bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions of community healthcare workers on the use of teledentistry for seniors in Singapore: A qualitative study
Authors: Nurjono Milawaty , Ho Ezra , Lee Jing Yi , Petcu Roland , Sim Christina PC
Published: January 2025

Objective

This study aimed to identify barriers and facilitators surrounding the implementation of TDOCS from Community Health Workers (CHW)'s perspective before TDOCS implementation.

Methods

A descriptive qualitative study was conducted through semistructured interviews with a purposive sampling of CHWs from partner nursing homes and home care teams. A French framework outlining barriers to asynchronous oral teleconsultation adoption was used to develop the topic guide for this study. Then, the Consolidated Framework for Implementation research (CFIR 1.0) was used to guide coding and analysis.

Results

A total of 43 CHWs from participating institutions were interviewed prior to receiving teledentistry training. Perceived barriers included low awareness about the importance of dental care, limiting conditions to T-DOCS participation among beneficiaries, limited understanding of T-DOCS, perceived low self-efficacy among CHWs, manpower shortages, perceived low priority of dental care, competition with other nursing duties and restricted access due to COVID-19. Facilitators included existing relationships between CHWs and beneficiaries, receptivity towards participation, CHWs’ motivation to upskill and improve dental care for seniors, prior experience with other telemedicine technology, perceived need for change, supportive management, colleagues and existing impediments to access dental care.

Conclusion

This study identified barriers and facilitators to implementing T-DOCS from the CHWs’ perspectives. We recommend for targeted CHW training, programme champions, workflow integration and incentivisation schemes. Addressing challenges like manpower strain and resource limitations through efficient scheduling and capacity building is vital for sustainability. Policy-level support, including legal frameworks, funding and regulatory structures, is essential for integrating teledentistry into mainstream healthcare.
“With a Little Help from my Friends”: Exploring Pseudo-Social Music Listening Experiences
Authors: Bannister Scott , Bailes Freya , Greasley Alinka E.
Published: January 2025

Contemporary research highlights intimate connections between music and social bonding, such that even modern music listening behaviors, including listening when alone, may be social experiences; in some cases, music may behave as a social “agent” with which interpersonal or social experiences can occur for listeners. However, these types of experiences, labeled here as pseudo-social music listening ( P-SML) experiences, have rarely been investigated directly. This paper outlines a preliminary study of P-SML experiences, exploring six conceptual types of experience identified in existing literature ( Company, Consolation, Empathy, Personas and Narratives, Identification, and Feeling One with music). Through a questionnaire containing rating scale and open-ended questions, participants ( N = 117) highlighted how relatable these six proposed P-SML types were to their own listening experiences, by ranking vignette statements describing the experiences of other listeners. Participants then recalled a P-SML experience of their own, describing their subjective feelings, qualities of the music involved, and whether this experience is consistent or situation-dependent. Results suggest that participants often described P-SML experiences as emotional experiences that involve a felt sense of connection or resonance between listener and music. Factors considered important for P-SML experiences include the emotional expression of the music, melodies and harmonies, and rhythm. Extra-musical knowledge, such as knowledge of the composer, songwriter, or performer, was considered less important. Findings are discussed in terms of links between music, emotion and social bonding, conceptualizing connection and resonance when listening to music in relation to parasocial interactions, and refining a conceptual foundation of P-SML experiences for future work.
Community-Partnered Training in Trauma-Informed Primary Care for Patients Experiencing Reentry From Incarceration: A Pilot Training Study
Authors: Szkodny Lauren E. , Yared Mahlet A. , Bardach Shoshana H. , Lascaze Joseph , Stevens Randy , Adachi-Mejia Anna M. , Satcher Milan F.
Published: January 2025

Introduction/Objectives:

Patients returning to the community from incarceration (ie, reentry) are at heightened risk of experiencing trauma when interacting with the healthcare system. Healthcare professionals may not recognize patients’ trauma reactions or know how to effectively respond. This paper describes the development and pilot evaluation of a single-session training to prepare primary care teams to deliver trauma-informed care (TIC) to patients experiencing reentry.

Methods:

A multidisciplinary team including community members with lived experience engaged in a multiphase human-centered design process that incorporated interviews, discussions, and a participatory process to design and evaluate a single-session interactive pilot training targeting providers’ attitudes toward formerly incarcerated patients and confidence to deliver TIC.

Results:

Both pre- and post-training surveys were completed by 12 TIC training attendees, which included primary care providers and staff. Trainees reported significant increases in confidence to reduce potentially re-traumatizing practices and improved attitudes toward formerly incarcerated individuals. They also expressed interest in receiving additional TIC training and learning how best to care for and meet the needs of persons with a history of incarceration. Trainees described the panel of community members with lived experience as one of the most rewarding aspects of the training.

Conclusion:

Centering people with lived experience in the training design and delivery produced a single-session TIC training that was both well-received and effective. Our TIC training helped primary care providers and staff move from being merely informed on trauma to having the self-efficacy to prevent and respond to trauma reactions during encounters with all patients, particularly those with a history of incarceration.
Evaluating the Efficacy and Safety of Halo-Femoral Traction and Halo-Gravity Traction Techniques in Severe Kyphoscoliosis With Spinal Cord Risk Classification (SCRC) Type 3 Over the Apex
Authors: Lo Yuan-Shun , Lin Erh-Ti Ernest , Yeh Chen-Wei , Chen Michael Jian-Wen , Chiang Cheng-Hung , Tsai Chun-Hao , Fong Yi-Chin , Chang Pao-Lung , Chen Yen-Jen , Chen Hsien-Te , Qiu Yong
Published: January 2025

Study design

Retrospective cohort study.

