bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on lightweight speech emotion recognition in vehicle noisy environment
Authors: Tang Chunqiu , Qi Ao , Xie Bin
Published: June 2024

In order to reduce the incidence of traffic accidents caused by the emotional state of drivers, this study proposes an emotion recognition algorithm based on vehicle noise environment. This algorithm can effectively identify the emotional state of drivers and provide support for further improving their emotions. To address challenges in existing research on speech emotion recognition, such as excessive model parameters, poor generalization, and suboptimal performance in noisy environments, this paper proposes a lightweight network model suitable for small datasets. The model utilizes Power Normalized Cepstral Coefficients (PNCC) as input features, and employs parallel feature extraction layers at different scales. These features are then fed into a feature learning module for in-depth extraction, with the final determination of the driver’s emotional state made by the output layer. Experimental results show that the model achieves an accuracy of 96.08% on the EMO-DB speech dataset. Even in simulated in-vehicle noise environments, the model exhibits high accuracy and robustness. Moreover, compared to other lightweight models, it has fewer training parameters and faster processing speed, making it suitable for deployment on edge devices in mobile applications.
Lipid-lowering therapies and long-term stroke prevention in East Asians: A systematic review and meta-analysis of randomized controlled trials
Authors: Guo Bao-Qiang , Li Hong-Bin , Xu Peng-Wei , Zhao Bing
Published: June 2024

Background:

Stroke prevention is a pressing global health priority, with reducing elevated lipids recognized as a key strategy. East Asians, constituting more than 1.6 billion individuals and the largest racial group worldwide, are a key demographic in this effort. Yet, the effectiveness of lipid-lowering therapies for stroke prevention in this population remains uncertain.

Aims and Methods:

We conducted a systematic review and meta-analysis of large-scale randomized controlled trials (RCTs) with at least 3 years of follow-up to evaluate the long-term impact of lipid-lowering therapies on stroke incidence in East Asians. We systematically searched four electronic databases up to 11 January 2024. The association was quantified using relative risk (RR) with a 95% confidence interval (CI), and between-study heterogeneity was evaluated using the I2 statistic. In addition, we utilized the Cochrane Risk of Bias Tool to assess the risk of bias in each included RCT and applied the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to evaluate the certainty of the evidence.

Results:

This study incorporated data from nine large-scale RCTs involving 54,354 participants. Our findings of overall analyses revealed that lipid-lowering therapies did not significantly affect the long-term incidence of all strokes (9 RCTs; 54,354 participants; RR = 0.98 (95% CI = 0.87–1.10); P = 0.75), ischemic stroke (7 RCTs; 52,059 participants; RR = 0.91 (95% CI, = 0.79–1.04); P = 0.16), or hemorrhage stroke (7 RCTs; 52,059 participants; RR = 1.24 (95% CI = 0.97–1.59); P = 0.09) in East Asians. Notably, there was no evidence of heterogeneity or publication bias, and the quality of evidence assessed using GRADE methodologies was rated as high. Sensitivity analyses confirmed the robustness of our results, with no single study significantly affecting the overall findings. Furthermore, subgroup analyses consistently supported the conclusions, further bolstering the reliability of our study.

Conclusions:

Lipid-lowering therapies did not demonstrate any beneficial effects on long-term stroke prevention among East Asians.
The potential of point-of-care ultrasound in UK general practice
Authors: Poppleton Aaron , Pursglove Lee , Leceaga Eva , Dupont Fabian , Hagiu Dragos-Paul , Andersen Camilla
Published: June 2024

Ultrasound has been described as the stethoscope for the 21st century. It can rapidly answer a specific clinical question or support a procedure. Use of point-of-care ultrasound (PoCUS) by doctors has increased in the UK and internationally over the past decade. Training in PoCUS is now a core part of some undergraduate and postgraduate learning curricula. The World Organization of Family Doctors (WONCA Europe) has endorsed use of PoCUS in general practice. The rapid uptake of PoCUS in primary care in other countries suggests that the UK may soon follow suit. This article aims to provide an overview of PoCUS in primary care, including what PoCUS is, its current and potential use within primary care, limitations, legal considerations, and resources to develop an interest and skill in PoCUS as a GP in the UK.
Irish Supreme Court rules pizza delivery drivers are employees for tax purposes: What's the takeaway for the gig economy in Europe?
Authors: Lasek-Markey Marta
Published: June 2024

In October 2023, Ireland's Supreme Court handed down its judgment in the case of The Revenue Commissioners v Karshan Midlands t/a Domino's Pizza. Following the CJEU ruling in Yodel, and that of the UK Supreme Court in Uber v Aslam, this decision is yet another addition to the debate around the employment status of gig workers that European courts have been grappling with, in common and civil law jurisdictions alike. In Karshan, the Irish Supreme Court ruled that Domino's pizza delivery drivers should indeed be treated as employees for the purposes of taxation. Importantly, however, the ruling was delivered based on a different set of facts than some of the other gig economy cases heard in Europe – notably, in Karshan there was no digital platform and, therefore, the link between the delivery drivers and Domino's was more pronounced than in cases involving a platform. The scope of comparison to Yodel is, thus, limited. Furthermore, the judgment is narrow in its scope and, disappointingly, appears to deliberately leave many questions unanswered, failing to seize the opportunity to provide more clarity for gig workers and employers alike. This is typical of the current state of affairs in employment law, which, while aware that traditional approaches are inadequate to the evolving world of work, has not yet come up with a comprehensive way of addressing these challenges. Despite these shortcomings, Karhsan offers some valuable insights into the discussion on the gig economy as the EU institutions are working to adopt the much-anticipated Platform Workers Directive.
What influences post-operative opioid requirements for tibial fractures?
Authors: Zhang James , Limonard Aaron , Bradshaw Florence , Hussain Ishrat , Josipović Maša , Krkovic Matija
Published: June 2024

