bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral frailty: a concept analysis
Authors: Zhao Huimin , Wu Bei , Zhou Yuqiu , Yang Zhilan , Zhao Hua , Tian Ziwei , Jiang Manhong , Huang Deqin
Published: May 2024

Background

Oral frailty has become a worldwide problem among older adults. Although researchers have conducted various studies on oral frailty, its definition remains controversial.

Purpose

To clarify the concept of oral frailty.

Methods

Online databases PubMed, Web of Science, CINAHL, Cochrane Library, ProQuest, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang database were searched from inception to September 20, 2023. The reference lists of relevant studies were searched manually. Eligible articles, theses, and books were analyzed using Walker & Avant’s concept analysis model.

Results

The attributes of oral frailty were abnormal oral structure and/or decline in multi-faceted oral function and coexisting decline in physical, cognitive and social functions. Its antecedents were aging, social frailty, and severe periodontitis, whereas its consequences were decline in physical health and mental health, social withdrawal, lower quality of life and systemic frailty.

Conclusion

Oral frailty could result in worse conditions among older adults physically, psychologically and socially. Tools based on the concept analysis need to be developed to comprehensively assess oral frailty.
The impact of specialized pediatric palliative care on advance care planning and healthcare utilization in children and young adults: a retrospective analysis of medical records of in-hospital deaths
Authors: Kim Cho Hee , Lee Jung , Lee Ji Weon , Kim Min Sun
Published: May 2024

Background

Pediatric palliative care supports children and young adults with life-limiting conditions and their families, seeking to minimize suffering and enhance quality of life. This study evaluates the impact of specialized palliative care (SPC) on advance care planning (ACP) and patterns of end-of-life care for patients who died in the hospital.

Methods

This is a retrospective cohort study of medical records extracted from a clinical data warehouse, covering patients who died aged 0–24 in an academic tertiary children’s hospital in South Korea. Participants were categorized into before (2011–2013; pre-period) and after (2017–2019; post-period) the introduction of an SPC service. Within the post-period, patients were further categorized into SPC recipients and non-recipients.

Results

We identified 274 and 205 patients in the pre-period and post-period, respectively. ACP was conducted more and earlier in the post-period than in the pre-period, and in patients who received palliative care than in those who did not. Patients who received SPC were likely to receive less mechanical ventilation or cardiopulmonary resuscitation and more opioids. A multivariable regression model showed that earlier ACP was associated with not being an infant, receiving SPC, and having a neurological or neuromuscular disease.

Conclusions

SPC involvement was associated with more and earlier ACP and less intense end-of-life care for children and young adults who died in the hospital. Integrating palliative care into routine care can improve the quality of end-of-life care by reflecting patients’ and their families’ values and preferences.
Feedback practices in undergraduate clinical teaching in Sri Lanka - a qualitative study
Authors: Sanchayan Sivapalan , Olupeliyawa Asela , Chandratilake Madawa
Published: May 2024

Background

Feedback is integral to medical education, enabling students to improve their knowledge, skills, and attitudes. Feedback practices may vary according to prevalent cultural and contextual factors. This study aimed to explore how feedback is conceptualized and practised in the clinical education of medical students in Sri Lanka.

Methods

The study was conducted in three medical schools and affiliated hospitals that represent the cultural diversity of Sri Lanka. Purposive sampling was utilized to recruit clinical teachers and students who would provide rich information for the study. The study had three components: an observation study, interviews with clinical teachers and focus group discussions with clinical students. During the observation study, video recording was used as a data collection tool to observe feedback in real-life clinical teaching/learning settings. A constructivist grounded theory approach was adapted for analysis to explore current practices and perceptions inductively.

Results

Feedback was conceptualised as spontaneous unidirectional provision of information for the improvement of students. It was often provided in public settings and in student groups. Error correction was the primary focus of feedback, but both teachers and students desired a balanced approach with reinforcement and reflection. Although the direct approach to corrective feedback was found beneficial for student learning, participants agreed that harsh feedback was to be avoided. The hierarchical culture and lack of programmed feedback in the curricula influenced feedback practices, suggesting the need for modification.

Conclusions

This study highlighted feedback practices in the local context, emphasizing the need to address the hierarchical gap in clinical settings, balance reinforcement and correction, and promote dialogue and reflection in the feedback processes. The findings will help clinical teachers from both the global south as well as the global north to recognize cultural and contextual differences in providing feedback.
Enhancing clinical skills in pediatric trainees: a comparative study of ChatGPT-assisted and traditional teaching methods
Authors: Ba Hongjun , zhang Lili , Yi Zizheng
Published: May 2024

Background

As artificial intelligence (AI) increasingly integrates into medical education, its specific impact on the development of clinical skills among pediatric trainees needs detailed investigation. Pediatric training presents unique challenges which AI tools like ChatGPT may be well-suited to address.

Objective

This study evaluates the effectiveness of ChatGPT-assisted instruction versus traditional teaching methods on pediatric trainees’ clinical skills performance.

Methods

A cohort of pediatric trainees (n = 77) was randomly assigned to two groups; one underwent ChatGPT-assisted training, while the other received conventional instruction over a period of two weeks. Performance was assessed using theoretical knowledge exams and Mini-Clinical Evaluation Exercises (Mini-CEX), with particular attention to professional conduct, clinical judgment, patient communication, and overall clinical skills. Trainees’ acceptance and satisfaction with the AI-assisted method were evaluated through a structured survey.

