bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncovering perspectives on physical activity in nursing homes: a qualitative exploration of the experiences of healthcare professionals and family caregivers
Authors: Trollebø Stine Øverengen , Taraldsen Kristin , Heiland Jonas Saur , Hawley-Hague Helen , Bardal Ellen Marie , Skjaeret-Maroni Nina
Published: October 2024

Background

The ageing population has increased the demand for healthcare services. In Norway, community-based long-term care are prioritised, leading to fewer nursing home places. As a result, nursing home residents are now older and have more complex needs. Nearly 92% of nursing home residents are affected by cognitive impairments accompanied by neuropsychiatric symptoms (NPS) that affect their daily activity, physical function, cognition, and behaviour. Traditionally, pharmacological therapy has been the prevailing treatment for NPS. However, emerging evidence suggests that physical activity can serve as an alternative treatment approach. Physical activity has the potential to maintain physical independence and enhance the quality of life (QoL) for the residents. Despite these benefits, institutionalisation in a nursing home often restricts activity levels of residents. This study explores facilitators and barriers to physical activity in nursing homes through the experiences of healthcare professionals and family caregivers. The goal is to enhance our understanding of how to promote and support physical activity for nursing home residents by identifying essential factors for successfully implementing daily physical activity initiatives.

Methods

Seven focus groups were conducted with a total of 31 participants. Participants included healthcare professionals (physiotherapists, nurses, unit- and department managers, assistant occupational therapists, and assistant nurses) and family caregivers of residents at nursing homes. Data were analysed using Braun and Clarke’s reflexive thematic analysis, underpinned by hermeneutic phenomenology.

Results

Three main themes related to facilitators and barriers to physical activity in nursing homes were identified: inconsistency in task prioritisation; need for improved interprofessional collaboration; and need for improved utilisation of external resources. The participants experienced task prioritisation and lack of interdisciplinary collaboration as barriers to physical activity. The involvement of external societal resources was considered as both a facilitator and a necessity for obtaining physical activity in nursing homes.

Conclusions

This study highlights the need for a consensus in task prioritisation, enhanced competence among healthcare professionals, and better interdisciplinary collaboration to facilitate physical activity in nursing homes. Involving external societal resources could be a strategic approach to address barriers and support physical activity initiatives. Future research should focus on developing effective strategies for interdisciplinary collaboration that prioritises and promotes physical activity in nursing homes.
Representation of multimorbidity and frailty in the development and validation of kidney failure prognostic prediction models: a systematic review
Authors: Walker Heather , Day Scott , Grant Christopher H. , Jones Catrin , Ker Robert , Sullivan Michael K. , Jani Bhautesh Dinesh , Gallacher Katie , Mark Patrick B.
Published: October 2024

Background

Prognostic models that identify individuals with chronic kidney disease (CKD) at greatest risk of developing kidney failure help clinicians to make decisions and deliver precision medicine. It is recognised that people with CKD usually have multiple long-term health conditions (multimorbidity) and often experience frailty. We undertook a systematic review to evaluate the representation and consideration of multimorbidity and frailty within CKD cohorts used to develop and/or validate prognostic models assessing the risk of kidney failure.

Methods

We identified studies that described derivation, validation or update of kidney failure prognostic models in MEDLINE, CINAHL Plus and the Cochrane Library—CENTRAL. The primary outcome was representation of multimorbidity or frailty. The secondary outcome was predictive accuracy of identified models in relation to presence of multimorbidity or frailty.

Results

Ninety-seven studies reporting 121 different kidney failure prognostic models were identified. Two studies reported prevalence of multimorbidity and a single study reported prevalence of frailty. The rates of specific comorbidities were reported in a greater proportion of studies: 67.0% reported baseline data on diabetes, 54.6% reported hypertension and 39.2% reported cardiovascular disease. No studies included frailty in model development, and only one study considered multimorbidity as a predictor variable. No studies assessed model performance in populations in relation to multimorbidity. A single study assessed associations between frailty and the risks of kidney failure and death.

Conclusions

There is a paucity of kidney failure risk prediction models that consider the impact of multimorbidity and/or frailty, resulting in a lack of clear evidence-based practice for multimorbid or frail individuals. These knowledge gaps should be explored to help clinicians know whether these models can be used for CKD patients who experience multimorbidity and/or frailty.

Systematic review registration

This review has been registered on PROSPERO (CRD42022347295).
iPSC-derived blood-brain barrier modeling reveals APOE isoform-dependent interactions with amyloid beta
Authors: Ding Yunfeng , Palecek Sean P. , Shusta Eric V.
Published: October 2024

Background

Three common isoforms of the apolipoprotein E (APOE) gene - APOE2, APOE3, and APOE4 - hold varying significance in Alzheimer’s Disease (AD) risk. The APOE4 allele is the strongest known genetic risk factor for late-onset Alzheimer’s Disease (AD), and its expression has been shown to correlate with increased central nervous system (CNS) amyloid deposition and accelerated neurodegeneration. Conversely, APOE2 is associated with reduced AD risk and lower CNS amyloid burden. Recent clinical data have suggested that increased blood-brain barrier (BBB) leakage is commonly observed among AD patients and APOE4 carriers. However, it remains unclear how different APOE isoforms may impact AD-related pathologies at the BBB.

