bluuebunny/crossref_metadata_2025 huggingface dataset:
Do students’ ICT skills pay off in math performance? Examining the moderating role of countries’ ICT promotive environment
Authors: Sze Ming Loh Renae , Kraaykamp Gerbert , van Hek Margriet
Published: October 2023

Students’ information and communication technology (ICT) skills have been shown to be a valuable resource for their educational performance, although to varying degrees across countries. Our paper adds to existing knowledge to understand how and why country-specific ICT characteristics make a difference to math performance benefits students glean from their ICT skills, thereby adding to a general understanding of how digital divides at different levels are interrelated. We home in specifically on two features that reflect a country’s ICT promotive environment, respectively national ICT access in education and government promotion of ICT. We specifically elaborate on how these country level features augment the learning and signaling function of student ICT skills. Multilevel linear regression analyses were conducted on a sample (PISA 2018) of 248,720 students across 43 countries, enriched with contextual information from the Networked Readiness Index 2016 and World Bank’s data. Congruent with past research our results indicate that student ICT skills serve as an education resource. This, our study reveals, is indeed dependent on the country’s ICT promotive environment, as students’ ICT skills translate to greater math performance gains in countries with higher levels of ICT access in educational environments.
DUSP1 Signaling Pathway Regulates Cytarabine Sensitivity in Acute Myeloid Leukemia
Authors: Sun Huali , Ren Yanling , Zhou Xinping , Chen Qi , Liu Yanmei , Zhu Chumeng , Ruan Yanyun , Ruan Hongli , Tong Hongyan , Ying Shenpeng , Lin Peipei
Published: October 2023

Objectives: Dual specificity phosphatase 1 (DUSP1) is high-expressed in various cancers and plays an important role in the cellular response to agents that damage DNA. We aimed to investigate the expressions and mechanisms of DUSP1 signaling pathway regulating cytarabine (Ara-C) resistance in acute myeloid leukemia (AML). Methods: Immunohistochemistry was performed on bone marrow biopsy specimens from AML and controls to explore the expression of DUSP1. Western blot and Q-PCR were used to detect the protein and mRNA expression levels. MTT assay was used to detect the proliferation of cells. Cell apoptosis was detected by flow cytometry. The immune protein-protein interaction (PPI) network of DUSP1 was analyzed in the platform of Pathway Commons, and immune infiltration analysis was used to study the immune microenvironment of AML. Results: We found that the expression levels of DUSP1 in AML patients exceeded that in controls. Survival analysis in public datasets showed that AML patients with higher levels of DUSP1 had poor clinical outcomes. Further public data analysis indicated that DUSP1 was overexpressed in NRAS mutated AML. DUSP1 knockdown by siRNA could sensitize AML cells to Ara-C treatments. The phosphorylation level of mitogen-activated protein kinase (MAPK) pathway was significantly elevated in DUSP1 down-regulated NRAS G13D mutated AML cells. The PPI analysis showed DUSP1 correlated with immune gene CREB1 and CXCL8 in NRAS mutated AML. We also revealed a correlation between tumor-infiltrating immune cells in RAS mutated AML microenvironment. Conclusion: Our findings suggest that DUSP1 signaling pathways may regulate Ara-C sensitivity in AML.
Exploring strength and conditioning practitioners’ perceptions about using priming exercise as a pre-competition strategy to improve performance
Authors: Holmberg Patrick M. , Russell Scott , O’Brien Katherine A. , James Lachlan P. , Kelly Vincent G.
Published: October 2023

The term ‘priming exercise’ has recently been introduced to describe exercise stimuli prescribed to enhance performance within 1–48 hours of that stimulus. Despite evidence of these activities being utilised in competitive settings, the reasoning underpinning the application of priming exercise is not yet clear. Therefore, this study aimed to explore practitioners’ perceptions about using priming exercise as a pre-competition strategy to improve performance. Semi-structured interviews were conducted with 28 practitioners involved in prescribing training programs to elite Australian athletes. Reflexive thematic analysis revealed six organising themes (i.e. ‘limited and inapplicable research findings’, ‘consideration of athletes’ training age’, risk-return of priming session outcomes’, ‘logistical concerns’, ‘buy-in’ and ‘priming exercise prescription’) later grouped into a global theme, representing the ‘challenges of applying priming exercise’. The findings highlight contextual factors influencing practitioners’ use of priming exercise and, based on these considerations, draw attention to the apparent uncertainty about whether these stimuli can be prescribed effectively to improve competition performance in sports. In addition to gaining insight into applied priming strategies, the present findings may be used to inform externally valid and relevant study designs that subsequently guide practice.
Efficacy and safety of first-line PD-1/PD-L1 inhibitor combinations for extensive-stage small-cell lung cancer: a Bayesian network meta-analysis
Authors: Li Huijuan , Han Hedong , Li Chuling , Wu Ranpu , Wang Zhaofeng , Wang Yimin , Zhan Ping , Lv Tangfeng , Zhang Fang , Song Yong , Liu Hongbing
Published: October 2023

Objectives:

Several randomized controlled trials (RCTs) indicated that first-line programmed cell death protein-1/death-ligand 1 inhibitors plus chemotherapy (PD-1/PD-L1 + chemo) led to survival benefits in extensive-stage small-cell lung cancer (ES-SCLC) compared with platinum-based chemotherapy. This study aims to identify the optimal PD-1/PD-L1 + chemo combination strategy.

