bluuebunny/crossref_metadata_2025 huggingface dataset:
“No man is an island”: How Chinese netizens use deliberate metaphors to provide “depression sufferers” with social support
Authors: Jing Youping , Jiang Guiying
Published: February 2024

Objective

Online social support provides a way to positively influence depression sufferers. In the present study, we aim to analyze how social support in Chinese online depression communities is communicated through the lens of deliberate metaphor theory (DMT) to deepen the understanding of the under-researched complicated, emotionally laden, and culture-related concepts of this experience.

Methods

We collected data (n = 3546 comments) from the Warm Supporting section of the Depression Super Topic, a major Chinese online depression community on Weibo. The data were analyzed using a metaphorical analysis with the Metaphor Identification Procedure Vrije Universiteit and a thematic analysis.

Results

Our findings identify two themes: deliberate metaphors (DMs) of depression and DMs of social environment for depression sufferers. The former conceptualizes future expectations without depression (as rosy images; victorious battles; the beaten black dog); disorder (as subtle objects; subjective initiative events); depression sufferers (as valuable objects; important roles); and present life with depression (as optional events; spiritual practices; fragile objects). The latter conceptualizes social connection (as solid objects; nonessentials); individuals in the social environment (as energetic objects; vicious roles); and prejudice (as colored objects).

Conclusions

The findings suggest that DMs as important online social support resources, helping to express empathy and normalize depression with more common-sense, and non-judgmental concepts. Additionally, in DMs, Chinese netizens navigate the intricate intersection of medical and moral perspectives on depression and its recovery, leveraging both aspects to offer comprehensive social support. “Confucian-based” elements are embedded in culture-related social support expressions in DMs. In practice, our findings contribute to tailored and appropriate health interventions for depression.
Enhancing Maternal Caregiving Capabilities Model to Prevent Childhood Stunting: A UNICEF-Inspired Model
Authors: Has Eka Mishbahatul Marah , Krisnana Ilya , Efendi Ferry
Published: February 2024

Introduction

The proportion of stunted children in Indonesia is slowly decreasing. In most families, a mother is responsible for child care. The quality of maternal caregiving capability influences the mother’s ability to adopt appropriate childcare practices, which is essential to prevent childhood stunting.

Objectives

This study aimed to develop a model to enhance maternal caregiving capabilities in preventing childhood stunting based on the UNICEF model of care.

Methods

The study used an analytical observational design involving a pair of mothers and their youngest 6–23-month-old children registered at Posyandu (Community-based Integrated Health Care Center). Six hundred respondents were taken using a cluster sampling technique across seven healthcare centers in Surabaya City, East Java, Indonesia. The independent variables were child, mother, father, and household factors, then maternal caregiving capabilities. The dependent variable was the nutritional behavior to prevent childhood stunting. Data were collected using questionnaires and then analyzed using the Structural Equation Model-Partial Least Squares (SEM-PLS) test.

Results

The study found that maternal caregiving capabilities are influenced by child (T-stat 2.605), mother (T-stat 3,800), and household factors (T-stat 10,338). Maternal caregiving capabilities affect stunting preventive behavior in children aged 6–23 months (T-stat 2.493). Household factors were the strongest factor affecting maternal caregiving capabilities.

Conclusion

Enhancing maternal caregiving capabilities model can be developed using its constituents, especially perceived physical health, psychological well-being, and decision-making. Household factors, including economic level and food security, were also important. High maternal caregiving capabilities were expected to enable mothers to improve their behavior to prevent childhood stunting (6–23 months).
Study within a trial 119: The effectiveness of a thank you card to improve trial follow up; a randomised study within a trial
Authors: Arundel Catherine , Welch Charlie , Tharmanathan Puvanendran , Dias Joseph
Published: February 2024

Background

With attrition common in randomised trials, strategies are needed to minimise this. Many retention strategies include ‘thanks’ elements however there is currently no evidence of the effectiveness of a ‘thank you’ intervention separate to other trial activity or information. This Study Within A Trial (SWAT) sought to assess if a thank you card increases completion of the host trial primary outcome.

Methods

A two arm SWAT, using a 1:1 (intervention:control) allocation ratio, embedded within the DISC trial. The primary outcome was the difference in retention rate at 1 year post-treatment. Secondary outcomes were outcome data completeness, cost, and retention at 2 years post-treatment. Analyses were conducted using logistic regression adjusting for SWAT and host trial allocation.

Results

A total of 358 participants were randomised and included in the SWAT analyses. Completion of the 1-year outcome visit was 89.7% ( n = 157) in the intervention group and 90.2% (165) in the control group (adjusted odds ratio (OR) 0.95, 95% CI 0.48 to 1.90, p = .89). There was no evidence of a difference in completeness of key outcome data (adjusted OR 1.84, 95% CI 0.71 to 4.73, p = .20) or retention at 2 years post treatment (adjusted OR 1.13, 95% CI 0.59 to 2.17, p = .72).