Results

Both groups performed similarly in theoretical exams, indicating no significant difference (p > 0.05). However, the ChatGPT-assisted group showed a statistically significant improvement in Mini-CEX scores (p < 0.05), particularly in patient communication and clinical judgment. The AI-teaching approach received positive feedback from the majority of trainees, highlighting the perceived benefits in interactive learning and skill acquisition.

Conclusion

ChatGPT-assisted instruction did not affect theoretical knowledge acquisition but did enhance practical clinical skills among pediatric trainees. The positive reception of the AI-based method suggests that it has the potential to complement and augment traditional training approaches in pediatric education. These promising results warrant further exploration into the broader applications of AI in medical education scenarios.
Respect for bioethical principles and human rights in prisons: a systematic review on the state of the art
Authors: Esposito Massimiliano , Szocik Konrad , Capasso Emanuele , Chisari Mario , Sessa Francesco , Salerno Monica
Published: May 2024

Background

Respect for human rights and bioethical principles in prisons is a crucial aspect of society and is proportional to the well-being of the general population. To date, these ethical principles have been lacking in prisons and prisoners are victims of abuse with strong repercussions on their physical and mental health.

Methods

A systematic review was performed, through a MESH of the following words (bioethics) AND (prison), (ethics) AND (prison), (bioethics) AND (jail), (ethics) AND (jail), (bioethics) AND (penitentiary), (ethics) AND (penitentiary), (prison) AND (human rights). Inclusion and exclusion criteria were defined and after PRISMA, 17 articles were included in the systematic review.

Results

Of the 17 articles, most were prevalence studies (n.5) or surveys (n.4), followed by cross-sectional studies (n.3), qualitative studies (n.1), retrospective (n.1) and an explanatory sequential mixed-methods study design (n.1). In most cases, the studies associated bioethics with prisoners’ access to treatment for various pathologies such as vaccinations, tuberculosis, hepatitis, HIV, it was also found that bioethics in prisons was related to the mental health of prisoners, disability, ageing, the condition of women, the risk of suicide or with the request for end-of-life by prisoners. The results showed shortcomings in the system of maintaining bioethical principles and respect for human rights.

Conclusions

Prisoners, in fact, find it difficult to access care, and have an increased risk of suicide and disability. Furthermore, they are often used as improper organ donors and have constrained autonomy that also compromises their willingness to have end-of-life treatments. In conclusion, prison staff (doctors, nurses, warders, managers) must undergo continuous refresher courses to ensure compliance with ethical principles and human rights in prisons.
Nurses’ self-regulation after engaging in end-of-life conversations with advanced cancer patients: a qualitative study
Authors: Du Jiayi , An Zifen , Wang Chunyu , Yu Liping
Published: May 2024

Background

Self-regulation is crucial for nurses who engage in in-depth end-of-life conversations with advanced cancer patients, especially in cultural contexts featuring death taboos. An improved understanding of the self-regulation process of nurses can help them address negative emotions and promote self-growth more effectively. Therefore, this study aimed to explore nurses’ self-regulation process after end-of-life conversations with advanced cancer patients.

Methods

This study employed a descriptive, qualitative approach. Seventeen nurses from four hospitals and a hospice unit in mainland China were interviewed between September 2022 and June 2023. Data were collected through face-to-face semistructured interviews. A thematic analysis method was used to analyse the data following the guidance of regulatory focus theory.

Results

Three main themes were developed: self-regulation antecedents include personality, experience, and support; promotion or prevention is a possible self-regulation process for nurses; both self-exhaustion and self-growth may be the outcomes of self-regulation, as did seven subthemes. Personality tendencies, life experience, and perceived support may affect nurses’ self-regulation, thereby affecting their self-regulation outcomes.

Conclusions

Nurses exhibit different self-regulatory tendencies and self-regulation outcomes. The provision of peer support and counselling support to nurses is highly important with regard to achieving good self-regulation outcomes.
The application of a single session of capacitive resistive electric transfer 24 h before exercise modifies the accelerometric pattern in standardbred racing trotters
Authors: Argüelles David , Saitua Aritz , Miraz Raquel , Calle-González Natalie , Requena Francisco , Nocera Irene , Vitale Valentina , Sgorbini Micaela , Muñoz Ana
Published: May 2024

Background

It has been reported that capacitive resistive electric transfer (CRET) increases blood circulation, hemoglobin oxygenation and temperature in muscles. The attributed benefits of these changes have been linked to improved athletic performance, enhanced muscle flexibility and fastening recovery from exercise-induced fatigue. For all of this, the present research aims to investigate whether the application of CRET 24 h before exercise affects the accelerometric pattern in horses during exercise. Six sound Standardbred trotters were subjected to a CRET session of 40 min of duration, applied on both sides of the neck, back and croup, 24 h before a training session. Training sessions consisted of a warming-up (WU) for 6400 m and a training bout (TB) at their maximal training speed for 1600 m. The same protocol was followed for the device off (sham protocol), also applied 24 h before the training session. CRET and sham experiments were separated by one week, the order of application of both was randomly defined for each individual and drivers were blinded for the duration of the experiment. During the training sessions, horses wore an accelerometer fixed at the sternal level. Speed, stride frequency (SF), length (SL), regularity and symmetry and accelerometric activities were measured during WU and TB.