Objective

To analyze the efficacy and safety of Halo-femoral traction (HFT) following spinal release, and preoperative Halo-gravity traction (HGT) in patients with severe spinal kyphoscoliosis and spinal cord risk classification (SCRC) type 3 at the apex.

Methods

A total of 73 patients (24 males, 49 females, mean age 22.4 ± 6.4 years) and 56 patients (15 males, 41 females, mean age 22.9 ± 10.4 years) were included in the HFT and HGT group, respectively. Radiographic parameters were measured at the initial assessment, post-traction, post-final surgery, and during each follow-up. Neurologic function was assessed using the Frankel score system. IONM alerts and all complications were documented. Quality-of-life was evaluated using the SF-36 questionnaire.

Results

In the HFT vs HGT group, the total correction rates were 39.9 ± 7.2% v.s. 41.3 ± 6.8% for the major Cobb and 36.6 ± 9.3% v.s. 44.4 ± 9.2% for global kyphosis (GK) after final surgery, respectively. The traction contributions were 57.6 ± 11.1% v.s. 52.3 ± 9.3% for major Cobb and 70.1 ± 10.5% v.s. 63.9 ± 11.1% for global kyphosis (GK), respectively. More than half of the total correction can be achieved gradually and safely through preoperative traction with patients in an awake state. No deterioration in neurological function was found post-final surgery. During the last follow-up, SF-36 questionnaire scores improved significantly in both groups ( P < .05).

Conclusions

Significant outcomes can be expected in patients with severe kyphoscoliosis, even with spinal cord risk classification (SCRC) type 3 at the apex undergoing HFT and HGT.
Clinical Outcomes of a New Foot-Worn Non-Invasive Biomechanical Intervention Compared to Traditional Physical Therapy in Patients With Chronic Low Back Pain. A Randomized Clinical Trial
Authors: Veeramachaneni Ratnakar , Gitkind Andrew , Yerra Sandeep , Hagan Michael , Hasanoglu Asude N. , Akile Natnael , Kareff Hannah , Ho Derek , Bartels Matthew N.
Published: January 2025

Study Design

Randomized Controlled Trial.

Objective

Chronic low back pain (CLBP) is a major public health concern that will continue to grow with the expected aging of the population. The purpose of this study was to examine the clinical effect of a personalized, home-based biomechanical intervention compared to traditional physical therapy in patients with CLBP.

Methods

This was a randomized controlled trial. One-hundred and sixty-two patients were randomized in a 2:1 ratio to a home-based biomechanical intervention (HBBI, AposHealth) or traditional physical therapy (TPT), respectively. Patients were assessed at baseline and after 12 weeks and 52 weeks. The primary outcome measure was pain at 52 weeks, using a standard Numeric Rating Scale (NRS). Secondary outcomes included pain and function metrics, quality of life and objective spatio-temporal gait test. A Linear Mixed Model assessed changes over time across all study visits.

Results

A significant reduction in NRS was found after 52 weeks with a superiority effect of the HBBI arm compared to TPT (F = 13.82, P < 0.001). Patients in the HBBI arm demonstrated a marginal mean reduction of 3.5 points, from 6.2 to 2.7 (a 56% reduction), while patients in the TPT arm reported a mean decrease of 1.8 points from 6.9 to 5.1 (a 26% reduction).

Conclusions

A new foot-worn, home-based, biomechanical intervention for patients with chronic non-specific back pain was found to be clinically effective. Given the lack of non-surgical, non-pharmacological interventions for this populations, this treatment might serve as an adjunct to the current standard of care.
“Three Sides to Every Story”: Living the Patient, Carer and Staff Experience of COVID
Authors: Hurst Helen , Ramsey Sarah M.
Published: January 2025

In 2020, the UK’s National Health Service (NHS) braced itself for the challenge of the COVID pandemic. Older, frail adults were among those at highest risk for morbidity and mortality. This study aimed to capture the lived experiences of patients, families/carers and staff on a COVID ward. Thirty participants were included, and data collected through in-depth unstructured interviews. The data were analyzed using interpretive phenomenology. Four main themes were constructed, capturing the collective experiences of the participants. The first theme, the changing and uncertain period of time, describes the shared sense of immersion in the chaotic situation, lack of control and resulting fears related to the contagion. Secondly, challenges of care, focuses on shared anxieties and guilt related to shortcomings in care delivery, and efforts to adapt to the new situation. The third theme, communication and keeping in touch, details the effect restrictions had on efforts to maintain contact and its toll on mental health. The last theme of challenging situations in end-of-life care, reflects experiences of grief and loss shared by all three participant groups. This study adds to the growing evidence base around experiences of the COVID pandemic through exploration of the profound triangulated experience of all participants.
Developing Research-Oriented Health Professionals: Understanding Students’ Perceptions and Needs for Extracurricular Research Opportunities
Authors: Xu Peihao , Pfeiffer Shona , Boland Fiona , Stevens Niall T.
Published: January 2025

BACKGROUND

Undergraduate training in research principles is often mandated by healthcare profession regulators in Ireland to prepare graduates for higher specialist training. Students can be offered the opportunity to participate in extracurricular research activities, in addition to those embedded in the curricula. This cross-sectional study aims to explore student attitudes towards research and to understand their motivations for engaging in research-related activities and any barriers that might prevent them from doing so.