Conclusion

It remains unclear if thank you cards increased the rate of primary outcome follow-up completion within the DISC trial. However, as the first evaluation of a distinct ‘thank you’ intervention for improving retention rates, further replications are required to determine effectiveness, ideally in populations other than older, male, Caucasians.
Dmitryvarlamovite, Ti2(Fe3+Nb)O8, a new columbite-supergroup mineral related to the wolframite group
Authors: Udoratina Oksana V. , Panikorovskii Taras L. , Chukanov Nikita V. , Voronin Mikhail V. , Lutoev Vladimir P. , Agakhanov Atali A. , Isaenko Sergey I.
Published: February 2024

The new columbite-supergroup mineral dmitryvarlamovite, ideally Ti2(Fe3+Nb)O8, was discovered in weathered alkaline metasomatic assemblages formed after late Riphaean sedimentary carbonate rocks of the Verkhne-Shchugorskoe deposit, Middle Timan Mts., Russia. The associated minerals are columbite-(Fe), pyrochlore-group minerals, monazite-(Ce), xenotime-(Y), baryte, pyrite, drugmanite and plumbogummite. Dmitryvarlamovite occurs as isolated anhedral equant grains up to 0.5 mm across. The colour of dmitryvarlamovite is black, the streak is black and the lustre is submetallic. The new mineral is brittle, with the mean VHN hardness of 753 kg mm–2corresponding to the Mohs’ hardness of 6. No cleavage is observed. The fracture is conchoidal. The calculated density is 4.891 g⋅cm–3. In reflected light, dmitryvarlamovite is light grey; no pleochroism is observed. The reflectance values (Rmin, % /Rmax, % / λ, nm) are: 19.8/20.3/470, 18.3/18.9/546, 17.8/18.5/589 and 17.3/17.8/650. The chemical composition is (electron microprobe data, with iron divided into Fe2O3and FeO based on the charge balance, wt.%): MnO 0.11, FeO 1.51, V2O30.89, Cr2O30.28, Fe2O319.26, TiO237.72, Nb2O540.08, total 99.85. The IR and Raman spectra indicate the absence of H-, C- and N-bearing groups. The empirical formula is (Fe2+0.08V3+0.05Cr3+0.01Fe3+0.92Ti1.79Nb1.15)Σ4.00O8. The crystal structure was determined using single-crystal X-ray diffraction data and refined toR= 0.048. Dmitryvarlamovite is orthorhombic, space groupP21212,a= 4.9825(6),b= 4.6268(4),c= 5.5952(6) Å andV= 5.5952(6) Å3(Z= 1). The structure is related to those of wolframite-group minerals but differs in the scheme of cation ordering. The crystal-chemical formula derived based on the structural data is (Ti0.57Nb0.21Fe3+0.15Fe2+0.04V0.02Cr0.01)2(Nb0.36Ti0.33Fe3+0.31)2O8. The strongest lines of the powder X-ray diffraction pattern [d, Å (I, %) (hkl)] are: 3.58 (40) (011), 2.911 (100) (111), 2.809 (40) (002), 2.497 (38) (020), 2.447 (29) (103), 1.7363 (32) (103) and 1.7047 (29) (220). Dmitryvarlamovite is named after Dmitry Anatol'evich Varlamov (b. 1965).
Strategies for improving ED-related outcomes of older adults who seek care in emergency departments: a systematic review
Authors: Memedovich Ally , Asante Benedicta , Khan Maha , Eze Nkiruka , Holroyd Brian R. , Lang Eddy , Kashuba Sherri , Clement Fiona
Published: February 2024

Background

Despite constituting 14% of the general population, older adults make up almost a quarter of all emergency department (ED) visits. These visits often do not adequately address patient needs, with nearly 80% of older patients discharged from the ED carrying at least one unattended health concern. Many interventions have been implemented and tested in the ED to care for older adults, which have not been recently synthesized.

Methods

A systematic review was conducted to identify interventions initiated in the ED to address the needs of older adults. Embase, MEDLINE, CINAHL, Cochrane CENTRAL, the Cochrane Database of Systematic Reviews, and grey literature were searched from January 2013 to January 18, 2023. Comparative studies assessing interventions for older adults in the ED were included. The quality of controlled trials was assessed with the Cochrane risk-of-bias tool for randomized trials, and the quality of observational studies was assessed with the risk of bias in non-randomized studies of interventions tool. Due to heterogeneity, meta-analysis was not possible.

Results

Sixteen studies were included, assessing 12 different types of interventions. Overall study quality was low to moderate: 10 studies had a high risk of bias, 5 had a moderate risk of bias, and only 1 had a low risk of bias. Follow-up telephone calls, referrals, geriatric assessment, pharmacist-led interventions, physical therapy services, care plans, education, case management, home visits, care transition interventions, a geriatric ED, and care coordination were assessed, many of which were combined to create multi-faceted interventions. Care coordination with additional support and early assessment and intervention were the only two interventions that consistently reported improved outcomes. Most studies did not report significant improvements in ED revisits, hospitalization, time spent in the ED, costs, or outpatient utilization. Two studies reported on patient perspectives.

Conclusion

Few interventions demonstrate promise in reducing ED revisits for older adults, and this review identified significant gaps in understanding other outcomes, patient perspectives, and the effectiveness in addressing underlying health needs. This could suggest, therefore, that most revisits in this population are unavoidable manifestations of frailty and disease trajectory. Efforts to improve older patients’ needs should focus on interventions initiated outside the ED.
Mitochondrial genomes provide insights into the Euholognatha (Insecta: Plecoptera)
Authors: Cao Jin-Jun , Wang Ying , Murányi Dávid , Cui Jian-Xin , Li Wei-Hai
Published: February 2024

Background

Euholognatha is a monophyletic group within stoneflies comprised by a superfamily Nemouroidea and a family Scopuridae. Based on morphological data, the family-level phylogenetic relationships within Euholognatha are widely accepted, but there is still controversy among different molecular studies. To better understand the phylogeny of all six extant euholognathan families, we sequenced and analyzed seven euholognathan mitogenomes.