Methods:

We included RCTs comparing PD-1/ PD-L1 + chemo versus chemo alone in ES-SCLC. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and grade ⩾3 treatment-related adverse events were considered. Odds ratios (ORs), hazard ratios (HRs), and their 95% confidence intervals (CIs) were extracted.

Results:

Six RCTs with 2600 patients were analyzed in this Bayesian network meta-analysis. Results showed that adding PD-1/PD-L1 inhibitors to chemotherapy led to significant benefits in OS (HR = 0.72, 95% CI: 0.66–0.79), PFS (HR = 0.69, 95% CI: 0.63–0.75), and ORR (OR = 1.32, 95% CI: 1.12–1.56), and no differences in toxicity were found (OR = 1.09, 95% CI: 0.92–1.30). Serplulimab plus chemotherapy was found to provide the best OS (HR = 0.63, 95% CI: 0.49–0.82), the best PFS (HR = 0.47, 95% CI: 0.38–0.59), and the best ORR (OR = 1.7, 95% CI: 1.15–2.53). Moreover, although there were no difference between PD-L1 + chemo and PD-1 + chemo regarding OS (HR = 0.99, 95% CI: 0.91–1.08) and ORR (OR = 1.27, 95% CI: 0.91–1.78), PD-1 + chemo showed a significant benefit in PFS (HR = 0.82, 95% CI: 0.68–0.98) compared with PD-L1 + chemo.

Conclusions:

Serplulimab plus chemotherapy seems to be superior first-line immunotherapy combination for patients with ES-SCLC. PD-1 + chemo seems to outperform PD-L1 + chemo in PFS.
Defending a Vulnerable yet Resilient Democracy: Civil Society Activism in Jokowi's Indonesia
Authors: Setiawan Ken M. P. , Tomsa Dirk
Published: October 2023

For the first two decades after the end of the authoritarian New Order regime, Indonesian civil society was widely hailed as a bulwark against elite attempts to roll back the country's democratic achievements. More recent assessments, however, have highlighted how polarisation, socio-religious conservatism and growing state repression have increasingly restricted civil society's ability to defend Indonesian democracy against further backsliding. In the face of these growing pressures, political activists have nonetheless demonstrated adaptability, resourcefulness and resilience, and, despite the narrowing space for dissent and protest, occasionally succeeded in halting and even reversing anti-democratic trends. In this article, we focus on two segments of civil society – women's rights groups and environmental activists – to illustrate under what circumstances progressive political activism in contemporary Indonesia can still be effective in upholding diagonal accountability and defending human rights.
Changes in Quadriceps Rate of Torque Development After Anterior Cruciate Ligament Reconstruction and Association to Single-Leg Hop Distance
Authors: Tayfur Beyza , Keneen Johnson Alexa , Palmieri-Smith Riann
Published: October 2023

Background:

Quadriceps neuromuscular function is negatively affected after anterior cruciate ligament reconstruction (ACLR). The specific effect that the ACLR has on the quadriceps femoris rate of force production and its impact on functional recovery is unknown.

Hypothesis:

The anterior cruciate ligament (ACL) limb would present persistent deficits in the rate of torque development (RTD), when compared with the non-ACL limb before ACLR until 9 months (9M) post-ACLR.

Study Design:

Prospective cohort study.

Level of Evidence:

Level 3.

Methods:

Twenty-eight participants performed quadriceps maximum voluntary isometric contractions (MVICs) before (PRE), at 5 months (5M) and at 9M after ACLR. Single-leg hop distance was also assessed at 9M. Quadriceps RTD was calculated at 50, 100, and 200 ms after the onset of torque production. Maximum RTD was also calculated. A 2 (limb) × 3 (time) repeated-measures analysis of variance was used for RTD50, RTD100, RTD200, and RTDmax. Linear regressions were used to evaluate the associations of MVIC and RTD values at 5M and 9M with single-leg hop distance at 9M.

Results:

The ACL limb had lower RTD values at all times compared with the non-ACL limb ( P < 0.05). RTD of the ACL limb significantly decreased from PRE to 5M, and then recovered to PRE levels at 9M ( P < 0.05). The non-ACL limb displayed no differences from baseline to either 5M or 9M. MVIC and RTD200at 5M predicted ( R2= 0.313 and R2= 0.262, respectively) single-leg hop distance at 9M, better than the strength and RTD at 9M ( R2= 0.235 and R2= 0.128, respectively).

Conclusion:

Quadriceps RTD is negatively affected after ACLR, and deficits may persist at the time of return to activity. Strength and RTD during recovery at 5M may predict more than 25% of the variance in single-leg hop distance at 9M, independently; hence, both provide important information to monitor functional recovery post-ACLR.