Methods

To explore potential impacts of APOE genotypes on BBB properties and BBB interactions with amyloid beta, we differentiated isogenic human induced pluripotent stem cell (iPSC) lines with different APOE genotypes into both brain microvascular endothelial cell-like cells (BMEC-like cells) and brain pericyte-like cells. We then compared the effect of different APOE isoforms on BBB-related and AD-related phenotypes. Statistical significance was determined via ANOVA with Tukey’s post hoc testing as appropriate.

Results

Isogenic BMEC-like cells with different APOE genotypes had similar trans-endothelial electrical resistance, tight junction integrity and efflux transporter gene expression. However, recombinant APOE4 protein significantly impeded the “brain-to-blood” amyloid beta 1–40 (Aβ40) transport capabilities of BMEC-like cells, suggesting a role in diminished amyloid clearance. Conversely, APOE2 increased amyloid beta 1–42 (Aβ42) transport in the model. Furthermore, we demonstrated that APOE-mediated amyloid transport by BMEC-like cells is dependent on LRP1 and p-glycoprotein pathways, mirroring in vivo findings. Pericyte-like cells exhibited similar APOE secretion levels across genotypes, yet APOE4 pericyte-like cells showed heightened extracellular amyloid deposition, while APOE2 pericyte-like cells displayed the least amyloid deposition, an observation in line with vascular pathologies in AD patients.

Conclusions

While APOE genotype did not directly impact general BMEC or pericyte properties, APOE4 exacerbated amyloid clearance and deposition at the model BBB. Conversely, APOE2 demonstrated a potentially protective role by increasing amyloid transport and decreasing deposition. Our findings highlight that iPSC-derived BBB models can potentially capture amyloid pathologies at the BBB, motivating further development of such in vitro models in AD modeling and drug development.
Three-month outcomes and cost-effectiveness of interferon gamma-1b in critically ill patients: a secondary analysis of the PREV-HAP trial
Authors: Bouras Marwan , Tessier Philippe , Poulain Cécile , Schirr-Bonnans Solène , Roquilly Antoine
Published: October 2024

Background

Interferon gamma‑1b has been proposed to treat critical illness-induced immunosuppression. We aimed to determine the effects on 90-day outcomes and the cost-effectiveness of interferon gamma‑1b compared to placebo in mechanically ventilated critically ill patients.

Methods

A cost-effectiveness analysis (CEA) was embedded in the “PREV-HAP trial”, a multicenter, placebo‑controlled, randomized trial, which randomly assigned critically ill adults under mechanical ventilation to receive interferon gamma or placebo. The CEA compared interferon-gamma with placebo using a collective perspective at a 90-day time horizon. The primary outcome was the incremental cost-effectiveness ratio (ICER) expressed in terms of adjusted cost per adjusted Quality-Adjusted Life-Years (QALYs) gained. QALYs were estimated from the responses of patients and proxy respondents to the health-related quality of life questionnaire EQ-5D-3L.

Results

The 109 patients in the PREV-HAP trial were included in the CEA. At day 90, all-cause mortality rates were 23.6% in the interferon group and 25% in the placebo group (Odds Ratio (OR) = 0.88 (0.40 –1.93) p = 0.67). The difference in the mean adjusted costs per patient at 90 days was €-1.638 (95%CI €-17.534 to €11.968) in favor of interferon gamma-1b. The mean difference in adjusted QALYs between interferon gamma-1b and the placebo group was + 0.019 (95%CI -0.005 to 0.043). The probability that interferon gamma-1b was cost-effective ranged from 0.60 to 0.71 for a willingness to pay a QALY between €20k and €150k for the base case analysis.

Conclusion

Early administration of interferon gamma might be cost-effective in critically ill patients supporting the realization of other studies on this treatment. However, the generalization of the findings should be considered cautiously, given the small sample size due to the premature end of PREV-HAP.

Trial registration ClinicalTrials.gov Identifier: NCT04793568, Registration date: 2021–02-24.
A literature review on the integration of microlearning and social media
Authors: Denojean-Mairet Marc , López-Pernas Sonsoles , Agbo Friday Joseph , Tedre Matti
Published: October 2024

The study aimed to perform a literature review to identify the trends, impacts, and challenges associated with the integration of microlearning and social media. A total of seven academic databases were used as sources for searching: Scopus, Web of Science, ACM, EBSCOhost, PubMed, ProQuest, and IEEE. A combination of keywords related to microlearning and social media was employed during the search process. No specific date limit was imposed, but only materials published in English were considered for inclusion. A total of 2312 articles were identified in the first phase of the search. Sixteen articles were selected during phase two after applying the inclusion and exclusion criteria. The reviewed studies encompassed various fields, including computing, programming, language, nursing, surgery, and radiology. Additionally, multiple social media platforms were identified, such as podcasts, chatbots, Facebook, Instagram, LinkedIn, MP3, TikTok, Twitter, YouTube, and Sina Weibo. The results indicate that the integration of microlearning and social media has the potential to enhance learning outcomes positively. These outcomes include increased learner satisfaction, expanded reach, improved learner engagement, and enhanced learning effectiveness. Additionally, the review highlights that the most significant benefits of combining microlearning with social media are increased reach and enhanced learner engagement.
Interactions between cancer and stroma mediated by extracellular vesicles
Authors: Najafzadeh Mahsa , Sajjadi Seyed Mehdi , Kharazi Sam , Karimifard Farzaneh , Safarpour Hossein , Kharazinejad Ebrahim
Published: October 2024