Results

CRET increased speed, mediolateral and total accelerometric activities during WU and speed, SL, dorsoventral, longitudinal and total accelerometric activities during TB, but stride regularity and symmetry decreased.

Conclusion

The application of CRET 24 h before exercise increased speed and accelerometric activities, results that highlight the need to evaluate the interaction between CRET and training in order to develop new methods to limit fatigue. However, the decrease in stride regularity and symmetry after CRET application could be negative effects, which could be attributed to the increased speed.
Strategies for improving fengycin production: a review
Authors: Yin Ying , Wang Xin , Zhang Pengsheng , Wang Pan , Wen Jianping
Published: May 2024

Fengycin is an important member of the lipopeptide family with a wide range of applications in the agricultural, food, medical and cosmetic industries. However, its commercial application is severely hindered by low productivity and high cost. Therefore, numerous studies have been devoted to improving the production of fengycin. We summarize these studies in this review with the aim of providing a reference and guidance for future researchers. This review begins with an overview of the synthesis mechanism of fengycin via the non-ribosomal peptide synthetases (NRPS), and then delves into the strategies for improving the fengycin production in recent years. These strategies mainly include fermentation optimization and metabolic engineering, and the metabolic engineering encompasses enhancement of precursor supply, application of regulatory factors, promoter engineering, and application of genome-engineering (genome shuffling and genome-scale metabolic network model). Finally, we conclude this review with a prospect of fengycin production.
Evaluation of Apixaban standard dosing in underweight patients with non-valvular atrial fibrillation: a retrospective cohort study
Authors: Sulaiman Khalid Al , Aljuhani Ohoud , Alkofide Hadeel , Aljohani Manal A. , Badreldin Hisham A. , Al Harbi Mahasen , Aquil Ghalia , Alhajaji Raghad , Alqahtani Rahaf A. , Babonji Alaa , Altuwayr Maha , Alshehri Asma A. , Alfaifi Mashael , Alharthi Abdullah F. , Alzahrani Mohammed , Al Sulaiman Tareq , Alqahtani Nasser , Alshahrani Walaa A. , Al Katheri Abdulmalik , Albekairy Abdulkareem M.
Published: May 2024

Background

Recent guidelines recommend using direct oral anticoagulants (DOACs) as first-line agents in patients with non-valvular atrial fibrillation (NVAF). Research is currently investigating the use of Apixaban in underweight patients, with some results suggesting altered pharmacokinetics, decreased drug absorption, and potential overdosing in this population. This study examined the effectiveness and safety of standard Apixaban dosing in adult patients with atrial NVAF weighing less than 50 kg.

Methods

This is a retrospective cohort study conducted at King Abdulaziz Medical City (KAMC); adult patients with a body mass index (BMI) below 25 who received a standard dose of Apixaban (5 mg twice daily) were categorized into two sub-cohorts based on their weight at the time of Apixaban initiation. Underweight was defined as patients weighing ≤ 50 kg, while the control group (Normal weight) comprised patients weighing > 50 kg. We followed the patients for at least one year after Apixaban initiation. The study’s primary outcome was the incidence of stroke events, while secondary outcomes included bleeding (major or minor), thrombosis, and venous thromboembolism (VTE). Propensity score (PS) matching with a 1:1 ratio was used based on predefined criteria and regression model was utilized as appropriate.

Results

A total of 1,433 patients were screened; of those, 277 were included according to the eligibility criteria. The incidence of stroke events was lower in the underweight than in the normal weight group at crude analysis (0% vs. 9.1%) p-value = 0.06), as well in regression analysis (OR (95%CI): 0.08 (0.001, 0.76), p-value = 0.002). On the other hand, there were no statistically significant differences between the two groups in the odds of major and minor bleeding (OR (95%CI): 0.39 (0.07, 2.03), p-value = 0.26 and OR (95%CI): 1.27 (0.56, 2.84), p-value = 0.40, respectively).

Conclusion

This exploratory study revealed that underweight patients with NVAF who received standard doses of Apixaban had fewer stroke events compared to normal-weight patients, without statistically significant differences in bleeding events. To confirm these findings, further randomized controlled trials with larger sample sizes and longer observation durations are required.
Cost-utility analysis of prenatal diagnosis of congenital cardiac diseases using deep learning
Authors: Ginsberg Gary M. , Drukker Lior , Pollak Uri , Brezis Mayer
Published: May 2024

Background

Deep learning (DL) is a new technology that can assist prenatal ultrasound (US) in the detection of congenital heart disease (CHD) at the prenatal stage. Hence, an economic-epidemiologic evaluation (aka Cost-Utility Analysis) is required to assist policymakers in deciding whether to adopt the new technology.