Results

The sequence heterogeneity analysis observed a low degree of compositional heterogeneity in euholognathan mitogenomes. Meanwhile, leuctrid mitogenomes were more heterogeneous than other euholognathan families, which may affect the phylogenetic reconstruction. Phylogenetic analyses with various datasets generated three topologies. The Leuctridae was recovered as the earliest branching lineage, and the sister relationship of Capniidae and Taeniopterygidae was supported by most tree topologies and FcLM analyses. When separately excluding sparsely sampled Scopuridae or high heterogeneity leuctrid taxa, phylogenetic analyses under the same methods generated more stable and consistent tree topologies. Finally, based on the results of this study, we reconstructed the relationships within Euholognatha as: Leuctridae + (Scopuridae + ((Taeniopterygidae + Capniidae) + (Nemouridae + Notonemouridae))).

Conclusion

Our research shows the potential of data optimizing strategies in reconstructing phylogeny within Euholognatha and provides new insight into the phylogeny of this group.
Wellens Syndrome: prevalence, risk factors and coronary angiographic variation. A cross-sectional study
Authors: Mohamed Sami , Abdelaziz Samoal
Published: February 2024

Background

Wellens syndrome complicates acute coronary syndrome and, if unmanaged, can lead to immanent myocardial infarction. This study aimed towards determining the prevalence of Wellens syndrome among acute coronary syndrome patients while focusing on both types and identifying the associated risk factors, then exploring the variation in affected coronary arteries within patients fulfilling Wellens syndrome criteria.

Methods

Implementing a descriptive cross sectional hospital based observational study design, at Ahmed Gasim Teaching Hospital for Cardiac Surgery and Renal Transplantation in Khartoum North, Sudan, the study was conducted following using a non probability convenience sampling of patients fitting the inclusion criteria. Data was collected using closed ended structured questionnaires. Ethical clearance was obtained from relevant authorities. Statistical analysis was done using descriptive and comparative data analysis with the aid of the SPSS software, and STROBE guidelines were followed.

Results

A total of 120 patients were included, 70 males and 50 females, majority in their fifth decade. 14 patients had no documented risk factors. 42.5% had STEMI, 34.2% had NSTEMI and 23.3% had unstable angina. Patients fulfilling Wellens syndrome criteria were 18 (15%), 55.6% of them were type A and 44.4% were type B. Most frequently encountered risk factor among Wellens syndrome patients was Diabetes (50%). Out of 16 Wellens syndrome patients who underwent coronary angiography, 50% had mid LAD involvement, most were type A; 25% had proximal LAD involvement and 25% had normal coronary angiography. There was some association between Wellens syndrome and NSTEMI, but no significant association with any specific risk factor.

Conclusion

Wellens syndrome complicates 15% of acute coronary syndrome patients with a 55.6% possibility of becoming type A, it can present even without a specific predisposing risk factor and coronary angiographic variation other than the proximal part of the LAD artery may occur, including multiple vessels involvement.

Condensed abstract

This is a descriptive cross sectional study conducted at Ahmed Gasim Teaching Hospital in Sudan, to determine the prevalence and risk factors of Wellens syndrome. Data was collected using questionnaires and analyzed with the SPSS software. Out of 120 patients, 14 patients had no documented risk factors. 34.2% had NSTEMI and 23.3% had unstable angina. Patients fulfilling Wellens syndrome criteria were 18 (15%). The commonest risk factor among Wellens syndrome patients was Diabetes (50%). 50% of Wellens syndrome patients had mid LAD involvement. The study concluded that Wellens syndrome is not rare, it can present without specific risk factor and coronary angiographic variation other than the proximal LAD artery can occur.
A methodical exploration of imaging modalities from dataset to detection through machine learning paradigms in prominent lung disease diagnosis: a review
Authors: Kumar Sunil , Kumar Harish , Kumar Gyanendra , Singh Shailendra Pratap , Bijalwan Anchit , Diwakar Manoj
Published: February 2024

Background

Lung diseases, both infectious and non-infectious, are the most prevalent cause of mortality overall in the world. Medical research has identified pneumonia, lung cancer, and Corona Virus Disease 2019 (COVID-19) as prominent lung diseases prioritized over others. Imaging modalities, including X-rays, computer tomography (CT) scans, magnetic resonance imaging (MRIs), positron emission tomography (PET) scans, and others, are primarily employed in medical assessments because they provide computed data that can be utilized as input datasets for computer-assisted diagnostic systems. Imaging datasets are used to develop and evaluate machine learning (ML) methods to analyze and predict prominent lung diseases.

Objective

This review analyzes ML paradigms, imaging modalities' utilization, and recent developments for prominent lung diseases. Furthermore, the research also explores various datasets available publically that are being used for prominent lung diseases.

Methods

The well-known databases of academic studies that have been subjected to peer review, namely ScienceDirect, arXiv, IEEE Xplore, MDPI, and many more, were used for the search of relevant articles. Applied keywords and combinations used to search procedures with primary considerations for review, such as pneumonia, lung cancer, COVID-19, various imaging modalities, ML, convolutional neural networks (CNNs), transfer learning, and ensemble learning.