Extracellular vehicles (EVs) are small membrane-bound particles that are released by both cancer and stromal cells. These vesicles have emerged as key mediators of intercellular communication within the tumor microenvironment. In particular, EVs have been shown to play a critical role in facilitating the interactions between cancer cells and the surrounding stroma. Through the transfer of various bioactive molecules, including proteins, lipids, and nucleic acids, EVs are able to modulate the behavior of recipient cells and promote tumorigenesis. Additionally, EVs can also contribute to the development of drug resistance and immune evasion, further highlighting their importance in cancer progression. This review will summarize the current knowledge regarding EV-mediated interactions between cancer and stromal cells, and discuss their implications for cancer diagnosis and therapy.
Computed tomography perfusion as a predictor of gastric cancer grades
Authors: Khalaf Lamiaa M. R. , El-sharkawy Mostafa A. M. , Samy Marwa , Saad Emad , Khallaf Salah , Desoky Hagar H. M. , El-Barody Mohamed M. , Kamel Hosam M.
Published: October 2024

Background

Gastric cancer stands as one of the most prevalent malignancies globally, conventional endoscopic specimens have been the primary means of diagnosing preoperative gastric histopathology, however, their limitations in capturing intra-tumor heterogeneity compromise their efficacy in evaluating angiogenesis. Perfusion Computed Tomography (P-CT) emerges as a pivotal functional imaging modality, facilitating objective assessment of tissue perfusion, serving as a marker of angiogenesis. So, our research objective was to evaluate the efficacy of CT perfusion imaging in the prediction of histological grades of gastric tumors using quantitative perfusion parameters such as permeability surface (PS), blood flow (BF), mean transient time (MTT), and blood volume (BV), in addition to the qualitative scoring system then comparing the findings with the histopathological results.

Results

PS and BF were statistically significant predictors of the grade of differentiation, their odds ratio (OR) was (1.05, 95% CI 1.02–1.09, for each of them) (P = 0.004, P = 0.009, respectively). MTT also emerged as a significant predictor of the grade of differentiation with an OR of 0.76 (95% CI 0.57–0.93, P = 0.025). Using multivariate logistic regression model, PS was the most potent individual P-CT predictor of differentiation of the grade and the diagnosis of poorly differentiated tumors at ≥ 39 mL/100 g/min cut off point, followed by BF at ≥ 82.2 mL/100 g/min, and MTT at < 8.4 s. Regarding the qualitative scoring system P-CT, poorly differentiated tumors generally received higher scores of PS (P < 0.001), BF (P < 0.001), and BV (P = 0.017), than well and moderately differentiated tumors, however, MTT showed that poorly differentiated tumors were more frequently scored as low compared to well and moderately differentiated tumors (P < 0.001).

Conclusions

P-CT is an innovative, non-invasive biomarker for predicting gastric cancer grade by quantitative and qualitative assessment by P-CT parameters (PS, BF and MTT) with particular role of PS as the strongest individual P-CT predictor of differentiation grade followed by BF and MTT at specific cut off points.
Opioid system and related ligands: from the past to future perspectives
Authors: Rullo Laura , Morosini Camilla , Lacorte Antonio , Cristani Marco , Coluzzi Flaminia , Candeletti Sanzio , Romualdi Patrizia
Published: October 2024

Chronic pain is a pathological condition affecting about 30% of population. It represents a relevant social-health issue worldwide, and it is considered a significant source of human suffering and disability, strongly affecting patients’ quality of life. Despite several pharmacological strategies to guarantee an adequate pain management have been proposed over the years, opioids still represent one of the primary choices for treating moderate-to-severe pain in both cancer and non-cancer patients. However, chronic use of opioids often leads to numerous side effects, including respiratory depression, constipation, analgesic tolerance, and opioid-induced hyperalgesia (OIH), which can strongly limit their use. Given the fundamental role of opioid system in pain relief, this review provides a general overview about the main actors (endogenous opioid peptides and receptors) involved in its modulation. Furthermore, this review explores the action and the limitations of conventional clinically used opioids and describes the efficacy and safety profile of some promising analgesic compounds. A deeper understanding of the molecular mechanisms behind both analgesic effects and adverse events could advance knowledge in this field, thus improving chronic pain treatment.
‘I can feel sad about it and I can worry, but inside I know everything happens for a reason’: personal experiences in the aftermath of the March 15 Christchurch mosque attacks
Authors: Dean Shaystah , Eggleston Kate , Ali Fareeha , Thaufeeg Zimna , Wells Hayley , Zarifeh Julie , Sulaiman-Hill Ruqayyah , Bell Caroline , Crowe Marie
Published: October 2024

Background

On 15 March 2019, a white supremacist gunman sequentially attacked two mosques in Christchurch, New Zealand, killing 51 people aged from 3 to 77 years and bullet-injuring 40 more. Approximately 250 people survived the atrocity, and many more family and community members have been directly or indirectly affected.

Aim

To develop an understanding of the personal experiences of some of those affected, including effects on daily life and well-being, in the 18–30 months following the attacks.

Method

Qualitative thematic analysis of semi-structured interviews with 21 men and women from September 2020 to August 2021 was performed. Participants were drawn from a larger quantitative study and included injured, bereaved, witnesses, family members and those from the wider Muslim community in Christchurch.