Methods

The incremental cost-utility ratios (CUR), of adding DL assisted ultrasound (DL-US) to the current provision of US plus pulse oximetry (POX), was calculated by building a spreadsheet model that integrated demographic, economic epidemiological, health service utilization, screening performance, survival and lifetime quality of life data based on the standard formula: $${\rm CUR} = \frac{{\text{Increase in Intervention Costs}} - {\text{Decrease in Treatment costs}}}{{\text{Averted QALY losses of adding DL to US}} \ \& \ {\rm POX}}$$

CUR
=

Increase in Intervention Costs

-

Decrease in Treatment costs

Averted QALY losses of adding DL to US

&

POX

US screening data were based on real-world operational routine reports (as opposed to research studies). The DL screening cost of 145 USD was based on Israeli US costs plus 20.54 USD for reading and recording screens.

Results

The addition of DL assisted US, which is associated with increased sensitivity (95% vs 58.1%), resulted in far fewer undiagnosed infants (16 vs 102 [or 2.9% vs 15.4%] of the 560 and 659 births, respectively). Adoption of DL-US will add 1,204 QALYs. with increased screening costs 22.5 million USD largely offset by decreased treatment costs (20.4 million USD). Therefore, the new DL-US technology is considered “very cost-effective”, costing only 1,720 USD per QALY. For most performance combinations (sensitivity > 80%, specificity > 90%), the adoption of DL-US is either cost effective or very cost effective. For specificities greater than 98% (with sensitivities above 94%), DL-US (& POX) is said to “dominate” US (& POX) by providing more QALYs at a lower cost.

Conclusion

Our exploratory CUA calculations indicate the feasibility of DL-US as being at least cost-effective.
Extracellular vesicles promote migration despite BRAF inhibitor treatment in malignant melanoma cells
Authors: Németh Afrodité , Bányai Gréta L. , Dobos Nikolett K. , Kós Tamás , Gaál Anikó , Varga Zoltán , Buzás Edit I. , Khamari Delaram , Dank Magdolna , Takács István , Szász A. Marcell , Garay Tamás
Published: May 2024

Extracellular vesicles (EVs) constitute a vital component of intercellular communication, exerting significant influence on metastasis formation and drug resistance mechanisms. Malignant melanoma (MM) is one of the deadliest forms of skin cancers, because of its high metastatic potential and often acquired resistance to oncotherapies. The prevalence of BRAF mutations in MM underscores the importance of BRAF-targeted therapies, such as vemurafenib and dabrafenib, alone or in combination with the MEK inhibitor, trametinib. This study aimed to elucidate the involvement of EVs in MM progression and ascertain whether EV-mediated metastasis promotion persists during single agent BRAF (vemurafenib, dabrafenib), or MEK (trametinib) and combined BRAF/MEK (dabrafenib/trametinib) inhibition.

Using five pairs of syngeneic melanoma cell lines, we assessed the impact of EVs – isolated from their respective supernatants – on melanoma cell proliferation and migration. Cell viability and spheroid growth assays were employed to evaluate proliferation, while migration was analyzed through mean squared displacement (MSD) and total traveled distance (TTD) measurements derived from video microscopy and single-cell tracking.

Our results indicate that while EV treatments had remarkable promoting effect on cell migration, they exerted only a modest effect on cell proliferation and spheroid growth. Notably, EVs demonstrated the ability to mitigate the inhibitory effects of BRAF inhibitors, albeit they were ineffective against a MEK inhibitor and the combination of BRAF/MEK inhibitors. In summary, our findings contribute to the understanding of the intricate role played by EVs in tumor progression, metastasis, and drug resistance in MM.
Barriers to viral load suppression among adolescents living with HIV on anti-retroviral therapy: a retrospective study in Tanga, Tanzania
Authors: Mushy Stella Emmanuel , Mtisi Expeditho , Mkawe Simon , Mboggo Eric , Ndega John , Yahya-Malima Khadija I. , Kamugunya Denice , Kilimba Edwin Samuel , Mlay Boniface S. , Muya Aisa , Ngalesoni Frida
Published: May 2024

Background

Despite the decreased incidence of the human immunodeficiency virus (HIV) in Tanzania, the number of adolescents living with HIV is increasing. This study aimed to describe factors independently associated with viral load non-suppression among adolescents living with HIV (ALHIV) on ART in the Tanga region.

Methods

We conducted a retrospective study of routinely collected data from ALHIV on ART from October 2018 to April 2022. We extracted data from the Care and Treatment Clinics form number 2 (CTC2) database that included age, sex, BMI, World Health Organization HIV clinical disease stage, marital status, ART duration, viral load suppression, facility level, and Dolutegravir (DTG)-based regimen. We did descriptive analysis using frequencies to describe the study participants’ socio-demographic and clinical characteristics. The Cox proportional hazard regression model was used to identify factors associated with viral load non-suppression (VLS). Viral load non-suppression was defined as viral load ≥ 1000 copies/ml. A total of 4735 ALHIV on ART were extracted from CTC2, then 2485 were excluded (2186 missed viral load results, 246 were lost to follow-up, and 53 deaths).

Results

2250 ALHIV on ART were tested for viral load, of whom 2216 (98.62%) adolescents were on first-line ART, and 2024 (89.96%) participants were virally suppressed, while 226 (10.04%) were virally non-suppressed. In addition, 2131 (94.71%) of participants were using a DTG-based regimen; of them, 1969 (92.40%) were virally suppressed. Not using a DTG-based regimen (HR: 9.36, 95% CI 3.41–15.31) and dispensary facility level (HR: 3.61, 95% CI 1.44–7.03) were independently associated with increased hazard for viral load non-suppression. In addition, adolescents aged between 15 and 19 years are less likely to be virally suppressed (HR: 0.55, 95% CI 0.30–0.99).