Clinical Relevance:

RTD should be measured to understand the changes in neuromuscular capacity after ACLR, and rehabilitation strategies that target quick force production, ie, quick muscle activation and functional tasks, should be implemented.
Can takotsubo syndrome be rapidly diagnosed in the emergency department? A case study
Authors: Alsagaff Mochamad Yusuf , Lusida Terrence Timothy Evan , Gunadi Ruth Irena
Published: October 2023

Some patients presenting with acute coronary syndrome may have had nonobstructive coronary arteries. Nevertheless, a lot of people are not aware that, as of the fourth universal definition of myocardial infarction, Takotsubo syndrome is no longer categorized as myocardial infarction with non-obstructive coronary arteies group. This can lead to diagnostic delays, the use of unnecessary examination, and harmful medical intervention. We present a 68-year-old woman with typical chest pain for 6 h. She had a history of hypertension, transient ischemic attack, and diabetes mellitus. She was diagnosed first with acute coronary syndrome but was later found to have takotsubo syndrome, based on high international takotsubo diagnostic score and transthoracic echocardiography findings of systolic apical ballooning. Within 5 days, she makes a gradual recovery.
Effects of Two Soluble ACE2-Fc Variants on Blood Pressure and Albuminuria in Hypertensive Mice: Research Letter
Authors: Trentin-Sonoda Mayra , Zimpelmann Joseph , Tailor Karishma , Gillard John W. , Yoganathan Nathan , Sulea Traian , Burns Kevin D.
Published: October 2023

Background:

Angiotensin-converting enzyme 2 (ACE2) hydrolyzes angiotensin (Ang) II to Ang-(1-7), promoting vasodilatation, and inhibiting oxidative stress and inflammation. Plasma membrane ACE2 is the receptor for all known SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) viral variants. In COVID-19 infection, soluble ACE2 variants may act as decoys to bind and neutralize the coronavirus, reducing its tissue infectivity. Furthermore, soluble ACE2 variants have been proposed as potential therapeutics for kidney disease and hypertensive disorders.

Objective:

Soluble ACE2 variants conjugated to human Fc domains and selected for high-potency viral SARS-CoV-2 neutralization were prepared and evaluated for ACE2 activity in vitro. Lead candidates were then tested for systemic ACE2 activity, stability, and effects on blood pressure and albuminuria in mice with Ang II-induced hypertension.

Methods:

ACE2 activity of 10 soluble ACE2 variants was first assessed in cell-free conditions using a fluorogenic substrate, or by Ang II hydrolysis to Ang-(1-7). Hypertension was induced in male or female mice by implantation of osmotic minipumps containing Ang II. Two lead ACE2 variants were injected intravenously (i.v.) into hypertensive mice, followed by measurements of blood pressure (tail-cuff plethysmography), albuminuria, and tissue ACE2 activity and protein (immunoblots).

Results:

Soluble ACE2-Fc variants demonstrated significant ACE2 enzymatic activity, with kinetics comparable with human recombinant ACE2. In hypertensive mice, single dose i.v. injection of ACE2-Fc variant K (10 mg/kg) significantly decreased systolic blood pressure at 24 hours, with partial lowering sustained to 48 hours, and tendency to reduce albuminuria at 72 hours. By contrast, ACE2-Fc variant I had no effect on blood pressure or albuminuria in hypertensive mice; ACE2-Fc variant K was detected by immunoblotting in plasma, kidney, heart, lung, liver, and spleen lysates 72 hours after injection, associated with significantly increased ACE2 activity in all tissues except kidney and spleen. Angiotensin-converting enzyme 2-Fc variant I had no effect on plasma ACE2 activity.

Conclusions:

Soluble ACE2-Fc variant K reduces blood pressure and tends to lower albuminuria in hypertensive mice. Furthermore, soluble ACE2-Fc variant K has prolonged tissue retention, associated with increased tissue ACE2 activity. The results support further studies directed at the therapeutic potential of soluble ACE2-Fc variant K for cardiovascular and kidney protection.
Filtering the I From the Ideal: Examining Preadolescents’ Online Self-Presentation in Relation to Their Perceived Attractiveness
Authors: Meeus Anneleen , Everaert Geert , Eggermont Steven , Beullens Kathleen
Published: October 2023

Social media use among preadolescents continues to increase each year. The current cross-sectional study examined how preadolescents’ different (i.e., authentic and inauthentic) online presentation strategies, as well as the social feedback these representations receive, are associated with their perceived attractiveness. The results of our study ( n = 638; 52.4% girls, 9–13 years, Mage = 10.94, SDage = 0.85) showed that more truthful online self-presentation practices coincided with feeling more positive about one’s appearance. A significant moderation effect was found for social feedback, with the association becoming stronger as levels of online feedback (e.g., online popularity, likes, comments, and tags by other users) increased. Contrary to our expectations, inauthentic self-presentation was negatively related to preadolescents’ perceived attractiveness, while no significant interaction effect with online feedback was found.
Effects of Sleep on Adolescents’ Appetite, Dietary Intake, and Weight
Authors: Juelich Janell , Owens Rhoda , Denny Dawn , Raatz Susan , Lindseth Glenda
Published: October 2023

Introduction

Several factors have been associated with excess weight gain in adolescents, including loss of sleep.

Objective

The purpose of this study is to examine the effects of sleep factors on appetite, dietary intake, and the body weights of adolescent youth.