Results

Four superordinate themes were identified: being overwhelmed in the midst of chaos; experiencing silent and enduring impact; living similarly, but differently; and gaining meaning and growth. These themes captured ongoing distress inclusive of physical symptoms, family and community relationship dynamics and connectedness, secondary stressors, and diversity in coping and growth. For most, the centrality of Islam as a faith tradition was woven throughout.

Conclusion

Consistent with previous literature, post-trauma reactions were pervasive and varied. This appeared to be compounded by secondary stressors in this cohort, such as sociopolitical circumstances, demographic diversity, the COVID-19 pandemic and justice processes. Findings also revealed a strong spiritual thread in the experiences of this minority faith community, shedding light on a complex interaction between recovery and post-traumatic growth.
Association between dietary fat intake and the risk of Alzheimer's disease: Mendelian randomisation study
Authors: Zhu Yunqing , Lan Yongbing , Lv Jun , Sun Dianjianyi , Li Liming , Zhang Dai , Yu Canqing , Yue Weihua
Published: October 2024

Background

Observational studies have shown a controversial relationship between dietary fat intake and Alzheimer's disease, and the causal effects are unclear.

Aims

To assess the causal effects of total fat, saturated fat and polyunsaturated fat (PUF) intakes on the risk of Alzheimer's disease.

Method

A two-sample Mendelian randomisation analysis was performed using genome-wide association study summary statistics on different types of fat intake from UK Biobank (n = 51 413) and on late-onset Alzheimer's disease (LOAD; 4282 cases, n = 307 112) and all forms of Alzheimer's disease (6281 cases, n = 309 154) from the FinnGen consortium. In addition, a multivariable Mendelian randomisation (MVMR) analysis was conducted to estimate the effects independent of carbohydrate and protein intakes.

Results

Genetically predicted per standard deviation increase in the total fat and saturated fat intakes were associated with 44 and 38% higher risks of LOAD (total fat: odds ratio = 1.44, 95% CI 1.03–2.02; saturated fat: odds ratio = 1.38, 95% CI 1.002–1.90; P = 0.049). The associations remained significant in the MVMR analysis (total fat: odds ratio = 3.31, 95% CI 1.74–6.29; saturated fat: odds ratio = 2.04, 95% CI 1.16–3.59). Total fat and saturated fat intakes were associated with a higher risk of all forms of Alzheimer's disease in the MVMR analysis (total fat: odds ratio = 2.09, 95% CI 1.22–3.57; saturated fat: odds ratio = 1.60, 95% CI 1.01–2.52). The PUF intake was not associated with LOAD or all forms of Alzheimer's disease.

Conclusions

This study indicated that total dietary fat intake, especially saturated fat, contributed to the risk of Alzheimer's disease, and the effects were independent of other nutrients. These findings informed prevention strategies and management for Alzheimer's disease directly towards reducing dietary saturated fat intake.
Salvage Surgery for Unifocal Progressive Metastatic Mismatch Repair–Deficient GI Cancer Responding to Immune Checkpoint Inhibition
Authors: Perremans Pieterjan , Van Herpe Filip , Rasschaert Gertjan , Van Ongeval Johan , Decaestecker Jochen , Topal Baki , Bislenghi Gabriele , Wolthuis Albert , Topal Halit , Deroose Christophe , Van Cutsem Eric , Dekervel Jeroen
Published: October 2024

Case series describing excellent outcomes for patients with dMMR GI cancer after resection of a single progressive lesion under immunotherapy.
Dose-Specific Effects of Denosumab on Serum Calcium Levels in Patients With Osteoporosis and Various Renal Functions
Authors: Sun Xiaoxu , Bolster Marcy B , Leder Benjamin Z , Fan WuQiang
Published: October 2024

Context

Patients with osteoporosis and advanced chronic kidney disease (CKD) are at increased risk for hypocalcemia when initiating denosumab. It remains unclear if subsequent doses of denosumab pose a similar hypocalcemia risk as the initial dose.

Objectives

To study dose-specific hypocalcemia risks of denosumab.

Design, Setting, Patients, and Exposure

An observational study of 10 398 consecutive patients with varying renal function who received denosumab within the Mass General Brigham healthcare system between January 1, 2016, and February 29, 2024.

Main Outcomes and Measures

Dose-specific effects of denosumab on serum calcium levels and incidence of hypocalcemia (albumin-corrected serum calcium level < 8.5 mg/dL).

Results

In 159 patients with sufficient data for 3 consecutive doses of denosumab, the initial dose of denosumab reduced serum calcium levels by an average of 0.34, 0.52, and 1.12 mg/dL in patients with glomerular filtration rate (GFR) of ≥60 (n = 89), 30 to 59 (n = 46), and < 30 (n = 24) mL/min/1.73m2, respectively (P < .001). Among patients with GFR of < 30 mL/min/1.73m2, the initial, second, and third dose of denosumab reduced serum calcium levels by an average of 1.12, 0.72, and 0.60 mg/dL, respectively (P = .014). In a cohort of 325 patients with sufficient data for 2 doses of denosumab, a Kaplan–Meier analysis revealed a trend of higher incidence of hypocalcemia following the initial dose compared to the second dose in patients with GFR of < 30 mL/min/1.73m2.