Conclusions

The dispensary facility level and not using a DTG-based regimen were significantly associated with viral load non-suppression. HIV intervention strategies should ensure a DTG-based regimen utilization in all adolescents living with HIV, and techniques used by higher-level health facilities should be disseminated to lower-level facilities.
Phillyrin reduces ROS production to alleviate the progression of intervertebral disc degeneration by inhibiting NF-κB pathway
Authors: Chen Enming , Li Ming , Liao Zhuangyao , Yao Dengbo , Li Yuxi , Huang Lin
Published: May 2024

Background

Intervertebral disc degeneration (IDD) is an increasingly important cause of low back pain (LBP) that results in substantial health and economic burdens. Inflammatory pathway activation and the production of reactive oxygen species (ROS) play vital roles in the progression of IDD. Several studies have suggested that phillyrin has a protective role and inhibits inflammation and the production of ROS. However, the role of phillyrin in IDD has not been confirmed.

Purpose

The purpose of this study was to investigate the role of phillyrin in IDD and its mechanisms.

Study design

To establish IDD models in vivo, ex-vivo, and in vitro to verify the function of phillyrin in IDD.

Method

The effects of phillyrin on extracellular matrix (ECM) degeneration, inflammation, and oxidation in nucleus pulposus (NP) cells were assessed using immunoblotting and immunofluorescence analysis. Additionally, the impact of phillyrin administration on acupuncture-mediated intervertebral disc degeneration (IDD) in rats was evaluated using various techniques such as MRI, HE staining, S-O staining, and immunohistochemistry (IHC).

Result

Pretreatment with phillyrin significantly inhibited the IL-1β-mediated reduction in the degeneration of ECM and apoptosis by alleviating activation of the NF-κB inflammatory pathway and the generation of ROS. In addition, in vivo and ex-vivo experiments verified the protective effect of phillyrin against IDD.

Conclusion

Phillyrin can attenuate the progression of IDD by reducing ROS production and activating inflammatory pathways.
Reporting on patient’s body mass index (BMI) in recent clinical trials for patients with breast cancer: a systematic review
Authors: Van Cauwenberge Josephine , Van Baelen Karen , Maetens Marion , Geukens Tatjana , Nguyen Ha Linh , Nevelsteen Ines , Smeets Ann , Deblander Anne , Neven Patrick , Koolen Stijn , Wildiers Hans , Punie Kevin , Desmedt Christine
Published: May 2024

Background

The proportion of patients with breast cancer and obesity is increasing. While the therapeutic landscape of breast cancer has been expanding, we lack knowledge about the potential differential efficacy of most drugs according to the body mass index (BMI). Here, we conducted a systematic review on recent clinical drug trials to document the dosing regimen of recent drugs, the reporting of BMI and the possible exclusion of patients according to BMI, other adiposity measurements and/or diabetes (leading comorbidity of obesity). We further explored whether treatment efficacy was evaluated according to BMI.

Methods

A search of Pubmed and ClinicalTrials.gov was performed to identify phase I-IV trials investigating novel systemic breast cancer treatments. Dosing regimens and exclusion based on BMI, adiposity measurements or diabetes, documentation of BMI and subgroup analyses according to BMI were assessed.

Results

495 trials evaluating 26 different drugs were included. Most of the drugs (21/26, 81%) were given in a fixed dose independent of patient weight. BMI was an exclusion criterion in 3 out of 495 trials. Patients with diabetes, the leading comorbidity of obesity, were excluded in 67/495 trials (13.5%). Distribution of patients according to BMI was mentioned in 8% of the manuscripts, subgroup analysis was performed in 2 trials. No other measures of adiposity/body composition were mentioned in any of the trials. Retrospective analyses on the impact of BMI were performed in 6 trials.

Conclusions

Patient adiposity is hardly considered as most novel drug treatments are given in a fixed dose. BMI is generally not reported in recent trials and few secondary analyses are performed. Given the prevalence of patients with obesity and the impact obesity can have on pharmacokinetics and cancer biology, more attention should be given by investigators and study sponsors to reporting patient’s BMI and evaluating its impact on treatment efficacy and toxicity.
START NOW WebApp—promoting emotion regulation and resilience in residential youth care and correctional institutions: study protocol for a cluster randomized controlled trial
Authors: Kersten Linda , Alfano Janine , Erlanger Tobias E. , Helfenstein Fabrice , Lanz Lelia , Weiss Stefan , Chilla Chiara , von Planta Beryll , Kapoor Madlaina , Borel Nathalie , Rocco Tabea , Papageorgiou Andreas , De Brito Catarina Fernandes , Bajrami Arzie , Savary Valentine , Mayor Melanie , Hurschler Jana , Traut Alex , Brunner Donja , Vriends Noortje , Stadler Christina
Published: May 2024

Background

Adolescents and young adults in residential care and correctional institutions face various challenges, leading to negative life outcomes. Implementation barriers within these institutions, such as limited financial and spatial resources, pose significant hurdles to providing necessary support. Web-based approaches address these challenges by offering cost-effective, accessible solutions. This study aims to assess the efficacy of a newly developed web-based version of the existing evidence-based START NOW skills training in fostering emotion regulation and resilience among institutionalized adolescents and young adults. We present the study protocol (Version 5, August 2023) of the trial titled “Implementation of an e-version of the skills training START NOW for promoting emotion regulation and resilience in residential youth care and correctional institutions”.