Introduction

Currently there are few opioid prescribing guidelines for orthopaedic fractures. Long-term post-surgical analgesia requirements, understandably, vary between orthopaedic cases. Our study aims to provide detailed information to clinicians and policy makers, on the opioid requirement associations for patients sustaining tibial fractures.

Methods

This study reviewed all patients sustaining an isolated tibial fracture at a major trauma centre that were operated on within 1 month of injury, from 2015 to 2022. The total opioid dosage used each month in morphine milligrams equivalents (MME) and the number of days opioids were used each month, within the first-year post-surgery were collected, representing the strength and coverage of opioid analgesia in the post-operative stage, respectively. We compared opioid strength and coverage requirements with types of definitive fracture fixations, location, fracture type and concurrent patient medical comorbidities to assess for any trends.

Results

A total of 1814 patients sustaining a combined of 1970 fractures were included in the study. Tibial plateau fractures had the highest opioid strength and coverage requirements in each month and the entire year ( p < .05). Across all fracture locations, Ex Fix frame showed higher opioid strength and coverage requirements compared to both IM nailing and plate ORIF. With regard to opioid coverage in the presence of specific comorbidities, only chronic kidney disease (quotient: 1.37, 95% Confidence interval [95%CI] = 1.19–1.55, p = .002) and hypertension (quotient: 1.34, 95%CI = 1.14–1.53, p = .009) showed significance at the 1-year overall level. For opioid strength, Chronic Kidney Disease (quotient: 1.72, 95%CI = 1.41–2.03 p = .005) and COPD (quotient: 1.90, 95%CI = 1.44–2.36, p = .014), show significance at the 1-year overall level.

Conclusion

Our study details opioid requirements post-surgery amongst tibial fractures with subgroup analysis assessing opioid needs amongst specific fracture locations, types, surgical techniques and medical comorbidities. This framework aids clinicians in anticipating rehabilitation and assists in risk stratifying patients at injury onset.
Challenges in differential diagnosis and treatment of cervical root resorption vs. root caries
Authors: Spielman Robert , Ameh Governor , Brandes Irene , Berkowitz Leonard , Elson Natalia , Blum Igor R.
Published: June 2024

External cervical root resorption may be occasionally mistaken for root caries and vice versa. Radiographical and clinical differential diagnoses of cervical root resorption and root caries are essential for correct treatment planning and a successful treatment outcome. This article reviews the contemporary literature and summarises the prevailing professional consensus pertaining to external cervical root resorption. Clinical diagnostics which help distinguish cervical root resorption from root caries are outlined and treatment approaches of external cervical root resorption are discussed.
The Correlation of MicroRNA-21 With the Nephrin, Podocin, and Urinary Albumin-Creatinine Ratio in Patients With Type 2 Diabetes and Albuminuria: A Cross-Sectional Study
Authors: Nugroho Pringgodigdo , Susanto Tri Hadi , Bonar Maruhum , Rizka Aulia , Lydia Aida , Koesno Soekamto , Soewondo Pradana , Shatri Hamzah , Chundiawan Carissa Cornelia , Hermanto Fidel
Published: June 2024

Background:

Diabetic kidney disease (DKD) is the most common and deranging microvascular complication of diabetes mellitus (DM). Podocytopathy is a key component of glomerular damage in DKD. Micro RNA-21 (miRNA-21) is an epigenetic regulator that plays a role in podocyte damage; however, the results of previous studies have not resolved the controversy about the role of miRNA-21 in the pathogenesis of DKD.

Objective:

The objective was to investigate the correlation between miRNA-21 levels and urinary nephrin, podocin, and urinary albumin-creatinine ratio (UACR) in patients with type 2 DM and albuminuria.

Design:

This is a cross-sectional study.

Setting:

This study was carried out in internal medicine outpatient clinic of Cipto Mangunkusumo Hospital Jakarta, Indonesia.

Patients:

This study consisted of 42 adults with type 2 DM and albuminuria.

Measurements:

The measurements include (1) Serum miRNA-21; (2) urinary podocin, nephrin, and albumin-creatinine ratio; and (3) serum miRNA-21 correlated to urinary podocin, nephrin, and albumin-creatinine ratio.

Methods:

The Spearman bivariate analysis to assess the correlation of miRNA-21 with nephrin, podocin, and UACR.

Results:

The mean relative expression of miRNA-21 was 0.069 (0.024), the median for nephrin, podocin, and UACR was 35.5 (15.75-51.25) ng/mL, 0.516 (0.442-0.545) ng/mL, and 150 (94.56-335.75) ng/mL, respectively. A correlation between miRNA-21 and nephrin was observed (r = 0.598; P < .0001). There was a correlation between miRNA-21 and UACR (r = 0.604; P < .0001). No correlation was found between miRNA-21 and podocin.