Conclusion

The magnitude of serum calcium decrease following subsequent dose(s) was smaller than that following the initial dose of denosumab among patients with osteoporosis and advanced CKD.
Spine Stereotactic Radiosurgery Provides Long-Term Local Control and Overall Survival for Benign Intradural Tumors
Authors: Taori Suchet , Adida Samuel , Kann Michael R. , Bhatia Shovan , Sefcik Roberta K. , Burton Steven A. , Flickinger John C. , Zinn Pascal O. , Gerszten Peter C.
Published: October 2024

BACKGROUND AND OBJECTIVES:

The role of radiosurgery in the treatment of benign intracranial tumors is well established. However, there are limited long-term follow-up studies on outcomes after stereotactic radiosurgery (SRS) for benign intradural spinal tumors. In this article, we report a large single-institution experience in using SRS to treat patients with benign intradural tumors of the spine.

METHODS:

Overall, 184 patients (55% female) and 207 benign intradural tumors were treated. The median patient age was 52 years (range: 19-93). Tumor histology included schwannoma (38%), meningioma (15%), neurofibroma (21%), hemangioma (9%), hemangioblastoma (8%), hemangiopericytoma (5%), and paraganglioma (4%). Thirty-four (16%) lesions underwent resection before radiosurgery. Twenty-three (11%) lesions were NF1-mutated. The median single-fraction margin dose was 14 Gy (range: 11-20), and the median multifraction margin dose was 21 Gy (range: 15-30).

RESULTS:

The median follow-up was 63 months (range: 1-258). At last follow-up, tumors volumetrically regressed (15%), remained stable (77%), or locally progressed (8%, median: 20 months [range: 3-161]) after SRS. The 1-, 5-, and 10-year local control rates were 97%, 92%, and 90%, respectively. On multivariable analysis, the absence of the NF1 mutation (P = .004, hazard ratio: 0.23, 95% CI: 0.08-0.63) and single-fraction SRS (P = .007, hazard ratio: 0.24, 95% CI: 0.08-0.68) correlated with improved local control. The median overall survival was 251 months (range: 1-258), and 1-, 5-, and 10-year overall survival rates were 95%, 85%, and 70%, respectively. For patients with pre-existing symptoms, tumor-associated pain and neurological deficits were noted to improve or remain stable in 85% and 87% of cases, respectively. Adverse radiation effects included delayed myelopathy (1%), acute pain flare (9%), dermatitis (0.5%), dysphagia (0.5%), and dysphonia (0.5%).

CONCLUSION:

With long-term follow-up, spine radiosurgery is a safe and effective treatment for benign intradural tumors. In carefully selected patients, even with an NF1 mutation, SRS is associated with a high likelihood of local tumor control.
Rapid phase current sampling in a permanent magnet synchronous motor servo system utilizing flexible memory controller bus
Authors: Wang Yukun , Fan Hongjie , Feng Heyang , Xu Dong
Published: October 2024

Background The permanent magnet synchronous motor (PMSM) servo system, integral to robots and other high-precision motion control applications, has its performance directly influenced by the current loop in the PMSM servo system. Though the theoretical adjustment time of the current loop can approach the electrical time constant of PMSM in order of magnitude, constraints such as control frequency make the adjustment time significantly larger than this theoretical limit. Methods This paper introduces a PMSM servo system using a flexible memory controller (FMC) bus for rapid phase current sampling. It leverages an independent current sampling module, equipped with an external analog-to-digital (AD) conversion chip for precise sampling of the output phase current of the PMSM. The sampling precision is 16-bit with a range of 0-3V. The sampled signal is preprocessed by a field-programmable gate array (FPGA), with the phase current data finally transmitted to the primary control chip through the FMC bus. Results By implementing this rapid current sampling architecture, we have successfully reduced the current sampling time by 95.4% while maintaining sampling accuracy. This scheme also substantially shortens the microcontroller unit’s (MCU) interrupt response time, potentially enhancing the current loop's control frequency, ultimately increasing the current loop bandwidth to 20kHz. Conclusions In conclusion, the proposed PMSM servo system with rapid current sampling significantly enhances the performance of the current loop. This advancement in sampling efficiency and control frequency offers substantial improvements for high-precision motion control applications, making it a valuable contribution to the field.
Reliability, validity, and minimal clinically important differences for the Thai-version of the Aberdeen Varicose Vein Questionnaire (AVVQ-Thai) in patients with chronic venous disease
Authors: Siribumrungwong Boonying , Noorit Pinit , Reanpang Termpong , Pornwaragorn Chaowanun , Wilasrusmee Chumpon , Wongsuwanich Suchat , Srikuea Kanoklada , Orrapin Saritphat , Benyakorn Thoetphum , Garratt Andrew Malcolm , Rerkaserm Kittipan
Published: October 2024