METHODS

Students participating in the Royal College of Surgeons in Ireland Research Summer School (RSS) 2023 completed a questionnaire at the start of the program to assess research experience as well as attitudes and motivations towards research.

RESULTS

Of the 120 participants in the summer research school, only 50 participated in the questionnaire. Of these 50, 42 were medical students. Twenty-nine students were undertaking a supervised research project, while 21 were enrolled in a 4-week taught research skills program. Five students had completed a previous undergraduate or postgraduate degree, and 29 had previously participated in research-related activities. The reasons for participating in the RSS program were to gain experience and skills, followed by having an interest in biomedical research. Twenty-nine students said their motivation was to participate in a more exploratory learning process beyond the syllabus. Thirty students felt the main factor preventing them from gaining research experience was the lack of research opportunities available to them.

CONCLUSION

Undergraduate health professions students recognize the importance of engaging in research-related activities. Gaining research experiences to enhance knowledge and build professional relations is important, but the lack of opportunities is perceived to be a barrier preventing engagement. Given the value undergraduate students place on research experiences, institutions specializing in health professions education should create customized programs to eliminate obstacles and offer undergraduate opportunities that encourage the development of research-focused healthcare professionals.
The wild workforce: Enlisting non-human labor in invasive species management
Authors: von Essen Erica , Wanderer Emily , Lennon Gabriel , Ahlberg Karin
Published: January 2025

An all-hands-on-deck rationality appears to characterize invasive alien species (IAS) eradication. Not only are citizens enrolled in their monitoring and management to extend authorities’ capabilities, but a recent trend in so-called nature-based solutions also outsources labor to non-human species. Within the realm of biocontrol initiatives, these non-human actors are strategically enlisted to counter invasive species through various methods such as predation, detection, sensing, niche occupation, and infiltration for internal destruction. This paper critically examines this conscription of non-humans, including sentient animals, to do the dirty work for us, by synthesizing ongoing cases from each of these categories or careers of non-human labor. These range from metabolic and ecological labor, performed with relatively little human intervention, to contrived schemes of capturing, sterilizing, tagging, and releasing Judas animals to locate conspecifics for culling. In the IAS management context, most of this is a kind of necro-labor, where non-human workers, wittingly or unwittingly, end up as assassins, snitches, moles, thieves and destroyers of their targets, the undesired invasives. We argue that wild animal labor has been invisibilized insofar as these non-human laborers either are said to perform their “natural” behaviors or relegated to nature/property themselves, that is, the product of labor. Our paper further helps de-exceptionalize human labor over nature and make visible the kinds of contracts that we are entering into with non-human laborers and hence also our duties and responsibilities. Our focus on labor specifically in invasive species eradication helps highlight the harms involved in the necro-labor that targets undesirable species.
Timing of vitrectomy for treatment of endophthalmitis after intravitreal anti-VEGF injection: a systematic literature review of case reports and series
Authors: Hu Daniel J. , Ghauri Sophia , Krzystolik Magdalena G.
Published: January 2025

Objective:

To perform a systematic literature review analyzing visual outcomes of immediate, early, and delayed vitrectomy in the treatment of acute endophthalmitis after intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections.

Methods:

We conducted a literature search using the Ovid Medline, Embase.com, and Web of Science databases, and relevant articles were selected from original English papers published from 2005 to 2021. Inclusion criteria were studies reporting cases of acute post-anti-VEGF endophthalmitis, defined as occurring within 6 weeks of injection treatment. Exclusion criteria were pediatric cases and cases explicitly reported to be caused by injections of contaminated drugs. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal tool for case reports and case series. The study dataset for descriptive and statistical analysis comprised patient-level data extracted from included studies. The timing of vitrectomy compared were defined as (1) immediate vitrectomy as occurring within 24 h of endophthalmitis diagnosis; (2) early vitrectomy as occurring between 24 and 48 h of endophthalmitis diagnosis; (3) late vitrectomy as occurring after 48 h of endophthalmitis diagnosis. Primary outcome was final visual acuity following treatment with vitrectomy.

Results:

Twenty-five articles were published that met our inclusion and exclusion criteria for a total of 86 cases. Thirty-seven were immediate vitrectomy, 25 were early, and 24 were late vitrectomy treatment groups, respectively. We observed differences in final visual outcomes and in improvement from diagnosis to final visual acuity, with patients receiving immediate and late vitrectomy to have better final visual outcomes than those patients receiving early vitrectomy ( p < 0.005).