Limitations:

A lack of non-DM and non-albuminuric control population and small sample size. We could not exclude concurrent disease, and all other potential confounding variables, particularly those related to inflammation.

Conclusions:

The miRNA-21 can be considered an early biomarker for podocytopathy and albuminuria in DM, highlighting its potential for early diagnostic and therapeutic interventions. Further research is required to confirm these findings and explore their clinical applications, which could significantly alter management strategies for DKD.
Quality controlled YouTube content intervention for enhancing health literacy and health behavioural intention: A randomized controlled study
Authors: Park Yujin , Kim Su Hwan , Yoon Hyung-Jin
Published: June 2024

Background

Individuals increasingly turn to the Internet for health information, with YouTube being a prominent source. However, the quality and reliability of the health information vary widely, potentially affecting health literacy and behavioural intentions.

Methods

To analyse the impact of health information quality on health literacy and behavioural intention, we conducted a randomized controlled trial using a quality-controlled YouTube intervention. Health information quality on YouTube was evaluated using the Global Quality Score and DISCERN. We randomly allocated (1 : 1) to the intervention group to watch the highest quality-evaluated content and to the control group to watch the lowest quality-evaluated content. Health literacy and health behavioural intention were assessed before and after watching YouTube. The trial was set for two different topics: interpreting laboratory test results from health check-up and information about inflammatory bowel disease (IBD).

Results

From 8 April 2022 to 15 April 2022, 505 participants were randomly assigned to watch either high-quality content (intervention group, n = 255) or low-quality content (control group, n = 250). Health literacy significantly improved in the intervention group (28.1 before and 31.8 after; p < 0.01 for health check-up; 28.3 before and 31.3 after; p < 0.01 for IBD). Health behavioural intention significantly improved in the intervention group (3.5 before and 4.1 after; p < 0.01 for health check-up; 3.6 before and 4.0 after; p < 0.01 for IBD). Control groups had no such effect.

Conclusion

High-quality health information can enhance health literacy and behavioural intention in both healthy individuals and those with specific conditions like IBD. It stresses the significance of ensuring reliable health information online and calls for future efforts to curate and provide access to high-quality health content.
Safety and Early Outcomes of Cochlear Implantation of Nucleus Devices in Infants: A Multi-Centre Study
Authors: Honigman Tal , Cushing Sharon L. , Papsin Blake C. , Waltzman Susan , Woodard Jennifer , Neumann Sara , Fitzgerald Matthew B. , Gordon Karen A.
Published: June 2024

This multi-center study examined the safety and effectiveness of cochlear implantation of children between 9 and 11 months of age. The intended impact was to support practice regarding candidacy assessment and prognostic counseling of pediatric cochlear implant candidates. Data in the clinical chart of children implanted at 9–11 months of age with Cochlear Ltd devices at five cochlear implant centers in the United States and Canada were included in analyses. The study included data from two cohorts implanted with one or two Nucleus devices during the periods of January 1, 2012–December 31, 2017 (Cohort 1, n = 83) or between January 1, 2018 and May 15, 2020 (Cohort 2, n = 50). Major adverse events (requiring another procedure/hospitalization) and minor adverse events (managed with medication alone or underwent an expected course of treatment that did not require surgery or hospitalization) out to 2 years post-implant were monitored and outcomes measured by audiometric thresholds and parent-reports on the IT-MAIS and LittlEARS questionnaires were collected. Results revealed 60 adverse events in 41 children and 227 ears implanted (26%) of which 14 major events occurred in 11 children; all were transitory and resolved. Improved hearing with cochlear implant use was shown in all outcome measures. Findings reveal that the procedure is safe for infants and that they show clear benefits of cochlear implantation including increased audibility and hearing development.
Failing to Mobilize: Prosecutors’ Framing Efforts and Anticorruption Campaigns
Authors: Vilaça Luiz
Published: June 2024

Social movement scholars have demonstrated that activists can increase mobilizing attitudes by articulating collective action frames. However, these studies have left unresolved whether and under which conditions state officials such as prosecutors can effectively use collective action frames to trigger mobilizing attitudes. This study draws on an experiment in Brazil to test the effect of different components of collective action frames articulated by prosecutors: identity, agency, urgency, and injustice frames that highlight the material or immaterial consequences of the issue. Respondents were randomly assigned to watch videos that simulated a press conference in which prosecutors discussed a corruption investigation and called for public support using different frames. Although social movement studies would lead us to expect framing components to effectively trigger mobilizing attitudes, results revealed that none of the frames consistently and significantly affected willingness to mobilize against corruption or support for bills that strengthen or weaken prosecutors’ anticorruption efforts.
Activating Family Safety Nets: Understanding Undergraduates’ Pandemic Housing Transitions
Authors: van Stee Elena G. , Kuperberg Arielle , Mazelis Joan Maya
Published: June 2024