Background Patient-reported outcome measures (PROMs) are essential for assessing the health of patients with chronic venous disease (CVD). Therefore, we aimed to translate the Aberdeen Varicose Vein Questionnaire into Thai language (AVVQ-Thai) and evaluate its reliability and validity. Minimal clinically important differences (MCID) of the AVVQ-Thai also be estimated. Methods International standards for PROM translation were followed including the forward-backwards translation of the AVVQ. Patients with Clinical-Etiology-Anatomy-Pathophysiology (CEAP) C2-C6 with truncal reflux were prospectively included. Venous interventions were used to treat reflux and varicosities. Patients’ characteristics, venous clinical severity scores (VCSS), EuroQol EQ-5D, and AVVQ-Thai were collected pre- and one-month post-intervention. AVVQ-Thai was also collected one to two weeks after the initial visit by reply-paid postal questionnaire. Results The study included 119 patients (30% C2, 29% C3, 28% C4, 11% C5, and 2% C6). The AVVQ-Thai had good internal consistency with Cronbach’s alpha of 0.783 and moderate reliability with the intraclass correlation coefficient of 0.67 (95%CI: 0.50, 0.79). The AVVQ-Thai was significantly correlated with VCSS and was able to discriminate patients with different levels of health problems as assessed by EQ-5D at both pre-and post-intervention, demonstrating good construct and discriminative validity. The median AVVQ scores improved significantly after intervention from 15.4 (IQR 8.3, 24.2) to 4.2 (IQR 1.3, 8.4) in C2-C3, and 18.9 (IQR 14.1, 25.5) to 7.3 (IQR 4.6, 16.3) in C4-C6. The MCID of the AVVQ was 6.21 on the 0-100 scale, which equates to the level of difference necessary to be clinically meaningful. Conclusions AVVQ-Thai has satisfactory evidence for internal consistency, reliability, validity, and responsiveness to change and is recommended for application in Thailand.
Enhancing Academic Success: A mixed Study on the Influencing Factors among Pharmacy Students in Syrian Universities
Authors: Qattan Mohab , Dashash Mayssoon , S. Malek Zeina
Published: October 2024

Background Academic achievement is the result of both effort and perseverance exerted by the students. This mixed-methods study aims to investigate the factors affecting the academic achievement of pharmacy students in Syrian universities. Methods A convergent parallel mixed-methods study was utilized. In the quantitative phase, a cross-sectional study was conducted on 1008 students (773 females and 235 males) from 23 Syrian universities. A questionnaire consisting of 48 items was designed to be completed by pharmacy students using a 5-point Likert scale. In the qualitative phase, twelve questions were developed to interview thirty pharmacy students from five Syrian universities to obtain in-depth insights into the factors influencing their academic achievement. Results A significant number of students lacked effective time management skills, identified as a weakness among students. The majority of students faced challenges in maintaining a consistent study routine, averaging a score of (2.0). Motivation towards learning emerged as a crucial factor in enhancing academic performance. Lecturers in the pharmacy faculty employed traditional teaching methods (2.01), and the pharmacy curriculum was perceived as lacking modernity (1.92). Quantitative findings demonstrated that pharmacy students experienced exam-related anxiety (2.05), identified as a weakness in the qualitative phase. Factors associated with the Syrian crisis, like unreliable electricity (1.87) and transportation issues (1.83), could have an impact on academic achievement. Economic conditions were identified as challenging to students’ academic performance, negatively affecting the learning process (1.98). Conclusion The results of the study demonstrate that personal factors, lecturers, educational environment, exams, and the Syrian crisis influence the academic achievement of pharmacy students in Syrian universities.
Trends of machine learning for dental caries research in Southeast Asia: insights from a bibliometric analysis
Authors: Hasan Faizul , Setia Budi Hendrik , Yuliana Lia Taurussia , Sujarwadi Mokh
Published: October 2024

Background Dental caries is a common chronic oral disease, posing a serious public health issue. By analyzing large datasets, machine learning shows potential in addressing this problem. This study employs bibliometric analysis to explore emerging topics, collaborations, key authors, and research trends in Southeast Asia related to the application of machine learning in dental caries management. Methods A comprehensive selection using the Scopus database to obtain relevant research, covering publications from inception to July 2024 was done. We employed the Bibliometric approaches, including co-authorship networks, yearly publishing trends, institutional and national partnerships, keyword co-occurrence analysis, and citation analysis, for the collected data. To explore the visualization and network analysis, we employed the tools such as VOSviewer and Bibliometrix in R package. Results The final bibliometric analysis included 246 papers. We found that Malaysia became the top contributor with 59 publications, followed by Indonesia (37) and Thailand (29). Malaysia had the highest Multiple Country Publications (MCP) ratio at 0.407. Top institutions including the Universiti Sains Malaysia led with 39 articles, followed by Chiang Mai University (36) and the National University of Singapore (30) became the leader. Co-authorship analysis using VOSviewer revealed six distinct clusters. A total of 1220 scholars contributed to these publications. The top 10 keywords, including ‘human’ and ‘dental caries,’ indicated research hotspots. Conclusion We found growing evidence of machine learning applications to address dental caries in Southeast Asia. The bibliometric analysis highlights key authors, collaborative networks, and emerging topics, revealing research trends since 2014. This study underscores the importance of bibliometric analysis in tackling this public health issue.
Maternal Mortality in the Governorate of Tunis between 2017 and 2023: evolution of Maternal Mortality Ratio and the main causes of death
Authors: magdoud khaoula , rezigui hanene , Arifi Nejla , Bayar Sirine , Ben Abdallah Hamza , Abouda Hassine Saber , Ben Hmid Rim
Published: October 2024