Conclusion:

Our results show that there may be an association between time to vitrectomy and visual outcomes. Immediate and late vitrectomy treatment groups had better visual outcomes than the early group. Our results were limited by the reliance on case reports and series and the paucity of data available specifying the timing of vitrectomy. Additional research is necessary to elucidate the effects of treatment timing in patients with endophthalmitis following anti-VEGF injection.
A 52-week, open-label, observational study evaluating tolerability, efficacy and physicians satisfaction of rivastigmine oral solution in Alzheimer's disease in Taiwan
Authors: Lee Chuo-Yu , Wang Wen-Fu , Hsu Jung-Lung , Yang Yuan-Han , Jhang Kai-Ming
Published: January 2025

Background

There is limited data on the use of rivastigmine oral solution in patients with Alzheimer's disease (AD).

Objective

To evaluate the tolerability, efficacy and physicians’ satisfaction of Rivast® (rivastigmine oral solution 2 mg/ml) in Taiwanese patients with mild to moderate AD over a 52-week period.

Methods

An open-label, non-comparative, observational study was conducted across four hospitals in Taiwan. 142 Patients with mild to moderate AD were enrolled. Adverse events and adherence rates were monitored throughout the 52-week study period, while cognitive (Mini-Mental State Examination (MMSE)) and global functional outcomes (Clinical Dementia Rating (CDR)-Sum of Boxes) were recorded at baseline and at week 52. Factors associated with discontinuation, adverse events, and declines in cognitive and global function were determined.

Results

The study achieved a 92.3% adherence rate, with 19% experiencing adverse events. The optimal dose was 3.8 ml, reached within 8.3 weeks. 43.7% of the patients reached an optimal dose of 4 ml and 59.8% achieved optimal dose within 4 weeks. Age and clinically significant electrocardiogram (EKG) abnormalities were associated with a higher risk of discontinuation, while female patients exhibited a lower risk. Additionally, both a higher initial dose and a higher optimal dose were associated with a reduced risk of adverse effects. Abnormal EKG findings were significantly associated with cognitive decline. More time to optimal dose was significantly associated with worse global function. All physicians regarded the medication is ease of use and the administration schedule is simple.

Conclusions

This study provides valuable insights into the tolerability and efficacy of rivastigmine oral solution in Taiwanese patients with mild to moderate AD.
Patient or prisoner? Perceptions of prison healthcare services in Norway and the conflict between care and control
Authors: Nyvoll Pernille
Published: January 2025

In Norway, prisons are part of the system of public welfare service provision, with the objective of providing equal high standards of public services to all. However, most incarcerated people seem to agree that the healthcare services available in prison are of a lower quality. This article explores this perception and what it tells us about the unsolvable conflict between care and control in prison. The article finds that, firstly, healthcare services in prison have objective shortcomings. Secondly, a gap between expectations and experiences can cause disappointment and thus create or exacerbate a negative perception. Incarcerated people anticipate, but do not always experience, to be treated as patients in a healthcare facility rather than as prisoners in a security-oriented setting. This inability to meet patients’ expectations, is arguably another shortcoming resulting from the prioritisation of control over care.
The challenges of recognition among the Tjwa people in Zimbabwe
Authors: Tandi Costain , Zhou Takavafira Musarira , Mapfumo Ericcson
Published: January 2025

For more than a century, the primordial inhabitants of the Zimbabwe, the Tjwa people, have experienced numerous injustices. The most significant of these has been the conspicuous absence of recognition from both the colonial and post-colonial administrations. It was not until the 2013 Constitution, in Chapter 1, Section 6 (1), that the Tjwao language – erroneously categorised as Khoisan – was finally acknowledged by the current government. Tragically, this indigenous language is now on the brink of extinction, with fewer than 3000 members, and less than 20 fluent speakers in the Tsholotsho region. This paper explores the challenges faced by these people using qualitative research methods, which reinforced their marginalisation in the context of Zimbabwe, in terms of culture and language.
A Systematic Review of Evaluated Labor Market Initiatives Addressing Precarious Employment: Findings and Public Health Implications
Authors: Gunn Virginia , Matilla-Santander Nuria , Kreshpaj Bertina , Vignola Emilia F. , Wegman David H. , Hogstedt Christer , Bodin Theo , Ahonen Emily Q. , Baron Sherry , Muntaner Carles , O’Campo Patricia , Lewchuk Wayne , Albin Maria , Badarin Kathryn , Håkansta Carin
Published: January 2025

Precarious employment (PE) is a major determinant of population health and contributor to health and social inequities. The purpose of this article is to synthesize and critically appraise available evidence on labor market initiatives addressing PE identified through a systematic review. Of the 21 initiatives reviewed, grouped into four categories—labor market policies, legislation, and reforms; union strategies; apprenticeships and other youth programs; social protection programs—10 showed consistently positive outcomes and 11 a combination of negative, mixed, or inconclusive outcomes. In addition to reviewing the key findings, we discuss public health implications and recommendations related to PE and the implementation and evaluation of initiatives. Given the wide diversity of initiatives, implementation approaches, evaluation methods, and socioeconomic and historical contexts characterizing the labor markets of the countries studied, we refrain from making recommendations regarding the most effective initiatives to address PE. Instead, we discuss several implications concerning the four types of initiatives to further support those searching for solutions to address PE. We strongly recommend tailoring adopted initiatives to local contexts to match a country's specific PE problems and unique labor market and socioeconomic context.
Amelioration of a von Willebrand disease type 2B phenotype in vivo upon treatment with allele-selective siRNAs
Authors: Linthorst Noa A. , Jongejan Yvonne K. , Dirven Richard J. , Laan Sebastiaan N. J. , Bierings Ruben , Casari Caterina , Cordfunke Robert A. , Dahlman James E. , Dolezal Natasja , Drijfhout Jan Wouter , Leebeek Frank W. G. , Ruhaak L. Renee , Schrader Echeverri Elisa , Voorberg Jan , van Vlijmen Bart J. M. , Denis Cécile V. , Eikenboom Jeroen C. J.
Published: January 2025