Safety nets are typically invisible until tested, and the COVID-19 pandemic provides an opportunity to observe how undergraduates responded to the common challenge of campus closures. Using survey data from two public universities (N = 750), we investigated the factors associated with students’ reports of moving to a parent’s home as a result of the pandemic. Our findings indicate that students’ material needs stemming from loss of housing (if on campus) or employment (if off campus) significantly affected but did not fully explain their housing decisions. Beyond these factors, older students and those living with a romantic partner, sibling, or extended family member were less likely to move in with a parent. These findings build on research documenting class-based differences by demonstrating the importance of life stage and other social ties. Moreover, they highlight how parent-child relationships evolve during the transition to adulthood, influencing decisions to seek support in times of crisis.
Latinx Blue Wave or Religious Red Shift? The Relationship between Evangelicalism, Church Attendance, and President Trump among Latinx Americans
Authors: Martinez Brandon C. , Martí Gerardo
Published: June 2024

Contrary to expectations of a leftward “blue wave,” there is now a largely unanticipated “red shift” of Latinx-identifying people toward Republican Party candidates. To examine this shift, data from the 2020 Cooperative Election Study, which features a robust sample of Latinx (Hispanic) Americans, are analyzed to study how religion contributes to the discussion of Latinx politics. Multivariate analyses reveal that Latinx Evangelical Protestants voted for President Trump and opposed his removal from office on the grounds of both articles of his first impeachment more so than other religious orientations. A postive correlation between Trump support and church attendance was also found. Both patterns indicate a religious right push for Latinxs. Scholars building on these findings are urged to more consistently distinguish Latinx voters by religious orientation and embeddedness, as they likely will have a significant impact on future political outcomes.
Paraphilic Interests in the Swiss Population: Results of a Representative Survey in the Canton of Zurich
Authors: Baier Dirk
Published: June 2024

This article presents results of the prevalence and correlates of paraphilic interests. A representative survey conducted in the largest canton of Switzerland among 18- to 50-year-olds ( n = 1,236) shows that masochism and sexual sadism are the most widespread paraphilic interests. At least 1 of 13 paraphilic interests was reported by 46.4% of the respondents. Only a small proportion said they suffered at least slightly from the interest. Among male respondents and younger respondents, various paraphilic interests are significantly more common. In addition, there are significant correlations between paraphilic interests and pornography consumption, on the one hand, and life satisfaction and mental health, on the other.
Three-dimensional path-effect model to simulate ground motion attenuation on the Korean Peninsula
Authors: Jee Hyun Woo , Han Sang Whan , Lee Kihak
Published: June 2024

In low-to-moderately active seismic regions such as the Korean Peninsula, it is difficult to analyze seismic hazards because only a limited number of strong ground motions have been recorded. To address this shortcoming in the data, ground motion simulation can be used to generate the strong ground motions associated with potentially large earthquakes, taking into account the attenuation that occurs as the distance from the source increases. To simulate this attenuation, the path effect, which is a component of the Fourier amplitude spectrum ( FAS), needs to be defined, along with the source and site effects. The path effect represents the propagation of seismic rays through a tectonic medium. In this study, a three-dimensional (3D) path effect model is developed for the Korean Peninsula, consisting of a 3D geometrical spreading factor, quality factor, and shear-wave velocity. The accuracy of the proposed model is verified by comparing the path-effect values obtained from the FAS of individual ground motions recorded on the Korean Peninsula and those calculated from the model. Examples that demonstrate the procedure to calculate the 3D path effect for the Korean Peninsula are also provided.
Chronic effects of commercial pesticide preparations on biomarkers and reproductive success in earthworm Eisenia andrei
Authors: Lončarić Željka , Lackmann Carina , Bjedov Dora , Šimić Antonio , Ečimović Sandra , Seiler Thomas-Benjamin , Hollert Henner , Velki Mirna
Published: June 2024

Chemical pollution resulting from pesticide usage has been a continuous issue since the 1960s, despite comprehensive European Union legislation designed to safeguard human health and the environment from the adverse effects of pesticides. While regulatory risk assessments primarily focus on the active ingredients, recent research indicates ecotoxicological impacts of commercial preparations on non-target organisms, particularly within the soil ecosystem where key species such as earthworms play a vital role in maintaining soil quality and fertility. Therefore, the aim of this study was the assessment of the long-term effects of the following respective commercial preparations: the insecticides Sumialfa (esfenvalerate) and Calypso (thiacloprid), as well as the herbicides Frontier (dimethenamid-p) and Filon (prosulfocarb) on the earthworm Eisenia andrei in standardized soil during long-term exposures of 7, 14, and 28 days. To study the possible effects on different levels of biological organization, enzymatic biomarkers: acetylcholinesterase (AChE), carboxylesterase (CES) glutathione S-transferase (GST), glutathione reductase (GR), glutathione peroxidase (GPx); non-enzymatic biomarkers: multixenobiotic resistance activity (MXR), levels of glutathione (GSH), and reactive oxygen species (ROS) as well as reproductive success were investigated. While Calypso appeared to be the least toxic substance, all pesticides showed significant effect on multiobiomarker response in E. fetida. That being said, the response of MXR activity was significantly altered by all tested pesticides indicating MXR being the most sensitive endpoint of the present research. Recovery of MXR was observed after 28 days, however, only in case of exposure to Filon, while the recovery of CAT activity was recorded after 28 days as well, subsequent to Sumialfa exposure. Reproductive success was negatively impacted regarding the Frontier and Sumialfa exposure at the highest concentration (100 mg/kg) reflected in reduced number of cocoons, while only the exposure to Frontier (100 mg/kg) reduced the number of juveniles. Based on the results, it is important to include commercial pesticide formulations in pesticide risk assessments. The toxicity classifications of the studied pesticides suggest the potential detrimental consequences to the key soil species in terrestrial ecosystems at various concentrations. Future studies should include other soil species as well as investigation of higher levels of biological organization, i.e., behavioral endpoints, to determine the potential risks to terrestrial ecosystems.
Genetic association analysis in sugarcane (Saccharum spp.) for sucrose accumulation in humid environments in Colombia
Authors: Saavedra-Díaz Carolina , Trujillo-Montenegro Jhon Henry , Jaimes Hugo Arley , Londoño Alejandra , Villareal Fredy Antonio Salazar , López Luis Orlando , Valens Carlos Arturo Viveros , López-Gerena Jershon , Riascos John J. , Quevedo Yeison Mauricio , Aguilar Fernando S.
Published: June 2024