Methods

A prospective correlational study design was used. Male and female adolescents (N = 76) ages 12–18 years completed a 5-night study. Sleep was assessed using Fitbits (88.5% accuracy) and the Pittsburgh Sleep Quality Index (PSQI) (test-retest reliability = .81); appetite was assessed by a Visual Analog Scale (α = 0.84); dietary intake was assessed by the Block Kids Food Screener (reliability up to .88); sleep hygiene was assessed using the Adolescent Sleep Hygiene Practice Scale (α = .67).

Results

Poor sleep quality was reported by 39.5% of participants, and 75% of participants had inadequate sleep time (7.33 h). Participants’ age significantly correlated with PSQI scores (r = .28, p < .05) and BMI (r = .37, p < .01). Participants’ PSQI scores significantly correlated with sleep hygiene (r = .45, p = .05) and appetite (r = .3 3, p < .01). Sleep latency significantly correlated with sleep hygiene (r = .32, p < .05). Several sleep hygiene factors correlated significantly with the participants’ sleep quality, quantity and latency scores and dietary intakes.

Conclusion

These findings suggest that changes in sleep hygiene practices may improve adolescent sleep quality and quantity as well as appetite and dietary intake.
Visible and Ultraviolet Plasma Lines of the He–Ne Gas Laser
Authors: McNiven Bradley D.E. , Clouter Maynard J. , Andrews G. Todd
Published: October 2023

A study of helium–neon laser plasma lines was done using a double grating spectrometer and a helium-neon laser with an emission wavelength of 632.8 nm (15 802 cm−1). The absolute wavenumber, measured to within [Formula: see text]0.2 cm−1, and wavelength of each plasma line are presented, along with intensity and shift relative to the main laser line. Several of the measured lines have not been reported in the literature and are observed at shifts between 0 and 1500 cm−1 from the laser line, a spectral region commonly probed by optical Raman scattering experiments. Accounting for the possibility of second-order diffraction permitted many previously unassigned lines to be attributed to known neon electronic transitions with wavelengths in the ultraviolet region of the electromagnetic spectrum.
Tribute to Barbara Ehrenreich: Fighting for Labor Through Critical Research Journalism
Authors: Muntaner Carles , Benach Joan
Published: October 2023

This is a short commentary to accompany the article “Hospital Workers: Class Conflicts in the Making” by Barbara Ehrenreich and John H. Ehrenreich. The article was originally published in the International Journal of Health Services in 1975. We are revisiting it in the current issue of the International Journal of Social Determinants of Health and Health Services due to its continued relevance and significance in the twenty-first Century.
Associations between vision impairment and multimorbidity among older Chinese adults: results from the China health and retirement longitudinal study
Authors: Xiong Kun , Mao Huiyan , Zhang Qi’ao , Lei Changrong , Liang Yuanbo
Published: October 2023

Background

Although several studies have reported the relationship between vision impairment (VI) and multimorbidity in high-income countries, this relationship has not been reported in low- and middle-income countries. This study aimed to explore the relationship between VI with multimorbidity and chronic conditions among the elderly Chinese population.

Methods

The cross-sectional analysis was applied to data from the China Health and Retirement Longitudinal Study (CHARLS) in 2018. A total of 8,108 participants ≥ 60 years old were included, and 15 chronic conditions were used in this study. Logistic regression analysis was used to analyze the relationship between VI with multimorbidity and chronic conditions.

Results

The prevalence of 15 chronic conditions and multimorbidity was higher among the elderly with VI than those without VI. After adjusting for demographic and socioeconomic confounders, 10 chronic conditions were associated with VI (all P < 0.05). Furthermore, positive association was observed between VI and one (odds ratio [OR]: 1.52; 95% confidence intervals [95%CI]: 1.16–2.00; P = 0.002), two (OR: 2.09; 95%CI: 1.61–2.71; P < 0.001), three (OR: 2.87; 95%CI: 2.22–3.72; P < 0.001), four (OR: 3.60; 95%CI: 2.77–4.69; P < 0.001), and five or more (OR: 5.53; 95%CI: 4.32–7.09; P < 0.001) chronic conditions, and the association increased as the number of chronic conditions (P for trend < 0.001). Sensitivity analysis stratified by gender, education, smoking status, and annual per capita household expenditure still found VI to be positively associated with multimorbidity.

Conclusions

For patients older than 60 years, VI was independently associated with multimorbidity and various chronic conditions. This result has important implications for healthcare resource plans and clinical practice, for example, increased diabetes and kidney function screening for patients with VI.
Effect of acute normovolemic hemodilution on anesthetic effect, plasma concentration, and recovery quality in elderly patients undergoing spinal surgery
Authors: Liu Tong , Bai Yu , Yin Lei , Wang Jin-Huo , Yao Na , You Lai-Wei , Guo Jian-Rong
Published: October 2023

Objective

To explore the effect of acute normovolemic hemodilution (ANH) on the anesthetic effect, plasma concentration, and postoperative recovery quality in elderly patients undergoing spinal surgery.