Results

This research finding indicates that X-ray datasets are preferred for detecting pneumonia, while CT scan datasets are predominantly favored for detecting lung cancer. Furthermore, in COVID-19 detection, X-ray datasets are prioritized over CT scan datasets. The analysis reveals that X-rays and CT scans have surpassed all other imaging techniques. It has been observed that using CNNs yields a high degree of accuracy and practicability in identifying prominent lung diseases. Transfer learning and ensemble learning are complementary techniques to CNNs to facilitate analysis. Furthermore, accuracy is the most favored metric for assessment.
Exploring humanistic burden of fatigue in adults with multiple sclerosis: an analysis of US National Health and Wellness Survey data
Authors: Le Hoa H. , Ken-Opurum Jennifer , LaPrade Anne , Maculaitis Martine C. , Sheehan John J.
Published: February 2024

Background

This retrospective study examined the humanistic burden of fatigue in patients with relapsing-remitting multiple sclerosis (RRMS), compared with adults without MS, using data from the 2017 and 2019 US National Health and Wellness Survey.

Methods

The 5-item Modified Fatigue Impact Scale (MFIS-5) was used to assess level of fatigue (MFIS-5 score <15: low fatigue [LF]; MFIS-5 score ≥15: high fatigue [HF]) in patients with RRMS. Health-related quality of life (HRQoL) measures (Short Form 36-Item Health Survey version 2, Euroqol-5 Dimensions-5 Levels [EQ-5D-5L], Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-7 [GAD-7], Perceived Deficits Questionnaire-5) and treatment-related characteristics were assessed.

Results

In total, 498 respondents were identified as RRMS (n=375 RRMS+LF, n=123 RRMS+HF) and compared with 1,494 matched non-MS controls. RRMS+LF and RRMS+HF had significantly lower Short Form 6 Dimensions health utility, Mental and Physical Component Summary, and EQ-5D-5L scores and higher PHQ-9 and GAD-7 scores, compared with matched non-MS controls (all p<0.001); scores were worse for RRMS+HF than RRMS+LF across all measures (all p<0.001). A higher proportion of RRMS+HF reported moderate-to-severe depression and moderate-to-severe anxiety, compared with RRMS+LF and matched non-MS controls (both p<0.001). Fatigue was a significant predictor of poor HRQoL across all measures (all p<0.001).

Conclusions

Patients with RRMS experienced lower HRQoL with higher levels of fatigue, highlighting an unmet need. Results may help to inform physician-patient communication and shared decision-making to address fatigue and its associated impact on patients’ HRQoL.
The effectiveness of physiotherapy for patients with isolated cervical dystonia: an updated systematic review and meta-analysis
Authors: Kassaye Shimelis Girma , De Hertogh Willem , Crosiers David , Gudina Esayas Kebede , De Pauw Joke
Published: February 2024

Background

Cervical dystonia is a movement disorder typically characterized by a patterned and twisting movement of sustained or intermittent muscle contractions. Recently, new clinical trials are emerging, highlighting the potential benefit of physiotherapy (PT) on disease outcomes. Thus, the objective of this review is to update the effectiveness of PT on cervical dystonia disease outcomes and subsequently perform a meta-analysis.

Methods

Interventional studies published in English with adult patients with isolated cervical dystonia following a physiotherapy program were included. Relevant articles were searched in PubMed (MEDLINE), Web of Science, and Scopus. Cochrane and Joanna Briggs Institute risk of bias checklists were used for quality reporting. Meta-analysis was done using Review Manager 5.3 statistical software and a pooled mean difference for pain was presented.

Results

Fourteen articles were included in the review and two articles were included in the meta-analysis. The meta-analysis revealed that PT intervention had a significant effect on pain reduction scale (-5.00, 95% CI -6.26, -3.74) when used as an additional therapy with botulinum toxin (BoNT) injection. Additionally, findings indicate a possible positive effect of PT disease severity, disability, and quality of life.

Conclusions

Physiotherapy in addition to BoNT is recommended to decrease pain. The findings suggest a reduction of disease severity, disability, and improvement in quality of life. The variety in the type and duration of PT interventions did not allow a clear recommendation of a specific type of PT.
The role of self-efficacy in women’s autonomy for health and nutrition decision-making in rural Bangladesh
Authors: Salinger Allison P. , Vermes Ellen , Waid Jillian L. , Wendt Amanda S. , Dupuis Sarah J. N. , Kalam Md Abul , Kader Abdul , Sinharoy Sheela S.
Published: February 2024

Background

Agency – including the sub-domains of intrinsic agency, instrumental agency, and collective agency – is a critical component of the women’s empowerment process. Self-efficacy (a component of intrinsic agency) may operate as a motivational influence for women to make choices according to their own preferences or goals, such that higher self-efficacy would be associated with more autonomous decision-making (a key component of instrumental agency).

Methods

We examine these relationships using mixed methods. We developed a series of decision-making autonomy indices, which captured alignment between the woman’s reported and preferred roles in health and nutrition decisions. Using ordinal logistic regression, we assessed the relationship between generalized self-efficacy and decision-making autonomy.