Background

Sucrose accumulation in sugarcane is affected by several environmental and genetic factors, with plant moisture being of critical importance for its role in the synthesis and transport of sugars within the cane stalks, affecting the sucrose concentration. In general, rainfall and high soil humidity during the ripening stage promote plant growth, increasing the fresh weight and decreasing the sucrose yield in the humid region of Colombia. Therefore, this study aimed to identify markers associated with sucrose accumulation or production in the humid environment of Colombia through a genome-wide association study (GWAS).

Results

Sucrose concentration measurements were taken in 220 genotypes from the Cenicaña’s diverse panel at 10 (early maturity) and 13 (normal maturity) months after planting. For early maturity data was collected during plant cane and first ratoon, while at normal maturity it was during plant cane, first, and second ratoon. A total of 137,890 SNPs were selected after sequencing the 220 genotypes through GBS, RADSeq, and whole-genome sequencing. After GWAS analysis, a total of 77 markers were significantly associated with sucrose concentration at both ages, but only 39 were close to candidate genes previously reported for sucrose accumulation and/or production. Among the candidate genes, 18 were highlighted because they were involved in sucrose hydrolysis (SUS6, CIN3, CINV1, CINV2), sugar transport (i.e., MST1, MST2, PLT5, SUT4, ERD6 like), phosphorylation processes (TPS genes), glycolysis (PFP-ALPHA, HXK3, PHI1), and transcription factors (ERF12, ERF112). Similarly, 64 genes were associated with glycosyltransferases, glycosidases, and hormones.

Conclusions

These results provide new insights into the molecular mechanisms involved in sucrose accumulation in sugarcane and contribute with important genomic resources for future research in the humid environments of Colombia. Similarly, the markers identified will be validated for their potential application within Cenicaña’s breeding program to assist the development of breeding populations.
Nirmatrelvir and ritonavir for inpatients with severe or critical COVID-19 beyond five days of symptom onset: a propensity score-matched, multicenter, retrospective cohort study
Authors: Zhang Huan , Tan Xiaojiao , Zhang Zheng , Wang Chenxi , Shi Haiqing , Li Yao , Li Jianbo , Kang Yan , Jin Xiaodong , Liao Xuelian
Published: June 2024

Background

There is an urgent need for therapeutic strategies for inpatients with severe or critical COVID-19. The evaluation of the clinical benefits of nirmatrelvir and ritonavir (Nmr/r) for these patients beyond five days of symptom onset is insufficient.

Methods

A new propensity score-matched cohort was constructed by using multicenter data from 6695 adult inpatients with COVID-19 from December 2022 to February 2023 in China after the epidemic control measures were lifted across the country. The severity of disease of the inpatients was based on the tenth trial edition of the Guidelines on the Diagnosis and Treatment of COVID-19 in China. The symptom onset of 1870 enrolled severe or critical inpatients was beyond five days, and they received either Nmr/r plus standard treatment or only standard care. The ratio of patients whose SOFA score improved more than 2 points, crucial respiratory endpoints, changes in inflammatory markers, safety on the seventh day following the initiation of Nmr/r treatment, and length of hospital stay were evaluated.

Results

In the Nmr/r group, on Day 7, the number of patients with an improvement in SOFA score ≥ 2 was much greater than that in the standard treatment group (P = 0.024) without a significant decrease in glomerular filtration rate (P = 0.815). Additionally, the rate of new intubation was lower (P = 0.004) and the no intubation days were higher (P = 0.003) in the first 7 days in the Nmr/r group. Other clinical benefits were limited.

Conclusions

Our study may provide new insight that inpatients with severe or critical COVID-19 beyond five days of symptom onset benefit from Nmr/r. Future studies, particularly randomized controlled trials, are necessary to verify the above findings.
Long-term outcomes after particle radiation therapy in patients with nasopharyngeal adenoid cystic carcinoma
Authors: Hu Weixu , Hu Jiyi , Huang Qingting , Gao Jing , Zhang Haojiong , Kong Lin
Published: June 2024

Background

Nasopharyngeal adenoid cystic carcinoma (NACC) is a relatively rare salivary gland tumor that is generally associated with poor outcomes. High-dose radiotherapy is a key treatment for patients with NACC. This study reported the long-term efficacy and safety of particle beam radiation therapy (PBRT) for NACC.