Methods

A total of 60 cases of elderly patients aged 65 to 75 years who underwent elective multilevel spinal surgery were assigned randomly into the ANH group (n = 30) and control group (n = 30). Hemodynamic and blood gas analysis indexes were observed and recorded before ANH (T1), after ANH (T2), immediately after postoperative autologous blood transfusion (T3), 10 min (T4), 20 min (T5), 30 min (T6), 40 min (T7), and 50 min (T8) after the transfusion, and at the end of the transfusion (i.e., 60 min; T9). At T3 ~ 9, bispectral index (BIS) and train-of-four (TOF) stimulation were recorded and the plasma propofol/cisatracurium concentration was determined. The extubation time and recovery quality were recorded.

Results

The ANH group presented a lower MAP value and a higher SVV value at T2, and shorter extubation and orientation recovery time (P < 0.05) compared with the control group. BIS values at T8 and T9 were lower in the ANH group than those in the control group (P < 0.05). TOF values at T7 ~ 9 were lower in the ANH group than those in the control group (P < 0.05). There were no statistically significant differences in the postoperative plasma concentrations of propofol and cisatracurium between the groups (P > 0.05).

Conclusion

During orthopedic surgery, the plasma concentration of elderly patients is increased after autologous blood transfusion of ANH, and the depth of anesthesia and muscle relaxant effect are strengthened, thus leading to delayed recovery of respiratory function and extubation.
Sedentary behaviour among older adults residing in flat and hilly neighbourhoods and its association with frailty and chronic disease status
Authors: Asiamah Nestor , Agyemang Simon Mawulorm , Vieira Edgar Ramos , Khan Hafiz T. A. , Gasana Janvier
Published: October 2023

Background

Living in hilly neighbourhoods can be associated with sedentary behaviour, but no study has compared sedentary behaviour and its associations with frailty, chronic diseases, and poor health between flat and hilly neighbourhoods among older adults. This study, therefore, compared older adults’ sedentary behaviour and its association with frailty, poor health, and chronic disease status between low and hilly neighbourhoods.

Methods

This study utilised a STROBE-compliant cross-sectional design with sensitivity analyses and a common methods bias assessment. The participants were 1,209 people aged 50+ years who resided in flat (Ablekuma North, n = 704) and hilly (Kwahu East, n = 505) neighbourhoods in Ghana. The data were analysed with the independent samples t-test and hierarchical linear regression.

Results

Older adults in the hilly neighbourhood were more sedentary than those in the flat neighbourhood. The association between sedentary behaviour and chronic disease status was significant in both neighbourhoods, but this relationship was stronger in the hilly neighbourhood. Older adults in the flat neighbourhood reported lower sedentary behaviour at higher frailty (β = -0.18; t = -3.2, p < 0.001), but those in the hilly neighbourhood reported higher sedentary behaviour at higher frailty (β = 0.16; t = 3.54, p < 0.001).

Conclusions

Older adults living in the hilly neighbourhood reported higher sedentary behaviour. In the hilly neighbourhood, sedentary behaviour was more strongly associated with frailty and chronic disease status. Older adults in hilly neighbourhoods may need extra support to avoid sedentary behaviour.
Maintenance of dental records and awareness of forensic odontology among pakistani dentists: a mixed-method study with implications for dental data repository
Authors: Baqai Haifa Saquib , Zaidi Syed Jaffar Abbas , Baig Qaiser Ali , Bashir Muhammad Bilal , Anwar Madiha , Ansari Asma Saher
Published: October 2023

Objective

Dental records and forensic odontology play an important role in both healthcare and the legal system, aiding in personalized patient care, human identification, and legal proceedings. This study aims to investigate dental record-keeping practices and assess the awareness of forensic odontology among Pakistani dentists over 12 months. This study aims to collect data from 500 dentists, identify areas for enhancement, and develop a strategic action plan to improve record-keeping quality and forensic odontology application, culminating in a comprehensive dental data repository to support legal and criminal investigations in Pakistan.

Methodology

This study employed a mixed-method approach conducted at Hamdard Dental College from January to March 2023. The quantitative phase involved distributing questionnaires to 463 dentists, chosen through stratified random sampling. Out of these, 413 responded, yielding an 86% response rate. These questionnaires focused on dental record-keeping practices and dentists’ awareness of forensic odontology. Subsequently, based on the questionnaire results, face-to-face interviews were conducted with 20 purposively selected dentists to gain deeper insight into the challenges and potential solutions. Data from both phases were integrated and analyzed accordingly.

Results

The study included 413 participants, mainly females (79%), with ages ranging from 27 to 65 years and an average age of 46.4 years. Most dentists had 5–20 years of work experience (53%), and most (87.4%) were practicing in private clinical settings. All the dentists generated medical and dental records, but the duration of their record-keeping varied, with some maintaining them for up to a year and others for two years or longer. Five themes were generated from the qualitative content analysis. These themes were dentists’ perceptions, barriers and challenges, knowledge and awareness, and improvement strategies.

Conclusion

Our study revealed that local practitioners in Pakistan exhibit subpar practices in dental record-keeping and maintenance of patient history, irrespective of whether they use a digital or traditional file-based system. Even though dentists are cognizant of the importance of record-keeping, they do not actively maintain comprehensive records. This suggests the need for improved training and system improvements to address the gaps in record-keeping practices.
eHealth literacy among hospital health care providers: a systematic review
Authors: Brørs Gunhild , Larsen Marie Hamilton , Hølvold Linn Benjaminsen , Wahl Astrid K.
Published: October 2023

Background

eHealth literacy is a key concept in the implementation of eHealth resources. However, most eHealth literacy definitions and frameworks are designed from the perceptive of the individual receiving eHealth care, which do not include health care providers’ eHealth literacy or acceptance of delivering eHealth resources.