Treatment options for the bleeding disorder von Willebrand disease type 2B (VWD2B) are insufficient and fail to address the negative effects of circulating mutant von Willebrand factor (VWF). The dominant-negative nature of VWD2B makes functionally defective VWF an interesting therapeutic target. Previous in vitro studies have demonstrated the feasibility of allele-selective silencing of mutant VWF using small interfering RNAs (siRNAs) targeting common single nucleotide polymorphisms (SNPs) in the human VWF gene, an approach that can be applied irrespective of the disease-causing VWF mutation. This study aims to extend this concept to a heterozygous VWD2B mouse model (c.3946G>A; p.Val1316Met) here using mouse strain-specific genetic differences as proxy for human SNPs. Homozygous VWD2B C57BL/6J (2B-B6) mice were crossed with homozygous wild-type 129S1/SvImJ (129S) mice to create heterozygous 2B-B6.129S F1 offspring. These 2B-B6.129S mice were intravenously injected with endothelial-specific lipid nanoparticles loaded with the allele-selective siVwf.B6 or control and 96 hours later, lung Vwf messenger RNA, plasma VWF levels, and phenotypic characteristics were evaluated. Treatment with siVwf.B6 reduced total VWF levels by 50%, with an expected selective reduction in mutant VWF protein. This coincided with normalization of multimeric structure, improved VWF collagen binding/VWF antigen ratio, and normalized bleeding times in two-thirds of heterozygous 2B-B6.129S mice. Being a novel approach in the field of hemostasis, we proved, for VWD, in mice, the concept of selectively inhibiting a mutant dominant-negative allele with siRNAs targeting a single nucleotide variation rather than the disease-causing mutation. For dominant-negative VWD, this offers potential for a customized therapeutic strategy.
Nasal CPAP increases alveolar number in a rhesus monkey model of moderate prematurity
Authors: McEvoy Cindy T. , MacDonald Kelvin D. , Shorey-Kendrick Lyndsey E. , Davies Michael H. , Lund Kelli C. , Lam Ryan , Dozier Brandy L. , Martin Lauren Drew , Corcoran Fiona , Schelonka Robert L. , Tepper Robert S. , Spindel Eliot R.
Published: January 2025

Rationale

Most premature human infants are born in the moderate to late preterm (MLP) range, ≥30 to <37 weeks gestation and demonstrate increased incidence of wheeze and respiratory illness as they age. Animal models suggest that mechanical lung distention stimulates lung growth and alveolar development. To determine if nasal continuous positive airway pressure (nCPAP) influences MLP infant lung development, we developed a rhesus monkey model of moderate prematurity, randomized to 9 days of nCPAP or sham nCPAP.

Methods

Timed-pregnant fetuses were delivered by elective hysterotomy at gestational age (GA) 140±1 days (85% gestation, term=165 days; human equivalent of 32–34 weeks), or at GA-149±1 days (GA-control) as a relative gestational age reference. The day after delivery, the GA-140 animals were treated with nCPAP or sham for 9 days, 12 consecutive hours each day. Pulmonary function testing followed by necropsy for analysis of lung structure and gene expression was performed on the equivalent of GA-150 for all animals.

Results

The nCPAP and sham groups were clinically similar but distinct from the gestational control group. Stereological analysis of lung structure showed significantly increased numbers of alveoli in the nCPAP group compared to the sham group. Other functional and anatomic changes were consistent with increased alveolarization. Gene expression between the nCPAP and sham groups remained highly similar and distinct from GA-control animals.

Conclusions

We show that nCPAP in MLP infants stimulates alveolarization with relatively few other changes. How this may benefit subsequent infant respiratory health requires further study.
Comparison of integrated versus parallel continuous renal replacement therapy combined with veno-venous extracorporeal membrane oxygenation in patients with COVID-19 ARDS
Authors: Schönfelder Kristina , Helmenstein Felix , Herbstreit Frank , Reinold Johanna , Kribben Andreas , Jahn Michael , Friebus-Kardash Justa
Published: January 2025

Introduction

Acute kidney injury (AKI) is a common complication of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) in patients receiving extracorporeal membrane oxygenation (ECMO) support, leading to requirement of continuous renal replacement therapy (CRRT) in 70% of ECMO patients. Parallel arrangement of CRRT and ECMO circuits is common in adult patients. However, CRRT may also be integrated directly into the ECMO circuit. This study compares the safety of both approaches.

Methods

This retrospective analysis included 105 patients treated with continuous veno-venous haemodiafiltration and veno-venous ECMO (Cardiohelp©) for COVID-19-induced ARDS between April 2020 and December 2021. Of these, 48 patients received a parallel connected CRRT running independently from ECMO (parallel approach), while in 57 patients, CRRT was integrated into the ECMO circuit (integrated approach) by connecting the CRRT access line to the post-oxygenator port and the CRRT return line to the pre-oxygenator position. Local protocol for risk assessment of this device combination mandated a maximum return line pressure below 250 mmHg in the CRRT system.