Methods and materials

Twenty-six patients with nonmetastatic NACC who received definitive PBRT alone were included in this retrospective study. The majority of patients (92.3%) had locally advanced disease. Twenty-five (96.15%) patients received intensity-modulated proton radiotherapy (IMPT) followed by a carbon ion radiotherapy (CIRT) boost, and one patient received CIRT alone. Overall survival (OS), local control (LC), regional control (RC), and distant metastasis control (DMC) rates were calculated via the Kaplan-Meier method.

Results

The median follow-up time was 46.95 months for the entire cohort. Seven patients experienced local recurrence, and one patient experience neck lymph node recurrence. The 3- and 4-year OS, LC, RC, and DMC rates were 100% and 91.7%, 92.3% and 84.6%, 95.8% and 87.8%, and 90.2% and 71.3%, respectively. A total of 91.3% of the patients achieved complete remission of gross tumors at 1 year after PBRT. Severe acute toxicity was observed in only two patients. A grade 4 decrease in visual acuity was observed in one patient with orbital apex invasion. No late grade 3 or 5 toxicity was observed.

Conclusion

Definitive PBRT provided a satisfactory 4-year OS for patients with locally advanced NACC. The toxicity was acceptable and mild. Further follow-up is necessary to confirm the efficacy and safety of definitive PBRT for patients with NACC.
Efficacy and safety of omega-3 fatty acids supplementation for anxiety symptoms: a systematic review and dose-response meta-analysis of randomized controlled trials
Authors: Bafkar Negar , Zeraattalab-Motlagh Sheida , Jayedi Ahmad , Shab-Bidar Sakineh
Published: June 2024

Background/Objectives

There is uncertainty about the optimum dose of omega-3 fatty acids for anxiety symptoms. We aimed to find the dose-dependent effect of omega-3 supplementation on anxiety symptoms.

Methods

We systematically reviewed PubMed, Scopus, and Web of Science until December 2022 to find randomized trials that assessed the effects of omega-3 fatty acids supplementation on anxiety symptoms in adults. Investigators performed the literature search and screened the titles/abstracts and full-texts and between-reviewer agreement was assessed as Cohen’s kappa coefficient. We conducted a random-effects dose-response meta-analysis to estimate standardized mean differences (SMD) and 95% confidence intervals (CIs) and assessed the certainty of evidence using the GRADE framework.

Results

A total of 23 trials with 2189 participants were included. Each 1 gram per day supplementation with omega-3 fatty acids resulted in a moderate decrease in anxiety symptoms (SMD: -0.70, 95%CI: -1.17, -0.22; GRADE = low). The non-linear dose-response analysis indicated the greatest improvement at 2 g/d (SMD: -0.93, 95%CI: -1.85, -0.01), and that supplementation in a dose lower than 2 g/d did not affect anxiety symptoms. Omega-3 fatty acids did not increase adverse events (odds ratio: 1.20, 95%CI: 0.89, 1.61; GRADE = moderate).

Conclusions

The present dose-response meta-analysis suggested evidence of very low certainty that supplementation with omega-3 fatty acids may significantly improve anxiety symptoms, with the greatest improvements at 2 g/d. More trials with better methodological quality are needed to reach more robust evidence.

Protocol registration

PROSPERO (CRD42022309636).
Effect of sexual health education on sexual function and satisfaction of menopausal migrant women: an application of the theory of planned behavior
Authors: Mohammadi Maryam , Peyman Nooshin , Hossainabadi Mohadese , Ghavami Vahid , Tehrani Hadi
Published: June 2024

Objectives

This study investigated the effect of an intervention based on the theory of planned behavior on sexual function and satisfaction of migrant women during menopause in Iran.

Methods

This quasi-experimental study was conducted on 88 migrant and menopausal women in Iran. Sampling was performed using the multistage methods in four health care centers. The educational program based on the theory of planned behavior was held in 4 sessions of 90 min for 4 weeks in the intervention group. The final evaluation of the intervention was performed immediately, and the follow-up stage (3 months after the intervention) by completing questionnaires in two groups. The data was analyzed with SPSS 20 software with statistical tests of mean and standard deviation, Manwitney, Frideman, Generalized Estimating Equations.

Results

The results showed that after the intervention, the mean score of sexual function in the intervention group increased from 16.53 ± 2.68 before to 17.52 ± 2.90 immediately and 17.38 ± 2.81 in follow up stage (p < 0.05). But in the control group, this score was not statistically significant during the study stages (p > 0.05).

Conclusion

The results indicate that the intervention based on the theory of planned behavior is effective in sexual function and satisfaction with the married life of migrant women during menopause. but to change the sexual function, studies with a longer duration and also the use of other educational models are suggested.
Effectiveness of nanosilver fluoride and silver diamine fluoride in arresting early childhood caries: a randomized controlled clinical trial
Authors: Quritum Maryam , Abdella Ahmed , Amer Hala , El Desouky Lubna M. , El Tantawi Maha
Published: June 2024

Background

One of the most prevalent health problems affecting children worldwide is untreated caries in primary teeth. Agents to arrest caries are used to manage untreated decay in children in disadvantaged communities. Nano Silver Fluoride (NSF) overcomes the staining problems of Silver Diamine Fluoride (SDF). This study compared the clinical cariostatic effect of NSF to 38% SDF for arresting caries lesions.