Background Maternal mortality is the main indicator of maternal health worldwide. The aims of your study were to determine the Maternal Mortality Ratio (MMR) in the governorate of Tunis and to identify the main causes of maternal death. Methods We included all maternal deaths between January 2017 and December 2023, reported to the Tunis Regional Health Directorate. The data collected included the MMR per 100000 live birth, sociodemographic characteristics, causes of death, circumstances of death, autopsy findings, and preventability. Results Sixty one maternal deaths were recorded. The average of MMR was 46, 88 per 100000 live births. Two peaks in the MMR were noted in 2017 and 2020. The average age of the patients was 34, 1 years (±5.1). We noted that 43, 75 % of the patients were not residents of the governorate of Tunis. The postpartum period was the most critical. In fact, 83, 33 % of maternal deaths occurred postpartum. Hemorrhage was the main etiology in 20.8% of cases. The second cause was COVID- 19complicationsin 16, 6% of cases. Conclusion This study of maternal mortality in Tunis opens the debate on the effectiveness of maternal health policies in Tunisia and the areas for improvement.
Communicating with Deaf Patients in the Clinical Environment: Lessons Learned from a Virtual Patient Panel
Authors: Snyder Natalie P. , Olonilua Benedicta O. , Frasso Rosemary , Croce Julia , Papanagnou Dimitrios
Published: October 2024

Background Communication and cultural differences predispose Deaf patients to suboptimal healthcare. Despite this disparity, health professionals have historically received little to no training in caring for Deaf patients. Patient panels are an effective tool in medical education to model communication strategies. Objective In this paper, we describe the design, implementation, and results of a virtual patient panel focused on communicating with Deaf patients in clinical contexts. We offer practical suggestions for incorporating similar educational interventions in health professions education to prepare trainees to effectively navigate these conversations with their patients. Methods The panel consisted of a one-hour question and answer discussion facilitated by the authors with Deaf patients and Certified Deaf Interpreters (CDI). The panel was presented to 271 second-year medical students at our institution in November of 2023. Following this discussion, students were encouraged to share one or two key takeaways from the session through a survey link. These results were analyzed using pile-sorting qualitative analysis to identify main themes. Results There were 73 respondents, with a response rate of 27%. After the panel, the most popular takeaway points from student reflections included communication (n=56, 77%) and access to care (n=47, 64%), followed by autonomy (n=17, 23%), the doctor-patient relationship (n=15, 21%), and culture (n=11, 15%). Based on this initiative, we identified and offer twelve tips for developing similar exercises. These tips are thematically presented under three groupings: Planning Considerations, Patient Panelist Considerations, In-Session Considerations, and Post-Session Considerations. Conclusion This patient panel was the first of its kind in our medical school curriculum. Important considerations in panel design and implementation should focus on delivery time constraints with live-interpreting and further exploring the role of trust and communication in the physician-patient relationship.
The labor market of socially vulnerable groups: potential, new trends and problems of regulation
Authors: Zabyelina Olga , Mirzabalaeva Farida Islamudinovna , Sankova Larisa , Alieva Patimat , Asaliev Asali , Kucherenko Kirill , Ledneva Svetlana , Opryatnov Arseniy , Pashkova Svetlana , Smirnova Ekaterina , Shichkin Igor'
Published: October 2024

The monograph presents a comprehensive characteristic of the problems of labor market development and regulation for socially vulnerable groups of the population. It allows to make recommendations for improving the state employment policy and increasing efficiency of the public employment service in the Russian Federation.
The study focuses on four main population groups whose development and labor potential are crucial for stabilizing and improving the labor shortage in the Russian labor market in the future: persons with disabilities; women with minor children; persons of older working age and pensioners, as well as labor and forced migrants. The authors also touch upon specific issues concerning other socially vulnerable groups of the population (for example, young people, including graduates of vocational education organizations).
The authors study international approaches to the development of an inclusive labor market; the role and prospective tasks of the public employment service in the employment of socially vulnerable groups of the population; systematize the problems of promoting the employment of persons with disabilities in domestic and foreign scientific literature; provide a statistical assessment of the labour market situation of certain socially vulnerable groups of the population; consider domestic and foreign measures to promote the employment of persons with disabilities, women with children, and the elderly; the possibilities of creating conditions for ensuring decent work and social protection for labor and forced migrants; problems of realizing the labor potential of socially vulnerable groups of the depressed areas population. Special emphasis in the monograph is made on the development of continuing professional education as a factor of adaptation of the employed and unemployed to the labor market. The authors consider the unemployment insurance institute as a way to increase the protection of socially vulnerable groups of the population, as well as the practice of labour market development for them in the CIS countries.
The monograph may be of interest to researchers, representatives of government and municipal authorities, employees of the public employment service, teachers of higher educational institutions, postgraduates and students studying the problems raised by the authors.
From Aches to Answers: Understanding and Managing Hip Joint Issues in Kids
Authors: Rutkowski Wojciech , Salwa Adam , Gajdzińska Natalia , Rostkowska Weronika , Rzepka Maciej , Sztuba Karolina , Puchała Justyna , Rymaszewska Katarzyna , Starzomska Dominika , Basiura Karolina
Published: October 2024