Aims

To identify existing research on eHealth literacy domains and measurements and identify eHealth literacy scores and associated factors among hospital health care providers.

Methods

This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. A systematic literature search was conducted in MEDLINE, Cinahl, Embase, Scopus, PEDro, AMED and Web of Science. Quantitative studies assessing eHealth literacy with original research, targeting hospital health care providers were included. Three eHealth literacy domains based on the eHealth literacy framework were defined a priori; (1) Individual eHealth literacy, (2) Interaction with the eHealth system, and (3) Access to the system. Pairs of authors independently assessed eligibility, appraised methodological quality and extracted data.

Results

Fourteen publications, of which twelve publications were conducted in non-Western countries, were included. In total, 3,666 health care providers within eleven different professions were included, with nurses being the largest group. Nine of the included studies used the eHealth literacy scale (eHEALS) to measure eHealth literacy, representing the domain of individual eHealth literacy. A minority of the studies covered domains such as interaction with the eHealth system and access to the system. The mean eHEALS score in the studies ranged from 27.8 to 31.7 (8–40), indicating a higher eHealth literacy. One study reported desirable eHealth literacy based on the Digital Health Literacy Instrument. Another study reported a relatively high score on the Staff eHealth literacy questionnaire. eHealth literacy was associated with socio-demographic factors, experience of technology, health behaviour and work-related factors.

Conclusions

Health care providers have good individual eHealth literacy. However, more research is needed on the eHealth literacy domains dependent on interaction with the eHealth system and access to the system. Furthermore, most studies were conducted in Eastern and Central-Africa, and more research is thus needed in a Western context.

Trial registration

PROSPERO International Prospective Register of Systematic Reviews (CRD42022363039).
Perceived harms and protective behavioural strategies among khat chewers: a qualitative study in Jimma, Ethiopia
Authors: Olani Amanti Baru , Decorte Tom
Published: October 2023

Background

While there have been many previous studies focusing on the adverse effects of khat chewing, attempts to investigate the protective behavioural strategies (PBS) employed by the khat using population are rare. PBS are strategies that substance users employ to minimize or alleviate the possible negative consequences related to the behaviour. This study focuses on the harms that chewers associate with khat use, and the behavioural strategies they practise to prevent or minimize these harms.

Methods

A community-based qualitative study was conducted using a snowball sampling technique to recruit a diverse sample of khat chewing participants (N = 102) in Jimma city, Ethiopia. Face-to-face in-depth interviews were carried out with the participants.

Results

Participants identified a variety of harms likely to result from chewing khat. These include impacts on their finances, work, social life and health. The PBS that participants employed to avoid or minimize the risks were classified into four themes based on their temporal sequence with khat chewing sessions: prior to chewing, during chewing, after chewing and general PBS covering the whole of their khat chewing career. The PBS enable khat chewers to prevent or minimize the adverse health consequences of chewing, socialize and work without or with fewer difficulties and manage their economy successfully.

Conclusion

The study participants believe that khat-related harms are avoidable if khat users implement appropriate strategies prior to, during and after chewing, and if they apply PBS to khat-related factors (e.g. type, amount and frequency), set factors (e.g. reason for using and health behaviour) and setting factors (e.g. place of use, when used, with whom used and social norms) covering the whole of their khat chewing career.
Family planning service availability and readiness assessment of primary health care facilities in Delta State, Nigeria: a mixed methods survey
Authors: Obong Dorcas Tom , Oyibo Patrick
Published: October 2023

Background

The availability of contraceptives, family planning guidelines, and Information, Education, and Communication (IEC) materials can increase access to family planning services. This study assessed the availability of commodities and readiness of primary health care (PHC) facilities in Delta State to offer family planning services.

Methods

A cross-sectional design with an explanatory mixed-method approach was used i.e., the authors first collected the quantitative data, and after preliminary analysis of quantitative information, the qualitative approach was utilised to gather data on the perspectives of 32 PHC facility managers and 6 reproductive health supervisors on factors affecting family planning service availability and readiness.

Results

Twenty-one (65.6%) of the PHC facilities surveyed offered at least five modern methods of family planning. Stock-outs of emergency contraceptives, implants, intra-uterine contraceptive device (IUCD), oral contraceptive pills (OCP), condoms, and injectables were observed in 31 (96.9%), 17 (53.1%), 13 (40.6%), 4 (12.5%), 2 (6.3%), and 1 (3.1%) of the facilities respectively. Eleven (34.4%) and 8 (25.0%) of the facilities had IEC materials and family planning guidelines, and contraceptive commodity checklists respectively. Seventeen (53.1%) of the facilities did not have complete records of family planning activities.