Results

At CRRT initiation, the integrated group had significantly higher median pressures in CRRT lines compared to the parallel approach group (access line 110 mmHg vs. -25 mmHg, return line 170 mmHg vs. 50 mmHg; p < 0.01). However, median transmembrane pressures were similar between both groups (20 mmHg vs. 20 mmHg, p = 0.16). In-hospital mortality (p = 0.99), catheter associated infections (p = 0.47), bacteraemia (p = 0.96), filter clotting (p = 0.58) and unplanned CRRT system changes (p = 0.45) within the first 72 h of CRRT were comparable between both groups. The integrated group exhibited higher rates of bleeding events (37% vs. 23%; p = 0.08). Thromboembolism occurred in four cases in the integrated group, while one pneumothorax was observed in the parallel group. No cases of air embolism, device associated haemolysis or blood leakage was documented.

Conclusions

Despite higher pressures in CRRT lines, the integrated approach provided comparable safety to the parallel approach. In case of hygienically challenging settings (such as the COVID-19 pandemic), the minimization of extracorporeal accesses and the streamlining of alarm management are decisive factors in providing intensive care medicine. Therefore, the integrated configuration of CRRT into the ECMO circuit can be advantageous in daily intensive care medicine.
Rabies knowledge and prevention practices in Gombe state, Nigeria: a community-based comparative cross-sectional study of rabies hotspot and non-hotspot areas
Authors: Eugene Eugene Chidi , Odunze Pius , Nuhu Bile , Olugbade Olukemi Titilope , Dauda Mishel , Egwuenu Abiodun , Samuel Olugbemisola W. , Okagbue Hilary I.
Published: January 2025

Background

Rabies remains a significant public health concern in Nigeria, particularly in rural areas with limited awareness and resources. Gombe State is recognized as a rabies hotspot, facing challenges in controlling the spread of the disease. This study aimed to assess and compare the knowledge and prevention practices related to rabies among community members in hotspot and non-hotspot areas of Gombe State.

Methods

A community-based comparative cross-sectional study was conducted in Gombe State. Multistage sampling technique was used to select 816 eligible respondents from selected households with pet dogs or cats (408 each from hotspot and non-hotspot areas). A semi-structured, pre-tested digital interviewer-administered questionnaire was used to collect data on socio-demographics, rabies knowledge, and prevention practices. Data were analyzed using SPSS version 26. The univariate and bivariate analysis compared rabies knowledge and prevention practices at p value < 0.05. Logistic regression identified predictors of good practice.

Results

Respondents from hotspot areas demonstrated better overall knowledge of rabies compared to those from non-hotspot areas. However, a higher proportion of respondents from non-hotspot areas exhibited better rabies prevention practices, particularly in terms of vaccinating their dogs within the previous year. Factors such as older age (AOR: 0.47, 95% CI: 0.27– 0.84), farming occupation (AOR: 0.48, 95% CI: 0.27 – 0.84), and good overall rabies knowledge (AOR: 3.04, 95% CI: 1.37 – 6.73) were significant predictors of rabies prevention practices in the hotspot area.

Conclusion

Targeted educational interventions and tailored prevention strategies are needed to improve rabies awareness and practices, especially among specific demographic groups like older individuals and farmers. Enhancing overall knowledge of rabies and promoting consistent vaccination practices for pets are crucial steps towards reducing the incidence of rabies in both hotspot and non-hotspot areas.
Investigating papillary thyroid cancer risk factors among women living at the central region of Iran: a case–control study
Authors: Ghoshouni Hamed , Hosseini Saeed , Ghadiri-Anari Akram , Azizi Reyhaneh , Rahmanian Masoud , Hazar Narjes
Published: January 2025

Background

The etiology of thyroid cancer especially in women in not well recognized in Yazd, at the center of Iran. The aim of present study was to investigate the risk factors of thyroid cancer among women living in this province.

Methods

The present study was carried out as a case–control study, comprising women diagnosed with papillary thyroid cancer (PTC) as the case group, along with two distinct control groups sourced from different origins (i.e., relatives and non-relatives) between 2020 and 2022. Data pertaining to several risk factors including demographic characteristics, reproductive variables, medical history related to thyroid and non-thyroid ailments, exposure to head and neck radiation, as well as familial cancer history, was collected from all participants. Binary logistic regression was utilized to discover risk and protective factors.

Results

In present study, 77 individuals participated in the case group, 76 in the relative control group and 72 in the non-relative control group. The history of OCP use and exposure to head and neck radiation were remained in the model as risk factors in all three case‒relative control (OR = 6.65, 95%CI: 2.53‒17.49; P-value < 0.001), case‒non-relative control (OR = 6.32, 95%CI: 2.14‒18.70; P-value = 0.001) and case‒total control comparisons (OR = 6.66, 95%CI: 2.84‒15.64; P-value < 0.001).