Methods

The study included 360 children younger than 4 years, with at least one active lesion, ICDAS score ≥ 3, recruited from nurseries in a rural area in Alexandria, Egypt, in 2022. They were randomly assigned to receive a single application of NSF at baseline, or two applications of SDF at baseline and after 6 months. The arrest of active carious lesions was assessed after 6 and 12 months using ICDAS criteria, and parents’ satisfaction with child appearance was also assessed. Chi-Square test was used to compare the groups and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest at lesion level and binary logistic regression was used to assess the effect at patient level.

Results

1853 active lesions were included in children whose mean (SD) age was 42.3 (8.2) months. The arrest rate was significantly higher in the NSF than the SDF group at lesion level (78.4% and 65.0% at 6 months and 71.3% and 56.3% at 12 months,p < 0.001). In regression analysis, NSF had significantly higher odds of caries arrest than SDF at lesion level (at 6 months, AOR = 2.57, 95% CI: 1.55, 4.26 and at 12 month, AOR = 3.27, 95% CI: 1.89, 5.67). Parents of children receiving NSF had significantly greater satisfaction with their children’s dental appearance than those receiving SDF: (97.2% and 76.1%, respectively,p < 0.001).

Conclusion

NSF demonstrated greater effectiveness in arresting caries in preschool children without inducing black staining of teeth and with greater parental satisfaction than SDF. NSF can be an alternative to SDF in arresting caries especially in underprivileged communities.

Trial registration

The trial was registered in the clinicaltrials.gov registry (#NCT05255913)-16/02/2022.
A longitudinal study of sexual activity and influencing factors in breast cancer patients during treatment in the Southwest of China: a trajectory analysis model
Authors: Tian Zhang , Xiaolu Zhang , Jing Yang , Min Wen , Jiaqian Liao , Shouli Chen , Yingyin Wang , Xiaoyuan Deng , Xiaoyan Liu , Guorong Wang
Published: June 2024

Purpose

The aim of this study was to describe the longitudinal developmental trajectories and its influencing factors of sexual activity in patients with breast cancer during treatment.

Methods

A prospective longitudinal study was conducted, including 225 newly diagnosed breast cancer patients in A tumor specialty three-class hospital in Southwest China. We measured sexual activity at the time of admission and diagnosis (T0) and one month (T1), three months (T2), six months (T3), and nine months (T4) after diagnosis. A trajectory analysis model (GBTM) was used to explore the changes in sexual activity in breast cancer patients. Multivariate binary logistic regression analysis was used to analyse the factors that affected the classification of sexual activity trajectories.

Results

The ratio of sexual activity abruptly declined from 100% at baseline to 39.1% at T1. The percentage of sexual activity was improved, from 51.4% at T2 to 63.1% at T4. The optimal model was a 2-group trajectory of sexual activity in breast cancer patients,36.6% in the “low activity group” and 63.4% in the “high activity group.” The multivariate binary logistic regression analysis revealed statistically significant and positive correlations between sexual activity and age (β = 0.085, OR = 1.089, 95%CI 1.035 ∼ 1.145, P = 0.001),libido(β = 0.774, OR = 2.168, 95%CI 1.337 ∼ 3.515, P = 0.002), vaginal lubrication(β = 1.254, OR = 33.503, 95%CI 2.000 ∼ 6.137, P<0.001).

Conclusions

Breast cancer patients exhibited varying levels of sexual activity during treatment; higher age was associated with increased sexual activity, which can contribute to the recovery of sexual function. Therefore, it is crucial to provide appropriate guidance on sexual health for younger patients.
Use of Self-Efficacy Scale in Mass Casualty Incidents During Drill Exercises
Authors: Cardós-Alonso María Carmen , Inzunza Miguel , Gyllencreutz Lina , Espinosa Salvador , Vázquez Tatiana , Fernandez Maria Aranzazu , Blanco Alberto , Cintora-Sanz Ana María
Published: June 2024

Introduction

Medical First Responders (MFRs) in the emergency department SUMMA 112 are tasked with handling the initial management of Mass Casualty Incidents (MCI) and building response capabilities. Training plays a crucial role in preparing these responders for effective disaster management. Yet, evaluating the impact of such training poses challenges since true competency can only be proven amid a major event. As a substitute gauge for training effectiveness, self-efficacy has been suggested.

Objective

The purpose of this study is to employ a pre- and post-test assessment of changes in perceived self-efficacy among MFRs following an intervention focused on the initial management of MCI. It also aimed to evaluate a self-efficacy instrument for its validity and reliability in this type of training.

Method

In this study, we used a pretest (time 1 = T1) – post-test (time 2 = T2) design to evaluate how self-efficacy changed after a training intervention with 201 MFRs in initial MCI management. ANOVA within-subjects and between subjects analyses were used.

Results

The findings reveal a noteworthy change in self-efficacy before and after training among the 201 participants. This suggests that the training intervention positively affected participants’ perceived capabilities to handle complex situations like MCI.