Introduction: Joint pain is a prevalent concern among pediatricians, orthopedists, and general practitioners, affecting up to 50% of children during childhood. The hip joint is particularly vulnerable, with degenerative diseases of the hip joints (DDHJ) being the leading cause of pediatric orthopedic visits. Various conditions, such as developmental dysplasia of the hip (DDH), Legg-Calve-Perthes Disease (LCPD), and slipped capital femoral epiphysis (SCFE), contribute to the spectrum of hip joint disorders in children.
Material and methods: We have gathered the available materials and scientific reports, analyzing and summarizing them in a single study.
Aim of study: This study aims to explore the etiology, diagnosis, and management of hip joint pain in children, focusing on DDH, LCPD, SCFE, and other related conditions. By examining the risk factors, clinical presentations, and current treatment strategies, the study seeks to enhance the understanding and early detection of these disorders, ultimately improving patient outcomes.
Conclusion: Hip joint pain in children encompasses a broad differential diagnosis, ranging from self-limiting conditions like transient synovitis to serious disorders such as septic arthritis and JIA. Early identification and appropriate management of conditions like DDH, LCPD, and SCFE are crucial in preventing long-term complications. While physical activity is generally safe, intense exercise may increase the risk of musculoskeletal pain. A multidisciplinary approach, supported by further research, is essential for effective pain management and treatment optimization in pediatric patients.
Shaken to the core - understanding the impact of infant trauma
Authors: Sztuba Karolina , Rutkowski Wojciech , Gajdzińska Natalia , Salwa Adam , Rzepka Maciej , Rymaszewska Katarzyna , Starzomska Dominika , Puchała Justyna , Basiura Karolina , Rostkowska Weronika
Published: October 2024

Introduction: Shaken Baby Syndrome (SBS), a severe form of abusive head trauma (AHT), primarily affects infants due to their vulnerable anatomy and physiology. SBS results from violent shaking, causing the brain to collide with the skull, leading to critical injuries including brain damage and long-term disabilities. Despite its severity, SBS is often misperceived as non-harmful, leading to delays in diagnosis and intervention.
Materials and Methods: The study involves a comprehensive review of SBS and AHT related literature from the last 10 years available in English, focusing on the mechanisms, epidemiology, clinical presentation, and diagnostic challenges associated with the syndrome. Aim of the Study: The primary aim is to elucidate the diagnostic difficulties and underrecognized nature of SBS. The study seeks to raise awareness among healthcare providers and caregivers about the critical need for early detection and intervention. It also aims to emphasize the importance of educational programs to prevent SBS and improve outcomes for affected children.
Conclusion: SBS is a severe and frequently underrecognized form of child abuse with potentially devastating consequences. Effective prevention and intervention hinge on improved awareness and education. Raising consciousness among healthcare providers and the general public, along with implementing robust educational initiatives, is crucial to reduce the incidence and impact of SBS. Early diagnosis and intervention, supported by targeted education, are essential to protecting vulnerable children and mitigating long-term harm.
What makes medical students choose their residencies? Association between mental health of medical students and their choices of future medical specialties
Authors: Bartosik Natalia Karina , Smolarek Aleksandra , Frączek Adrianna , Dobielska Maria , Kosmalski Marcin , Pietras Tadeusz , Jóźwik Adam
Published: October 2024

Background: Excessive cognitive demands and chronic stress contribute to the occurrence of mental health problems among medical students. It may be hypothesized that the presence of such disturbances have an influence on their choices of post-graduate training programs.
Objective: The aim of the study was to evaluate the state of mental health of medical students and to assess if there is any association between the prevalence of mental health problems and their residency choices.
Materials and methods: 114 medical students were surveyed in terms of their residencies' choices and their mental health with the usage of validated psychological questionnaires.
Results: 74 (64,91%) of medical students needed psychiatric or psychological treatment at some stage in their lives. Intensity of risky alcohol consumption was positively correlated with the choice of surgery (p=.0000) and negatively correlated with the choice of psychiatry (p=.0000). The severity of depressive symptoms was positively correlated with emergency medicine choice (p=.0479). Anxiety symptoms, eating disorders and autism spectrum severity symptoms were not significantly correlated with the choice of any medical specialty.
Conclusions: Medical students were found seriously affected by mental health problems, what to some extent seemed to impact their future career choices.
El gesto desnudo: Guillermo Vélez
Authors: Rendón Catherine
Published: October 2024

He aquí una serie de trazos que dibujan el gesto de una figura asombrosa. Guillermo Vélez Mejía perteneció a una innombrada generación de artistas de la segunda mitad del siglo XX en Colombia. Viajó por ciudades pintorescas: Manizales, Cali, Nueva York, Lisboa, Armenia. Buscó una estética propia que recordara el placer de vivir de mil formas y de encontrar soluciones imaginarias a los desafíos de la razón, porque acaso la realidad y la lógica no le eran suficientes. Incursionó en una nueva dimensión plástica y poética donde halló lugar entre Alfred Jarry, César Vallejo, Fernando Pessoa, Alberto Caeiro y otros personajes multidimensionales a los que dio rostro y nombres sonoros en sus pinturas. Fue rebelde con causa, alfabetizó a los presos políticos, serigrafió horóscopos, viajó por los países comunistas, resistió como migrante en Estados Unidos y Europa y regresó a su tierra con esa suma de experiencias convertido en un pintor patafísico. El gesto desnudo. Guillermo Vélez de Catherine Rendón aproxima a la vez a una obra plástica y a una vida que inspirará en cualquiera una indoblegable vocación artística.