Conclusion

This study shows that a significant proportion of PHC facilities had stock-outs of contraceptive commodities, no complete records of contraceptive activities, no IEC materials and no family planning checklists. Continuous training of health providers and increased government commitment can help to improve contraceptive services.
Clinical impact of spacer placement surgery with expanded polytetrafluoroethylene sheet for particle therapy
Authors: Fujinaka Ryosuke , Komatsu Shohei , Terashima Kazuki , Demizu Yusuke , Omiya Satoshi , Kido Masahiro , Toyama Hirochika , Tokumaru Sunao , Okimoto Tomoaki , Fukumoto Takumi
Published: October 2023

Background

Spacer placement surgery is useful in particle therapy (PT) for patients with abdominopelvic malignant tumors located adjacent to the gastrointestinal tract. This study aimed to assess the safety, efficacy, and long-term outcomes of spacer placement surgery using an expanded polytetrafluoroethylene (ePTFE) spacer.

Methods

This study included 131 patients who underwent ePTFE spacer placement surgery and subsequent PT between September 2006 and June 2019. The overall survival (OS) and local control (LC) rates were calculated using Kaplan-Meier method. Spacer-related complications were classified according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0).

Results

The median follow-up period after spacer placement surgery was 36.8 months. The 3-year estimated OS and LC rates were 60.5% and 76.5%, respectively. A total of 130 patients (99.2%) were able to complete PT. Spacer-related complications of ≥ grade 3 were observed in four patients (3.1%) in the acute phase and 13 patients (9.9%) in the late phase. Ten patients (7.6%) required removal of the ePTFE spacer.

Conclusions

Spacer placement surgery using an ePTFE spacer for abdominopelvic malignant tumors is technically feasible and acceptable for subsequent PT. However, severe spacer-related late complications were observed in some patients. Since long-term placement of a non-absorbable ePTFE spacer is associated with risks for morbidity and infection, careful long-term follow-up and prompt therapeutic intervention are essential when complications associated with the ePTFE spacer occur.

Trial registration

retrospectively registered.
Psoralen synergizes with exosome-loaded SPC25 to alleviate senescence of nucleus pulposus cells in intervertebral disc degeneration
Authors: Yang Lei , Li Zhaoyong , Zhang Chao , Li Shuofu , Chen Long , Yang Shaofeng , Guo Yantao
Published: October 2023

Objective

To explore the mechanism of psoralen synergized with exosomes (exos)-loaded SPC25 on nucleus pulposus (NP) cell senescence in intervertebral disc degeneration (IVDD).

Methods

IVDD cellular models were established on NP cells bytert-butyl hydroperoxide (TBHP) induction, followed by the treatment of psoralen or/and exos from adipose-derived stem cells (ADSCs) transfected with SPC25 overexpression vector (ADSCs-oe-SPC25-Exos). The viability, cell cycle, apoptosis, and senescence of NP cells were examined, accompanied by the expression measurement of aggrecan, COL2A1, Bcl-2, Bax, CDK2, p16, and p21.

Results

After TBHP-induced NP cells were treated with psoralen or ADSCs-oe-SPC25-Exos, cell proliferation and the expression of aggrecan, COL2A1, Bcl-2, and CDK2 were promoted; however, the expression of Bax, p16, p21, and inflammatory factors was decreased, and cell senescence, cycle arrest, and apoptosis were inhibited. Of note, psoralen combined with ADSCs-oe-SPC25-Exos further decelerated NP cell senescence and cycle arrest compared to psoralen or ADSCs-oe-SPC25-Exos alone.

Conclusion

Combined treatment of psoralen and ADSCs-oe-SPC25-Exos exerted an alleviating effect on NP cell senescence, which may provide an insightful idea for IVDD treatment.
A novel technique of a new cannulated screw for treatment of inferior pole patellar fractures: a finite element study
Authors: Pan Mingmang , Yin Nuo , Du Li , Xue Feng , Shen Yuchun , Ding Liang
Published: October 2023

Objective

We invented a new cannulated screw with holes on the tail, which called Ding’s screw. The goal of this study was to evaluate the biomechanical outcomes of this new screw with tension band wiring for the treatment of inferior pole patellar fractures in a finite element model.

Methods

We conducted a finite element biomechanical study using two fixation methods: Ding’s screw and tension band wiring (DSTBW) and cannulated screws and tension band wiring (CSTBW). Two methods were simulated to fix the inferior pole patellar fracture in a finite element model. The relative displacement and stress distribution were analyzed and compared.

Result

There were less displacement and stress distribution of DSTBW in different knee movement (30°, 60°, 90°, 120°) when compared to CSTBW. The highest value of displacement of the fracture and von Mises stress of the internal fixation happened in 120° knee movement in both groups. The highest displacement of the DSTBW was less than that of the CSTBW (1.92 mm to 2.12 mm). The highest value of the stress on the screws was 110.60 MPa in DSTBW group, and 132.90 MPa in CSTBW group. The highest value of the stress on the titanium cable was 38.51 MPa in DSTBW group, and 41.91 MPa in CSTBW group.