Conclusion

The OCP use as well as exposure to head and neck radiation were determined to be strong or relatively strong risk factors in both case‒relative control and case‒non-relative control comparisons. Consequently, it seems these two factors represent genuine risk factors for papillary thyroid cancer.
Navigating ethics in HIV data and biomaterial management within Black, African, and Caribbean communities in Canada
Authors: Souleymanov Rusty , Akinyele-Akanbi Bolaji , Njeze Chinyere , Ukoli Patricia , Migliardi Paula , Larcombe Linda , Restall Gayle , Ringaert Laurie , Payne Michael , Kim John , Tharao Wangari , Wilcox Ayn
Published: January 2025

Background

This study explored the ethical issues associated with community-based HIV testing among African, Caribbean, and Black (ACB) populations in Canada, focusing on their perceptions of consent, privacy, and the management of HIV-related data and bio-samples.

Methods

A qualitative community-based participatory research (CBPR) approach was employed to actively engage ACB community members in shaping the research process. The design included in-depth qualitative interviews with 33 ACB community members in Manitoba, Canada. The study was guided by a Community Guiding Circle, which contributed to study design, data analysis, and interpretation. A diverse sample was recruited through community agencies, social media, and flyers, with considerations for variations in age, gender, sexual orientation, and geographical location. The study employed iterative inductive thematic data analysis.

Findings

Participants expressed significant concerns about the collection, sharing, and use of HIV data from healthcare encounters, revealing mistrust towards institutions like police, child welfare, and immigration accessing their health information. Their worries centered on the handling of biological samples, data misuse, potential human rights violations, HIV criminalization, deportations, challenging consent, privacy, and bodily autonomy principles. While open to contributing to medical research, they unanimously demanded greater transparency, informed consent, and control over the secondary use of their health data.

Conclusions

The study underscores the need for culturally safe approaches in HIV testing and ethical governance in healthcare for ACB communities. It highlights the importance of prioritizing participant empowerment, ensuring transparency, practicing informed consent, and implementing robust data security measures to balance effective HIV information management with the protection of individual rights.
Optimization of a micro-scale air–liquid-interface model of human proximal airway epithelium for moderate throughput drug screening for SARS-CoV-2
Authors: Sen Chandani , Rickabaugh Tammy M. , Jeyachandran Arjit Vijey , Yuen Constance , Ghannam Maisam , Durra Abdo , Aziz Adam , Castillo Kristen , Garcia Gustavo , Purkayastha Arunima , Han Brandon , Boulton Felix W. , Chekler Eugene , Garces Robert , Wolff Karen C. , Riva Laura , Kirkpatrick Melanie G. , Gebara-Lamb Amal , McNamara Case W. , Betz Ulrich A. K. , Arumugaswami Vaithilingaraja , Damoiseaux Robert , Gomperts Brigitte N.
Published: January 2025

Background

Many respiratory viruses attack the airway epithelium and cause a wide spectrum of diseases for which we have limited therapies. To date, a few primary human stem cell-based models of the proximal airway have been reported for drug discovery but scaling them up to a higher throughput platform remains a significant challenge. As a result, most of the drug screening assays for respiratory viruses are performed on commercial cell line-based 2D cultures that provide limited translational ability.

Methods

We optimized a primary human stem cell-based mucociliary airway epithelium model of SARS-CoV-2 infection, in 96-well air–liquid-interface (ALI) format, which is amenable to moderate throughput drug screening. We tested the model against SARS-CoV-2 parental strain (Wuhan) and variants Beta, Delta, and Omicron. We applied this model to screen 2100 compounds from targeted drug libraries using a high throughput-high content image-based quantification method.

Results

The model recapitulated the heterogeneity of infection among patients with SARS-CoV-2 parental strain and variants. While there were heterogeneous responses across variants for host factor targeting compounds, the two direct-acting antivirals we tested, Remdesivir and Paxlovid, showed consistent efficacy in reducing infection across all variants and donors. Using the model, we characterized a new antiviral drug effective against both the parental strain and the Omicron variant.

Conclusion

This study demonstrates that the 96-well ALI model of primary human mucociliary epithelium can recapitulate the heterogeneity of infection among different donors and SARS-CoV-2 variants and can be used for moderate throughput screening. Compounds that target host factors showed variability among patients in response to SARS-CoV-2, while direct-acting antivirals were effective against SARS-CoV-2 despite the heterogeneity of patients tested.
Disparities in Cancer Mortality Worldwide: A Novel Metric for Measuring Global Disparities and Prioritizing Cancer Control Efforts
Authors: Diehl Thomas M. , Ahmed Kaleem S. , Pourdashti Sheida , Stalter Lily , Hellner Jessica , Harrison Ewen M. , Zafar Syed Nabeel
Published: January 2025

PURPOSE

Cancer incidence is rising worldwide and estimated to double by 2040. A systematic method of allocating resources and prioritizing cancer control efforts is needed. We aimed to develop and test a simple metric to quantify disparities in cancer mortality.

METHODS

We extracted country-specific incidence and mortality rates for 33 cancers from 185 countries using data from Global Cancer Observatory (GLOBOCAN) 2020. Mortality-to-incidence ratios (MIRs) were calculated for each cancer in every country. Delta MIRs (dMIRs) were calculated as the difference between a country's MIR and the MIR of the highest performing country for each cancer. dMIR was validated against human development index (HDI), gender development index (GDI), and life expectancy index (LEI) using scatter plots, correlation coefficients, and linear regression.

