of reported negative experiences against standard ethical regulations in biomedical research, conducting a statistical analysis to inform generalizability. Most of the 19 survivors reported facing extreme ongoing vulnerabilities related to their disease status, including physical impairments, psychosocial stress, and socio-economic inequity. Results: Initially, the survivors tended to experience a sense of hope and pride in volunteering for PREVAIL. One in five participants reported benefiting from PREVAIL’s regular medical diagnoses. However, most of their survey responses indicated prevalent negative shared experiences, including continually being confused or misinformed of their study participant rights, roles, and benefits; being burdened by heavy participation transaction costs; and repeated incidents of poor treatment and discrimination by PREVAIL staff after initial recruitment. PREVAIL participant satisfaction ranking is negatively correlated with receiving insufficient financial compensation (r = −0.51), extensive time requirements for each medical visit (−0.40), and being poorly treated by clinical staff (−0.67).

Determinants of low satisfaction with life among wheelchair users with spinal cord injury in Egypt: a cross-sectional study

BackgroundSpinal cord injury (SCI) is one of the most catastrophic injuries that might lead to permanent use of a wheelchair and severely affects the quality of life, hence SCI patients report lower satisfaction with life (SWL) than the general population. Therefore, it is important to identify factors that determine SWL among wheelchair users with SCI. Our study aimed to assess the prevalence of low SWL and to identify its determinants among wheelchair users with SCI in Egypt.MethodsA cross-sectional study included 105 wheelchair users with SCI from the Al Hassan Foundation for wheelchair users in Egypt. The main outcome measure was low SWL, while the independent variables included sociodemographic characteristics, injury-related characteristics, anxiety, depression, neuropathic pain, functional independence, and environmental barriers.ResultsThe prevalence of low SWL among study participants was 57.1%. We found significant associations between SWL and age, area of living, and age at injury. Additionally, SWL correlated negatively with anxiety, depression, neuropathic pain, and environmental barriers, and positively with functional independence. Finally, the binary multiple logistic regression revealed that living in Upper Egypt (p = 0.017, OR = 13.7), depression (p = 0.034, OR = 6.08), older age (p = 0.002, OR = 1.21), and work and school environmental barriers (p = 0.022, OR = 0.46) were the predictors of low SWL.ConclusionTo improve the SWL for wheelchair users with SCI we need to effectively manage neuropathic pain, depression, and anxiety, and promote functional independence. There is an urgent need to reinforce legislation to improve the living conditions for wheelchair users with SCI in Egypt, especially in Upper Egypt.

Coverage and evaluation survey of post-mass drug administration for lymphatic filariasis in four endemic districts of Uttar Pradesh: are we on the track?

There is a persistent high microfilaria rate and variable reporting of coverage of Mass Drug Administration (MDA). The study aims to estimate the coverage, effective coverage, and compliance of drugs administered under MDA and to determine the predictors affecting the effective coverage. A community-based cross-sectional study was conducted in Amethi, Lucknow, Raebareli and Sultanpur districts of Uttar Pradesh, India. The study participants were selected using multi-stage random sampling using Probability Proportional to Estimated Size (PPES). The coverage, effective coverage and compliance of drugs were presented as proportion. The multivariable logistic regression model was applied to identify the significant predictors for effective coverage. Of 4151 participants, 997 (24.0%), 340 (8.2%), 1158 (27.9%) and 1656 (39.9%) belonged to Amethi, Lucknow, Raebareli and Sultanpur districts respectively. The coverage ranged from 49.8% to 87.9% and effective coverage ranged from 51.8% to 73.2% across districts. The compliance was the poorest (70.7%) in Sultanpur. The source of information about MDA, the sex of the study participants and the area of residence emerged as predictors for effective coverage in the districts. The effective coverage was poor with good drug complianceacross the districts. There is a need for a well-designed pre-MDA campaign addressing the fear of side effects of drugs and emphasising the presence of the community during the MDA round along with monitoring and evaluation of the round.

Genomic analysis of Enterobacteriaceae from colorectal cancer patients at a tertiary hospital in Ghana: a case-control study.

Colorectal cancer (CRC) is a severe gastrointestinal cancer and a leading cause of cancer-related deaths in Ghana. The potential role of gut Enterobacteriaceae in the increasing incidence of CRC in Ghana is yet to be thoroughly investigated. In this study, Enterobacteriaceae from CRC patients and healthy control participants were analyzed by whole genome sequencing to identify genomic features that are associated with CRC. Socio-demographic data showed a significant association between age and alcohol consumption and CRC. Escherichia coli was the most abundant Enterobacteriaceae isolated from the study participants and they were predominantly intestinal commensals. Escherichia coli isolates belonging to phylogroup D encoded the highest number of virulence genes. The agn43 and int genes were widespread in Escherichia coli isolates from the CRC patients. Multilocus sequence types of potentially pathogenic Escherichia coli from the CRC patients also encoded genes involved in aggregation, adherence and biofilm formation. The ampC2 and ampH antimicrobial resistance genes were also widespread in the genome of the Escherichia coli isolates. This study highlights the virulence tendencies of Escherichia coli from CRC patients and their ability to transfer virulence determinants to other Enterobacteriaceae residing in the gut.