Methods

The study is a monocentric, prospective, confirmatory randomized controlled trial with 150 institutionalized adolescents and young adults with a need to improve resilience (predefined cut-offs). Participating institutions will be randomized to one of three conditions: (i) 9-week web-based group training guided by a facilitator, (ii) 9-week web-based self-help training, (iii) and treatment as usual. The primary endpoint is the change in psychological flexibility, assessed by the Avoidance and Fusion Questionnaire for Youth score, from baseline to follow-up 12 weeks post skills training. Secondary objectives encompass assessing pre-post changes in psychological flexibility and other psychological health-related outcome measures in participating adolescents, young adults, and caretakers from baseline, to post training, and to 12- and 24-week follow-ups.

Discussion

This study evaluates the efficacy of START NOW as web-based training for institutionalized adolescents and young adults, providing valuable insights into web-based interventions and aiming to optimize support levels.

Trial registration {2a and 2b}

ClinicalTrials.gov NCT05313581. Registered on 6 April 2022.
Polygenic risk score predicting susceptibility and outcome of benign prostatic hyperplasia in the Han Chinese
Authors: Hung Sheng-Chun , Chang Li-Wen , Hsiao Tzu-Hung , Lin Guan-Cheng , Wang Shian-Shiang , Li Jian-Ri , Chen I-Chieh
Published: May 2024

Background

Given the high prevalence of BPH among elderly men, pinpointing those at elevated risk can aid in early intervention and effective management. This study aimed to explore that polygenic risk score (PRS) is effective in predicting benign prostatic hyperplasia (BPH) incidence, prognosis and risk of operation in Han Chinese.

Methods

A retrospective cohort study included 12,474 male participants (6,237 with BPH and 6,237 non-BPH controls) from the Taiwan Precision Medicine Initiative (TPMI). Genotyping was performed using the Affymetrix Genome-Wide TWB 2.0 SNP Array. PRS was calculated using PGS001865, comprising 1,712 single nucleotide polymorphisms. Logistic regression models assessed the association between PRS and BPH incidence, adjusting for age and prostate-specific antigen (PSA) levels. The study also examined the relationship between PSA, prostate volume, and response to 5-α-reductase inhibitor (5ARI) treatment, as well as the association between PRS and the risk of TURP.

Results

Individuals in the highest PRS quartile (Q4) had a significantly higher risk of BPH compared to the lowest quartile (Q1) (OR = 1.51, 95% CI = 1.274–1.783, p < 0.0001), after adjusting for PSA level. The Q4 group exhibited larger prostate volumes and a smaller volume reduction after 5ARI treatment. The Q1 group had a lower cumulative TURP probability at 3, 5, and 10 years compared to the Q4 group. PRS Q4 was an independent risk factor for TURP.

Conclusions

In this Han Chinese cohort, higher PRS was associated with an increased susceptibility to BPH, larger prostate volumes, poorer response to 5ARI treatment, and a higher risk of TURP. Larger prospective studies with longer follow-up are warranted to further validate these findings.
A family perspective for the mechanism of parent-child conflict on maternal anxiety in Chinese children with autism
Authors: Du Xue , Sun Le , Dong Qi
Published: May 2024

Background

Mothers of children with autism reported higher levels of anxiety than mothers of typical children. This study revealed the relationship between parent-child conflict, children’s problem behavior, parenting stress, and maternal anxiety from the perspective of the relationship within the family.

Methods

The State-Trait Anxiety Inventory (STAI) and Caregiver Strain Questionnaire (CGSQ) were used to measure maternal anxiety and parenting stress respectively from 102 mothers of children with autism. We also collected information on parent-child relationships and children’s problem behaviors by using the Child-Parent Relationship Scale (CPRS) and Conners Parent Symptom Questionnaire (PSQ).

Results

Parent-child conflict positively predicted state and trait anxiety in mothers of children with autism. The severity of children’s psychosomatic disorders fully mediated the positive association between parent-child conflict and state-trait anxiety in mothers of children with autism. Parenting stress significantly moderated the impact of parent-child conflict on maternal state anxiety and trait anxiety.