Results

There was a consistently positive association across all categories of decision-making, controlling for a number of individual and household-level covariates. In a sub-sample of joint decision-makers (i.e., women who reported making decisions with at least one other household member), we compared the association between generalized self-efficacy (i.e., one’s overall belief in their ability to succeed) and decision-making autonomy to that of domain-specific self-efficacy (i.e., one’s belief in their ability to achieve a specific goal) and decision-making autonomy. Across all decision-making categories, domain-specific self-efficacy was more strongly associated with decision-making autonomy than generalized self-efficacy. In-depth interviews provided additional context for interpretation of the regression analyses.

Conclusions

The results indicate the importance of the role of self-efficacy in the women’s empowerment process, even in the traditionally female-controlled areas of health and nutrition decision-making. The development of the decision-making autonomy index is an important contribution to the literature in that it directly recognizes and captures the role of women’s preferences regarding participation in decision-making.
A psychometric evaluation of inter-professional education competency tool in nursing and medicine students
Authors: Rasouli Davood , Norouzi Azam , Ramezani Ghobad , Hashemi Akram
Published: February 2024

Introduction

Collaboration between nurses and doctors is necessary for offering care to patients. Using team performance assessment tools and surveying them can be effective in promoting inter-professional collaboration, and the lack of a credible tool to assess inter-professional collaboration competency between the two groups is a major challenge in the healthcare sector. The present study aimed to translate and conduct a psychometric investigation on the inter-professional education collaboration (IPEC) tool for the students of medicine and nursing.

Methods

The present study was a cross-sectional one conducted as a psychometric investigation of the IPEC tool at the Iran University of Medical Sciences in 2022. The initial tool contained 42 items developed according to a 5-point Likert scale, which was translated into Persian with the consent of the original researcher. The validity index and the content validity ratio were investigated by a panel of 11 specialists in medical and clinical education, and its construct validity was evaluated using confirmatory factor analysis. Also, the second population of the study included medical and nursing students of Iran University of Medical Sciences and simple random sampling method. Moreover, the reliability of the instrument was investigated using internal consistency, Cronbach’s Alpha, and test–retest methods.

Results

Based on the indicators calculated to perform a psychometric investigation over the above tool, it had acceptable reliability and validity according to the specialists. The tool evaluates inter-professional collaboration competency between the students of medicine and nursing across four areas (values and ethics, roles and responsibilities, inter-professional communication, and team-based care and teamwork). Moreover, Cronbach’s Alpha coefficient for the tool was determined at 0.84.

Conclusion

The results of the study showed that the above tool could evaluate inter-professional competency as a valid and reliable questionnaire, and its results could be utilized in planning and education.
E-bibliotherapy for improving the psychological well-being of informal caregivers of people with dementia: a randomized controlled trial protocol
Authors: Wang Shanshan , Qin Jing , Cheung Daphne Sze Ki , Tyrovolas Stefanos , Leung Sze Him Isaac , Leung Angela Yee Man , Davidson Patricia Mary
Published: February 2024

Background

Providing informal care for individuals with dementia is frequently a challenging and demanding experience that can have detrimental effects on the psychological well-being of caregivers. Regrettably, community-based caregiver services often prove inadequate, highlighting the necessity for innovative approaches to support caregivers.

Aim

To test the efficacy of e-bibliotherapy in improving the psychological well-being of informal caregivers of people with dementia.

Method

The study is divided into two phases. In phase 1, the research team will co-design the e-bibliotherapy app with caregivers. In phase 2, a randomized controlled trial will be conducted among 192 informal caregivers of people with dementia in Hong Kong. Caregivers will be randomly assigned to either the e-bibliotherapy group or the control group using simple randomization. Outcome measures will encompass caregivers’ psychological well-being, caregiving appraisal, mental health, saliva cortisol levels as an indicator of stress, and health-related quality of life for caregivers. Data will be collected at baseline, immediately post intervention, and 3 months and 6 months post intervention. General linear mixed model will be employed to analyze intervention effects. Qualitative interviews will be undertaken to explore caregiver experiences within this study and evaluate intervention acceptability using conventional content analysis methods.

Discussion

This study represents a pioneering effort in utilizing e-bibliotherapy to enhance the psychological well-being of informal caregivers of individuals with dementia, addressing the existing gap in caregiver services and facilitating knowledge dissemination within the community.

Trial registration

The trial has been registered on ClinicalTrial.gov (Ref: NCT05927805).
Effectiveness of prime vendor system on availability of medicines and medical supplies in the selected public health facilities in Arusha district council
Authors: Elias Liberatus , Mushi Lawrencia
Published: February 2024

Introduction

The shortage of medicines and medical supplies remains to be a major issue that is facing public health facilities in Tanzania. This situation has been influenced by lack of consistency in the supply chain, increase in healthcare demand, poor regulatory system, insufficient funds, and lack of conducive infrastructure. Formerly, the Government initiatives such as engagement with the Prime Vendor System (PVS) demonstrated great assistance in getting rid of this challenge. Despite the operation of PVS, a recent shortage of medicines and medical supplies has been noticed.

Objectives

This study aimed to assess the effectiveness of PVS on the availability of medicine and medical supplies in the selected public health facilities in Arusha District Council.