Conclusion

The results allow us to recommend a training program with theory components together with practical workshops and live, large-scale simulation exercises for the training of medical first responders in MCI, as it significantly increases their perception of the level of self-efficacy for developing competencies associated with disaster response.
New insights into physician burnout and turnover intent: a validated measure of physician fortitude
Authors: Weinzimmer Laurence , Hippler Stephen
Published: June 2024

Background

Given the increasing prevalence of the physician burnout, this study provides new insights into the antecedents driving burnout and turnover intent. By introducing the concept of physician fortitude, we develop a valid and statistically-reliable measure that increases our understanding of these issues.

Methods

A two-sample design was employed. Using a sample of 909 physicians, Advanced Practice Providers (APPs) and healthcare leaders, exploratory factor analysis was employed to create a 12-item fortitude scale. In the second study, using a sample of 212 of practicing physicians, APPs and healthcare leaders, bivariate and tetrachoric correlations, and ordinary least square regression modeling were able to establish reliability and validity.

Results

The fortitude scale shows sufficient reliability. Moreover, we found significant support for convergent and criterion-related validity. Fortitude was significantly related to all three subdimensions of burnout, including emotional exhaustion (r = -.62, p < .01), depersonalization (r = -.70, p < .01) and personal accomplishment (r = .65, p < .01), and turnover intent (r = -.55, p < .01). Moreover, the fortitude measure explained more variance in all three subdimensions of burnout and turnover intent compared to common measures, including grit, hardiness, mental toughness and resilience (p < .01).

Conclusions

Results from this study empirically demonstrate that fortitude is significantly related to burnout, and turnover intent. This new fortitude measure adds a new perspective to assist in the development of more effective interventions. Opportunities for future research are discussed.
Unveiling the interplay between rational, psychological and functional factors in continuous glucose monitoring early adoption: Novel evidence from the Dexcom ONE case in Italy
Authors: Zoccarato Francesca , Manzoni Martina , Minotti Davide , Lettieri Emanuele , Boaretto Andrea
Published: June 2024

Background

The escalating prevalence of diabetes, with its multifaceted complications, poses a pressing challenge for healthcare systems globally. In response, the advent of continuous glucose monitoring (CGM) systems, offering technological solutions for daily diabetes management, presents significant opportunities. However, the widespread adoption faces several barriers, linked both to the technological configuration of the devices and to the psychological dimension of patients. Therefore, this study aims to apply and test a theoretical model that investigates the antecedents of the intention to use Continuous Glucose Monitoring systems.

Methods

The research model was built to unveil the impacts of psychological factors, functional components and rational constructs derived from the Technology Acceptance Model (TAM) on CGM systems sustained adoption. To ensure the comparability of results, we have collected data from people who had used Dexcom ONE Dexcom (San Diego, CA) for the first time for at least one month. Employing Structural Equation Modelling (SEM) techniques, the hypothesized relationships among constructs were assessed.

Results

The analyses confirmed the positive correlation of rational factors to the Intention to Use. Subjective Norm, intended as the physicians’ influence, is positively correlated with the Perceived Usefulness. Trend Arrows, albeit being negatively correlated with Perceived Usefulness, have a positive correlation on Perceived Ease Of Use, reinforcing its mediating effect towards Perceived Usefulness. Among psychological factors, Trust in the CGM technology positively correlates with Intention to Use. Health Literacy is negatively correlated to the Intention to Use.

Conclusions

These findings contribute to theoretical and managerial understanding, providing recommendations to enhance the adoption of CGM systems like Dexcom ONE.
Engineering nanoparticles-enabled tumor-associated macrophages repolarization and phagocytosis restoration for enhanced cancer immunotherapy
Authors: Gong Yonghua , Gao Wenyue , Zhang Jinyang , Dong Xia , Zhu Dunwan , Ma Guilei
Published: June 2024

Tumor-associated macrophages (TAMs) are pivotal within the immunosuppressive tumor microenvironment (TME), and recently, have attracted intensive attention for cancer treatment. However, concurrently to promote TAMs repolarization and phagocytosis of cancer cells remains challenging. Here, a TAMs-targeted albumin nanoparticles-based delivery system (M@SINPs) was constructed for the co-delivery of photosensitizer IR820 and SHP2 inhibitor SHP099 to potentiate macrophage-mediated cancer immunotherapy. M@SINPs under laser irradiation can generate the intracellular reactive oxygen species (ROS) and facilitate M2-TAMs to an M1 phenotype. Meanwhile, inhibition of SHP2 could block the CD47-SIRPa pathway to restore M1 macrophage phagocytic activity. M@SINPs-mediated TAMs remodeling resulted in the immunostimulatory TME by repolarizing TAMs to an M1 phenotype, restoring its phagocytic function and facilitating intratumoral CTLs infiltration, which significantly inhibited tumor growth. Furthermore, M@SINPs in combination with anti-PD−1 antibody could also improve the treatment outcomes of PD−1 blockade and exert the synergistic anticancer effects. Thus, the macrophage repolarization/phagocytosis restoration combination through M@SINPs holds promise as a strategy to concurrently remodel TAMs in TME for improving the antitumor efficiency of immune checkpoint block and conventional therapy.