Conclusion

In the case of children with autism spectrum disorders, parent-child conflict can directly affect maternal anxiety levels, especially when mothers have low levels of parenting stress. Parent-child conflict can also affect children’s problem behaviors and thus indirectly affect maternal anxiety. Therefore, this study is of great significance for the alleviation of anxiety of mothers of autistic children and the family intervention for the early rehabilitation of autistic children.
Adoptive Cell Therapy for Solid Tumors: Current Status in Melanoma and Next-Generation Therapies
Authors: Haanen John , Los Christy , Phan Giao Q. , Betof Warner Allison
Published: May 2024

Lifileucel or TIL has recently been FDA approved for metastatic melanoma patients as first cell therapy for a solid tumor. We discuss roll-out of TIL as new SOC and other upcoming new cell therapies.
Earth and Ore: Materializing Transalpine Relations on the Eve of the Reformation
Authors: Donkin Lucy
Published: May 2024

In 1519, soil from the Campo Santo Teutonico next to St. Peter's in Rome — a burial place thought to contain earth from Jerusalem — was spread over the extramural cemetery in the Saxon town of Annaberg. This article asks how the reception of the soil from Rome was shaped by the local community and its landscape at a time of religious change. It demonstrates the potential for both positive and negative views on the part of Annaberg's citizens, arguing that these were informed not only by traditional religiosity and reform ideas, but also by the distinctive visual and material culture of a silver mining community. In this way, the article offers new perspectives on the transalpine connections of the Campo Santo Teutonico, the role of the substance of the landscape in creating and criticizing links with the Roman Church at the start of the Reformation, and the relationship between materialities of religion and the environment.
Biomechanical properties of non-flight vibrations produced by bees
Authors: Vallejo-Marin Mario , Field David L. , Fornoni Juan , Montesinos Daniel , Dominguez Cesar A. , Hernandez Ivan , Vallejo Gillian C. , Woodrow Charlie , Ayala Barajas Ricardo , Jafferis Noah
Published: May 2024

Bees use thoracic vibrations produced by their indirect flight muscles for powering wingbeats in flight, but also during mating, pollination, defence and nest building. Previous work on non-flight vibrations has mostly focused on acoustic (airborne vibrations) and spectral properties (frequency domain). However, mechanical properties such as the vibration's acceleration amplitude are important in some behaviours, e.g. during buzz pollination, where higher amplitude vibrations remove more pollen from flowers. Bee vibrations have been studied in only a handful of species and we know very little about how they vary among species. In this study, we conducted the largest survey to date of the biomechanical properties of non-flight bee buzzes. We focused on defence buzzes as they can be induced experimentally and provide a common currency to compare among taxa. We analysed 15,000 buzzes produced by 306 individuals in 65 species and six families from Mexico, Scotland and Australia. We found a strong association between body size and the acceleration amplitude of bee buzzes. Comparison of genera that buzz-pollinate and those that do not suggests that buzz-pollinating bees produce vibrations with higher acceleration amplitude. We found no relationship between bee size and the fundamental frequency of defence buzzes. Although our results suggest that body size is a major determinant of the amplitude of non-flight vibrations, we also observed considerable variation in vibration properties among bees of equivalent size and even within individuals. Both morphology and behaviour thus affect the biomechanical properties of non-flight buzzes.
Study on the relationship between Methylation of Neuregulin (NRG) Gene and Cervical Carcinoma
Authors: Yan Xizhao , An Fenglan , Ding Zhenzhen , Ma Dong , Yang Xiaohui
Published: May 2024

Objective: To investigate the relationship between the DNA methylation state of NRG1 promoter and its expression changes, and to analyze the clinical significance of its regulatory mechanism of DNA methylation in cervical carcinoma.
Methods: This was a retrospective study. One-hundred and twenty patients from the Department of Gynecology of Cangzhou People’s Hospital from September 2017 to September 2019 were selected, including 40 cases of cervical SCC, 40 cases of high grade squamous intraepithelial lesions (HSIL) and 40 cases of control cervical tissues. RT-qPCR, immunohistochemistry and DNA methylation-specific PCR (MSP) were used to detect the mRNA and protein expression of NRG1 and DNA methylation status in different tissue types.
Results: Immunohistochemical results showed that the positive protein expression rate of NRG1 gene in the SCC group was lower than that in both HSIL and Control groups. RT-qPCR results showed that the mRNA gene of NRG1 gradually decreased in expression with the increase of cervical tissue lesions, with a statistically significant difference. Similarly, it also found that the mRNA expression level of NRG1 in the SCC group was independent of patients’ age (p>0.05), but significantly correlated with tumor pathological staging, surgical pathology staging and lymphatic metastasis (p<0.05). Furthermore, methylation-specific PCR results revealed a significantly higher DNA methylation rate of NRG1 gene in the SCC group than in both HSIL and Control groups, with a statistically significant difference. Moreover, the methylation degree of NRG1 gene in SCC tissues was negatively correlated with its mRNA expression (p<0.05).
Conclusions: Abnormal DNA hypermethylation of NRG1 gene inhibits the expression of mRNA and protein in the progression of cervical tissue from normal to cancerous state, which is involved in the occurrence and development of cervical carcinoma.
doi: https://doi.org/10.12669/pjms.40.6.7859
How to cite this: Yan X, An F, Ding Z, Ma D, Yang X. Study on the relationship between Methylation of Neuregulin (NRG) Gene and Cervical Carcinoma. Pak J Med Sci. 2024;40(6):1207-1213. doi: https://doi.org/10.12669/pjms.40.6.7859
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Investigation of the effect of task-oriented occupational therapy on daily living activity performance in chronic stroke patients
Authors: Cekmece Cigdem , Ilgin Sade  , Elif Ozcan  , Sibel Balci
Published: May 2024