Methods

The study used a case study design with mixed research approach. The study involved 77 respondents which included 25 health facility in-charges, 50 patients, 1 District Pharmacist and 1 Prime Vendor. Questionnaires, interviews, and observation methods were used to collect data. Data collected covered a period of 2021–2022. Thematic analysis was used to analyze the qualitative data whereas descriptive analysis was used to analyze the quantitative data with the help of Excel and the Statistical Package for Social Sciences (SPSS) version 28.0.

Results

The analysis indicates that PVS is not completely effective in supplying medicines and medical supplies due to its low capacity to conform to the orders placed by the public health facilities, a lack of supply competition, and a failure to adhere to contractual terms. Furthermore, at the time of data collection, the average availability of medicines and medical supplies at the selected public health facilities was 74.8%, while 80% of the selected public health facilities reported having a scarcity of medicines and medical supplies, and 92% of the interviewed patients reported having no full access to medicines.

Conclusion

Despite the shortcomings associated with the operation of the PVS, the system still seems to be very important for enhancing the availability of medicines and medical supplies once its effectiveness is strengthened. This study recommends a routine monitoring of PVS operations and timely interventions to reinforce an adherence to the contracted terms and improve PVS effectiveness.
Influences of specialty identity when implementing a new emergency department in Denmark: a qualitative study
Authors: Kirk Jeanette Wassar , Lindstroem Mette Bendtz , Stefánsdóttir Nina Thórný , Andersen Ove , Powell Byron J. , Nilsen Per , Tjørnhøj-Thomsen Tine
Published: February 2024

Background

The Danish Health Authority recommended the implementation of new types of emergency departments. Organizational changes in the hospital sector challenged the role, identity, and autonomy of medical specialists. They tend to identify with their specialty, which can challenge successful implementation of change. However, investigations on specialty identity are rare in implementation science, and how the co-existence of different specialty identities influences the implementation of new emergency departments needs to be explored for the development of tailored implementation strategies. The aim of this study was to examine how medical specialty identity influences collaboration between physicians when implementing a new emergency department in Denmark.

Methods

Qualitative methods in the form of participants’ observations at 13 oilcloth sessions (a micro-simulation method) were conducted followed up by 53 individual semi-structured interviews with participants from the oilcloth sessions. Out of the 53 interviews, 26 were conducted with specialists. Data from their interviews are included in this study. Data were analysed deductively inspired by Social Identity Theory.

Results

The analysis yielded three overarching themes: [1] ongoing creation and re-creation of specialty identity through boundary drawing; [2] social categorization and power relations; and [3] the patient as a boundary object.

Conclusions

Specialty identity is an important determinant of collaboration among physicians when implementing a new emergency department. Specialty identity involves social categorization, which entails ongoing creation and re-creation of boundary drawing and exercising of power among the physicians. In some situations, the patient became a positive boundary object, increasing the possibility for a successful collaboration and supporting successful implementation, but direct expressions of boundaries and mistrust were evident. Both were manifested through a dominating power expressed through social categorization in the form of in- and out-groups and in an “us and them” discourse, which created distance and separation among physicians from different specialties. This distancing and separation became a barrier to the implementation of the new emergency department.
Plasma fibroblast activation protein is decreased in acute heart failure despite cardiac tissue upregulation
Authors: Delgado-Arija Marta , Genovés Patricia , Pérez-Carrillo Lorena , González-Torrent Irene , Giménez-Escamilla Isaac , Martínez-Dolz Luis , Portolés Manuel , Tarazón Estefanía , Roselló-Lletí Esther
Published: February 2024

Background

Cardiac fibroblast activation protein (FAP) has an emerging role in heart failure (HF). A paradoxical reduction in its levels in pathological conditions associated with acute processes has been observed. We aimed to identify FAP cardiac tissue expression and its relationship with the main cardiac fibrosis-related signaling pathways, and to compare plasma FAP levels in acute and chronic HF patients.

Methods

Transcriptomic changes were assessed via mRNA/ncRNA-seq in left ventricle tissue from HF patients (n = 57) and controls (n = 10). Western blotting and immunohistochemistry were used to explore FAP protein levels and localization in cardiac tissue. ELISA was performed to examine plasma FAP levels in acute HF (n = 48), chronic HF (n = 15) and control samples (n = 7).

Results

FAPoverexpression in cardiac tissue is related to the expression of molecules directly involved in cardiac fibrosis, such asPOSTN, THBS4, MFAP5, COL1A2andCOL3A1(P < 0.001), and is directly and inversely related to pro- and antifibrotic microRNAs, respectively. The observedFAPoverexpression is not reflected in plasma. Circulating FAP levels were lower in acute HF patients than in controls (P < 0.05), while chronic HF patients did not show significant changes. The clinical variables analyzed, such as functional class or etiology, do not affect plasma FAP concentrations.

Conclusions

We determined that in HF cardiac tissue, FAP is related to the main cardiac fibrosis signaling pathways as well as to pro- and antifibrotic microRNAs. Additionally, an acute phase of HF decreases plasma FAP levels despite the upregulation observed in cardiac tissue and regardless of other clinical conditions.

Graphical abstract
Improving lesion detection in mammograms by leveraging a Cycle-GAN-based lesion remover
Authors: Lee Juhun , Nishikawa Robert M.
Published: February 2024

Background

The wide heterogeneity in the appearance of breast lesions and normal breast structures can confuse computerized detection algorithms. Our purpose was therefore to develop a Lesion Highlighter (LH) that can improve the performance of computer-aided detection algorithms for detecting breast cancer on screening mammograms.