RESULTS

Among 185 countries in the GLOBOCAN 2020 data set, mortality and incidence estimates were available for 54 high-income, 47 upper-middle–income, 54 lower-middle–income, and 27 low-income countries. The United States was the highest performing country for 10 of the 33 cancer subtypes, and South Korea was the highest performing country for eight cancer subtypes. Significant variation in dMIR was observed across the globe. The highest dMIRs were in sub-Saharan Africa and Southeast Asia, and the lowest dMIRs were in North America, Western Europe, and Australasia. dMIR showed strong correlations with HDI, GDI, and LEI.

CONCLUSION

In conclusion, dMIR is a novel and robust metric that can be used to track disparities in global cancer mortality and prioritize cancer control initiatives. We benchmarked cancer care performance for 33 cancers across 182 countries and provide country- and cancer-specific priority lists.
Proposals for the Implementation of a Multidimensional Platform That Allows the Advancement of Oncology Nursing in the Latin American Environment (The INCREASE Proposal)
Authors: Parra Milena , Prada Andrea , Casallas Alexander , Gutiérrez-Babativa Liliana , Jaramillo Andrea , Bernal Lina , Klumpp Claudia Cristina , Sánchez Natalia , Wagner-Gutíerrez Nicolle , Cardona Andrés F.
Published: January 2025

PURPOSE

Cancer constitutes a significant global health challenge, with projections indicating a continued increase in its prevalence in the foreseeable future. This trend is particularly pronounced in Latin America (LATAM), where the cancer burden has increased substantially over the coming decades. Concurrently, nursing, which represents the largest segment of the health care workforce globally, is important for addressing the multifaceted challenges posed by cancer care, particularly in low- and middle-income countries (LMICs). Despite the essential role of nursing in cancer care, several barriers hinder its optimal contribution, particularly in LMICs. These challenges include professional hierarchy, insufficient educational standards, underfunding for research, and limited representation in decision-making processes.

METHODS

To address these challenges, collaborative initiatives, such as the INCREASE Proposal, have emerged, aimed at fostering interdisciplinary dialogue and action in oncology nursing within LATAM. Through focused workshops and agile methodologies, the INCREASE Proposal seeks to identify barriers and formulate solutions across key areas including education, research, clinical practice, and policy implementation.

RESULTS

The outcomes of the INCREASE Proposal underscore the urgent need for comprehensive strategies to strengthen oncology nursing in the LATAM. These strategies include enhancing education and recognition within health care systems, fostering interdisciplinary collaboration, leveraging advanced technologies, conducting cost-benefit analyses, and promoting research-academic partnerships.

CONCLUSION

By addressing these challenges and implementing the proposed solutions, LATAM can advance toward optimized oncology nursing practice, improving cancer care delivery and outcomes across the region.
Interplay of SHH, WNT and BMP4 signaling regulates the development of the lamina propria in the murine ureter
Authors: Straube Philipp , Beckers Anja , Jany Ulrich W. H. , Bergmann Florian , Lüdtke Timo H.-W. , Rudat Carsten , Trowe Mark-Oliver , Peters Imke , Klopf Maximilian G. , Mamo Tamrat M. , Kispert Andreas
Published: January 2025

In mammalian ureters, the lamina propria presents as a prominent layer of connective tissue underneath the urothelium. Despite its important structural and signaling functions, little is known how the lamina propria develops. Here, we show that in the murine ureter the lamina propria arises at late fetal stages and massively increases by fibrocyte proliferation and collagen deposition after birth. WNT, SHH, BMP4 and retinoic acid signaling are all active in the common mesenchymal progenitor of smooth muscle cells and lamina propria fibrocytes. However, around birth, the lamina propria becomes a target for epithelial WNT and SHH signals and a source of BMP4 and retinoic acid. SHH and WNT signaling promote lamina propria and smooth muscle cell differentiation and proliferation at fetal and early postnatal stages, whereas BMP4 signaling is required for early smooth muscle cell differentiation but not for its later maintenance. Our findings suggest that, in the presence of SHH and WNT signaling, it is the modulation of BMP4 signaling which is the major determinant for the segregation of lamina propria and smooth muscle cells.
Η θρησκευτική ετερότητα στη σχολική ιστορία
Authors: Μαύρου Στέλλα
Published: January 2025

Η διατριβή εξερευνά τον τρόπο, με τον οποίο τα σχολικά εγχειρίδια μεσαιωνικής ιστορίας προσεγγίζουν την έννοια της θρησκευτικής ετερότητας, έχοντας πάντα κατά νου τη βαθιά ριζωμένη αντίληψη του Άλλου ως μιας εν δυνάμει απειλής. Το ερευνητικό υλικό αποτελούν τα αφηγηματικά μέρη, οι γραπτές πηγές και το εικονιστικό υλικό των εγχειριδίων μεσαιωνικής ιστορίας που διδάχθηκαν σε συγκεκριμένη περίοδο στην Ελλάδα, τη Γαλλία και την Τουρκία. Μέσα από τη μελέτη των τριών εθνικών παραδειγμάτων, αναζητούνται οι συγκλίσεις, οι αποκλίσεις και οι σιωπές, μέσα από τις οποίες διαμορφώνονται τα εθνικά αφηγήματα στη σύγχρονη πολυπολιτισμική κοινωνία.