Objective: Task-oriented therapy (TOT) is used to increase the effectiveness of upper extremity (UE) in activity daily living (ADL). This study aimed to investigate the effect of TOT on the participation and ADLs of stroke patients.
Methods: Between October 2018 and February 2019, 28 chronic stroke patients were included in the study treated in Kocaeli University Hospital, Department of Physical Medicine and Rehabilitation, Turkey. The performance areas and participation status of the patients in which they experienced limitations were evaluated with the Canadian Occupational Performance Scale (COPM), and their level of independence in ADLs was evaluated with the Modified Frenchay Activity Index (mFAI) and Barthel Index (BI). All patients were included in the occupational therapy (OT) program five days a week for three weeks at Kocaeli University Hospital. Three ADLs in which they had difficulties were studied with 28 patients. Each of the activities was designed specifically for the patient. All assessments were repeated after three weeks of treatment.
Results: A total of 28 patients, 12 females and 16 males, diagnosed with stroke, were included in the study. A statistically significant increase was found in the COPM performance and satisfaction value compared to the pre-treatment value (p<0.001). A statistically significant difference was found between pre- and post-treatment mFAI and BI values (p<0.001).
Conclusions: Adding task-oriented therapy to the rehabilitation programs of stroke patients will contribute to the improvement of ADL.
doi: https://doi.org/10.12669/pjms.40.6.7954
How to cite this: Cekmece C, Sade I, Ozcan E, Balci S. Investigation of the effect of task-oriented occupational therapy on daily living activity performance in chronic stroke patients. Pak J Med Sci. 2024;40(6):1214-1218. doi: https://doi.org/10.12669/pjms.40.6.7954
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Dietary perception and knowledge among cardiac patients visiting tertiary care hospital outpatient department
Authors: Zahid Maryam , Jamil Khan Eman , Nadeem Asif , Khalil Hafsa
Published: May 2024

Objective: To appraise the dietary perception and knowledge of cardiac patients visiting Outpatient department of a tertiary care hospital.
Methods: A cross sectional study of 466 patients attending cardiac outdoor clinic at a tertiary care cardiac hospital in Rawalpindi, Pakistan were selected through convenient sampling from January to April 2021. Patients included in the study were above 18 years of age and had a cardiac disease. A structured questionnaire in English and Urdu was drafted with questions related to patient demographics, dietary perception and knowledge.
Results: Among 466 patients, 60% (n=280) were males and 40% (n=186) were females whereas 14% (n=66) of the patients were uneducated and 15% (n=68) had completed postgraduate education. In this study 23% (n=106) of the participants used internet to search nutrition related information and 72 % (n=339) of the patients consider their lifestyle to be healthy. Majority (n=261, 56%) of the patients had no idea regarding sodium consumption. 46% (n=215) of the patients had no knowledge regarding the effects of bakery items on cardiac health.
Conclusion: Dietary Knowledge plays a predominant role in the management of cardiac disease. The study concluded that cardiac patients had inadequate knowledge regarding dietary intake in cardiac disease and has high prevalence of dietary myths and misconceptions. Strategic plan including nutritional awareness program and intensive counseling sessions should be designed to increase dietary knowledge of cardiac patients.
doi: https://doi.org/10.12669/pjms.40.6.8289
How to cite this: Zahid M, Khan EJ, Nadeem A, Khalil H. Dietary perception and knowledge among cardiac patients visiting tertiary care hospital outpatient department. Pak J Med Sci. 2024;40(6):1231-1234. doi: https://doi.org/10.12669/pjms.40.6.8289
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Construction of a prediction model for pulmonary infection and its risk factors in Intensive Care Unit patients
Authors: Dai Weilei , Zhong Ting , Chen Feng , Shen Miaomiao , Zhu Liya
Published: May 2024

Objective: To identify independent risk factors of pulmonary infection in intensive care unit (ICU) patients, and to construct a prediction model.
Methods: Medical data of 398 patients treated in the ICU of Jiaxing Hospital of Traditional Chinese Medicine from January 2019 to January 2023 were analyzed. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for pulmonary infection in ICU patients. R software was used to construct a nomogram prediction model, and the prediction model was internally validated using computer simulation bootstrap method. Predictive value of the model was analyzed using the receiver operating characteristic (ROC) curve.
Results: A total of 97 ICU patients (24.37%) developed pulmonary infection. Age, ICU stay time, invasive operation, diabetes, duration of mechanical ventilation, and state of consciousness were all identified as risk factors for pulmonary infection. The calibration curve of the constructed nomogram prediction model showed a good consistency between the predicted value of the model and the actual observed value. ROC curve analysis showed that the area under the curve (AUC) of the model was 0.784 (95% CI: 0.731-0.837), indicating a certain predictive value.
Conclusions: Age, length of stay in ICU, invasive operation, diabetes, duration of mechanical ventilation, and state of consciousness are risk factors for pulmonary infection in ICU patients. The nomogram prediction model constructed based on the above risk factors has shown a good predictive value.
doi: https://doi.org/10.12669/pjms.40.6.9307
How to cite this: Dai W, Zhong T, Chen F, Shen M, Zhu L. Construction of a prediction model for pulmonary infection and its risk factors in Intensive Care Unit patients. Pak J Med Sci. 2024;40(6):1129-1134. doi: https://doi.org/10.12669/pjms.40.6.9307
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.