Methods

We hypothesized that a Cycle-GAN based Lesion Remover (LR) could act as an LH, which can improve the performance of lesion detection algorithms. We used 10,310 screening mammograms from 4,832 women that included 4,942 recalled lesions (BI-RADS 0) and 5,368 normal results (BI-RADS 1). We divided the dataset into Train:Validate:Test folds with the ratios of 0.64:0.16:0.2. We segmented image patches (400 × 400 pixels) from either lesions marked by MQSA radiologists or normal tissue in mammograms. We trained a Cycle-GAN to develop two GANs, where each GAN transferred the style of one image to another. We refer to the GAN transferring the style of a lesion to normal breast tissue as the LR. We then highlighted the lesion by color-fusing the mammogram after applying the LR to its original. Using ResNet18, DenseNet201, EfficientNetV2, and Vision Transformer as backbone architectures, we trained three deep networks for each architecture, one trained on lesion highlighted mammograms (Highlighted), another trained on the original mammograms (Baseline), and Highlighted and Baseline combined (Combined). We conducted ROC analysis for the three versions of each deep network on the test set.

Results

The Combined version of all networks achieved AUCs ranging from 0.963 to 0.974 for identifying the image with a recalled lesion from a normal breast tissue image, which was statistically improved (p-value < 0.001) over their Baseline versions with AUCs that ranged from 0.914 to 0.967.

Conclusions

Our results showed that a Cycle-GAN based LR is effective for enhancing lesion conspicuity and this can improve the performance of a detection algorithm.
Assessing the role of redox partners in TthLPMO9G and its mutants: focus on H2O2 production and interaction with cellulose
Authors: Chorozian Koar , Karnaouri Anthi , Georgaki-Kondyli Nefeli , Karantonis Antonis , Topakas Evangelos
Published: February 2024

Background

The field of enzymology has been profoundly transformed by the discovery of lytic polysaccharide monooxygenases (LPMOs). LPMOs hold a unique role in the natural breakdown of recalcitrant polymers like cellulose and chitin. They are characterized by a “histidine brace” in their active site, known to operate via an O2/H2O2 mechanism and require an electron source for catalytic activity. Although significant research has been conducted in the field, the relationship between these enzymes, their electron donors, and H2O2 production remains complex and multifaceted.

Results

This study examines TthLPMO9G activity, focusing on its interactions with various electron donors, H2O2, and cellulose substrate interactions. Moreover, the introduction of catalase effectively eliminates H2O2 interference, enabling an accurate evaluation of each donor’s efficacy based on electron delivery to the LPMO active site. The introduction of catalase enhances TthLPMO9G’s catalytic efficiency, leading to increased cellulose oxidation. The current study provides deeper insights into specific point mutations, illuminating the crucial role of the second coordination sphere histidine at position 140. Significantly, the H140A mutation not only impacted the enzyme’s ability to oxidize cellulose, but also altered its interaction with H2O2. This change was manifested in the observed decrease in both oxidase and peroxidase activities. Furthermore, the S28A substitution, selected for potential engagement within the His1–electron donor–cellulose interaction triad, displayed electron donor-dependent alterations in cellulose product patterns.

Conclusion

The interaction of an LPMO with H2O2, electron donors, and cellulose substrate, alongside the impact of catalase, offers deep insights into the intricate interactions occurring at the molecular level within the enzyme. Through rational alterations and substitutions that affect both the first and second coordination spheres of the active site, this study illuminates the enzyme’s function. These insights enhance our understanding of the enzyme’s mechanisms, providing valuable guidance for future research and potential applications in enzymology and biochemistry.
CRISPR-TE: a web-based tool to generate single guide RNAs targeting transposable elements
Authors: Guo Yixin , Xue Ziwei , Gong Meiting , Jin Siqian , Wu Xindi , Liu Wanlu
Published: February 2024

Background

The CRISPR/Cas systems have emerged as powerful tools in genome engineering. Recent studies highlighting the crucial role of transposable elements (TEs) have stimulated research interest in manipulating these elements to understand their functions. However, designing single guide RNAs (sgRNAs) that are specific and efficient for TE manipulation is a significant challenge, given their sequence repetitiveness and high copy numbers. While various sgRNA design tools have been developed for gene editing, an optimized sgRNA designer for TE manipulation has yet to be established.

Results

We present CRISPR-TE, a web-based application featuring an accessible graphical user interface, available at https://www.crisprte.cn/, and currently tailored to the human and mouse genomes. CRISPR-TE identifies all potential sgRNAs for TEs and provides a comprehensive solution for efficient TE targeting at both the single copy and subfamily levels. Our analysis shows that sgRNAs targeting TEs can more effectively target evolutionarily young TEs with conserved sequences at the subfamily level.

Conclusions

CRISPR-TE offers a versatile framework for designing sgRNAs for TE targeting. CRISPR-TE is publicly accessible at https://www.crisprte.cn/ as an online web service and the source code of CRISPR-TE is available at https://github.com/WanluLiuLab/CRISPRTE/.
Knowledge of ocular infections among the dental practitioners across India: a cross sectional survey
Authors: Arvind Ritvi , Bakhshi Gayatri , Shenoy Ramya , Patil Amit , Jain Ashish , Roma M
Published: February 2024

Background

Ocular issues such as impaired vision, ophthalmia, orbital cellulitis, and blindness are not common with dental infections. However, there is absence of set guidelines in prevention and management of ocular issues arising from dental infections. Hence the knowledge and vantage point of the dentists with respect to ocular complications arising from dental infections was evaluated.

Objective

This study reviews the knowledge of dentists with association of eye infection due to dental contamination.

Method

A cross sectional survey using standardized questionnaires were sent suing social media platform among the academicians and practicing dental clinicians. All the questionnaires were content validated by three ophthalmologists. Descriptive statistics was scrutinized and tabulated by employing the Statistical Package for Social Sciences (SPSS), version 17 (SPSS Inc., Chicago IL). Chi square tests was used.

Results

About 69.1%(65) and 30.9%( 29) of BDS and MDS grduates have experienced ocular complications because of dental contamination. This distribution showed no statistical significance (p = 0.25). 73.8% (183) and 28.2%( 65) had compliance with the eye protection, 77.7% (160) of BDS graduates and 22.3% (46) of MDS graduates preferred safety eye wear. This distribution showed statistical significance (p = 0.00). About 76.2% (279) of BDS graduates and 23.8%( 67) of MDS graduates faced ocular infections because of different types of splashes which included water, blood and saliva. (p = 0.23)

Conclusion

This study puts an emphasis on the knowledge assessment among the dental practitioners on the importance of preventive barriers, and how special protective gear is required for doing cases undergoing dental treatment.
Diagnostic accuracy of intraoperative frozen section for margin evaluation of oral cavity squamous cell carcinoma
Authors: Ali Javaria P. , Mallick Bakhtawar Allauddin , Rashid Khushbakht , Malik Umair Arshad , Hashmi Atif Ali , Zia Shamail , Irfan Muhammad , Khan Amir , Faridi Naveen
Published: February 2024

Objectives

Intraoperative frozen-section evaluation is a valuable technique for detecting positive margins intraoperatively for oral squamous cell carcinoma. We conducted this study to determine the diagnostic accuracy of frozen section in detecting margin status and the effect of tumor grade and stage on diagnostic accuracy.

Results

A total of 251 biopsy-proven cases of oral squamous cell carcinoma were included in this study. The tissue specimen resected during surgery was sent to the laboratory for frozen section evaluation. The frozen section results were then compared with the permanent section results to determine the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. The mean age of the patients included in the study was 51.65 ± 10.03 years, with male predominance (55.4%). The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of frozen section were 88.81%, 94.84%, 95.20%, 88.10%, and 91.63%, respectively. We conclude that frozen section is a useful technique in determining the margin status intraoperatively in oral cancers, with high diagnostic accuracy. Moreover, certain clinical parameters such as age, gender, disease duration, and tumor stage and grade appear to affect the diagnostic accuracy of frozen section.
A foreign body that has been left for 20 years causes a pseudoaneurysm of the middle cerebral artery: a case report
Authors: Li Qiang , Jiang Zhengfang , Yuan Miao , Xu Chenglang , Zeng Lingyong
Published: February 2024

Background

We report a patient with extensive subarachnoid hemorrhage caused by the rupture of a middle cerebral artery pseudoaneurysm from a foreign body that had been left for two decades.

Case presentation

A 74-year-old male patient from Han nationality was admitted to the emergency department of our hospital with impaired consciousness for 1 hour. Cranial computed tomography examination indicated a massive subarachnoid hemorrhage with intraventricular blood accumulation, and a high-density short strip dense shadow was seen in the M1 segment of the right middle cerebral artery, considering the possibility of a foreign body. Subsequently, a cerebral angiography was suggested; the foreign body was seen through the right middle cerebral artery, and the aneurysm was seen in the lower wall, so a pseudoaneurysm was considered. The emergent surgical intervention involved the clipping of the pseudoaneurysm and intracranial extraction of the foreign body. Unfortunately,the patient ultimately expired due to severe pulmonary infection.

Conclusion

Intracranial pseudoaneurysm caused by foreign body has been rarely reported previously, and microsurgical treatment of an intracranial pseudoaneurysm caused by a foreign body is a good choice.
Engineering of Bacillus thuringiensis Cry2Ab toxin for improved insecticidal activity
Authors: Fu Bai-Wen , Xu Lian , Zheng Mei-Xia , Shi Yan , Zhu Yu-Jing
Published: February 2024

Bacillus thuringiensis Cry2Ab toxin was a widely used bioinsecticide to control lepidopteran pests all over the world. In the present study, engineering of Bacillus thuringiensis Cry2Ab toxin was performed for improved insecticidal activity using site-specific saturation mutation. Variants L183I were screened with lower LC50 (0.129 µg/cm2) against P. xylostella when compared to wild-type Cry2Ab (0.267 µg/cm2). To investigate the molecular mechanism behind the enhanced activity of variant L183I, the activation, oligomerization and pore-formation activities of L183I were evaluated, using wild-type Cry2Ab as a control. The results demonstrated that the proteolytic activation of L183I was the same as that of wild-type Cry2Ab. However, variant L183I displayed higher oligomerization and pore-formation activities, which was consistence with its increased insecticidal activity. The current study demonstrated that the insecticidal activity of Cry2Ab toxin could be assessed using oligomerization and pore-formation activities, and the screened variant L183I with improved activity might contribute to Cry2Ab toxin’s future application.