Conclusion

DSTBW fixation provides more stability than CSTBW fixation model in a finite element study.
Anticancer perspective of 6-shogaol: anticancer properties, mechanism of action, synergism and delivery system
Authors: Jia Yaoxia , Li Xing , Meng Xiangqi , Lei Jinjie , Xia Yangmiao , Yu Lingying
Published: October 2023

Cancer is a malignant disease that has plagued human beings all the time, but the treatment effect of commonly used anticancer drugs in clinical practice is not ideal by reason of their drug tolerance and Strong adverse reactions to patients. Therefore, it is imperative to find effective and low-toxic anticancer drugs. Many research works have shown that natural products in Chinese herbal medicine have great anticancer potential, such as 6-shogaol, a monomer composition obtained from Chinese herbal ginger, which has been confirmed by numerous in vitro or vivo studies to be an excellent anti-cancer active substance. In addition, most notably, 6-shogaol has different selectivity for normal and cancer cells during treatment, which makes it valuable for further research and clinical development. Therefore, this review focus on the anti-cancer attributes, the mechanism and the regulation of related signaling pathways of 6-shogaol. In addition, its synergy with commonly used anticancer drugs, potential drug delivery systems and prospects for future research are discussed. This is the first review to comprehensively summarize the anti-cancer mechanism of 6-shogaol, hoping to provide a theoretical basis and guiding significance for future anti-cancer research and clinical development of 6-shogaol.

Graphical Abstract
Impact of a ground intermediate transport from the helicopter landing site at a hospital on transport duration and patient safety
Authors: Hoechter Dominik J. , Schmalbach Bjarne , Schmidt Merve , Prueckner Stephan , Bayer Andreas
Published: October 2023

Background

Helicopter emergency medical service provides timely care and rapid transport of severely injured or critically ill patients. Due to constructional or regulatory provisions at some hospitals, a remote helicopter landing site necessitates an intermediate ground transport to the emergency department by ambulance which might lengthen patient transport time and comprises the risk of disconnection or loss of vascular access lines, breathing tubes or impairment of other relevant equipment during the loading processes. The aim of this study was to evaluate if a ground intermediate transport at the hospital site prolonged patient transport times and operating times or increases complication rates.

Methods

A retrospective analysis of all missions of a German air rescue service between 2012 and 2020 was conducted. Need of a ground transport at the accepting hospital, transfer time from the helipad to the hospital, overall patient transport time from the emergency location or the referring hospital to the accepting hospital and duration of the mission were analyzed. Several possible confounders such as type of mission, mechanical ventilation of the patient, use of syringe infusion pumps (SIPs), day- or nighttime were considered.

Results

Of a total of 179,003 missions (92,773 (51,8%) primary rescue missions, 10,001 (5,6%) polytrauma patients) 86,230 (48,2%) secondary transfers) an intermediate transport by ambulance occurred in 40,459 (22,6%) cases. While transfer times were prolonged from 6.3 to 8.8 min for primary rescue cases (p < 0.001) and from 9.2 to 13.5 min for interhospital retrieval missions (p < 0.001), the overall patient transport time was 14.8 versus 15.8 min (p < 0.001) in primary rescue and 23.5 versus 26.8 min (p < 0.001) in interhospital transfer. Linear regression analysis revealed a mean time difference of 3.91 min for mechanical ventilation of a patient (p < 0.001), 7.06 min for the use of SIPs (p < 0.001) and 2.73 min for an intermediate ambulance transfer (p < 0.001). There was no relevant difference of complication rates seen.

Conclusions

An intermediate ground transport from a remote helicopter landing site to the emergency department by ambulance at the receiving hospital had a minor impact on transportation times and complication rates.
Microinvasive pars plana vitrectomy combined with internal limiting membrane peeling versus anti-VEGF intravitreal injection for treatment-naïve diabetic macular edema (VVV-DME study): study protocol for a randomized controlled trial
Authors: Guo Haoxin , Li Wenbo , Nie Zetong , Zhang Xiang , Jiao Mingfei , Bai Siqiong , Duan Naxin , Li Xiaorong , Hu Bojie
Published: October 2023

Background

Diabetic macular edema (DME) is the main cause of vision loss in diabetic patients. Currently, anti-vascular endothelial growth factor (VEGF) intravitreal injection stands as the first-line therapy for DME. However, some patients exhibit insufficient response to anti-VEGF agents and often require multiple injections, imposing psychological and economic burdens. While microinvasive pars plana vitrectomy (PPV) has been shown to be safe and effective in treating refractory DME, scant research has explored its application to treatment-naïve DME. The purpose of this study is to determine whether early PPV combined with internal limiting membrane (ILM) peeling can lessen the therapeutic burden of DME patients, prevent vision loss, and maintain long-term stabilization of diabetic retinopathy.

Methods

This is a single-center, prospective, parallel-group, non-inferiority randomized controlled trial involving 102 DME participants. Participants will be randomly assigned to either the study group (PPV combined with ILM peeling) or the control group (conbercept intravitreal injection (IVC)) at a 1:1 ratio, with a scheduled follow-up at 12 months post-operation. Comparative analysis of results between the two groups will be conducted at months 1, 3, 6, and 12 after the intervention. The primary outcomes involve evaluating the changes in central subfield thickness (CST) and best corrected visual acuity (BCVA). The secondary outcomes include assessment of optical coherence tomography (OCT) and OCT angiography (OCTA) biomarkers, re-treatment and adverse events rates, diabetic retinopathy (DR) development, cost-effectiveness analysis, and vision-related quality of life (VRQL).

Discussion

Some patients do not respond well to anti-VEGF drugs and repeated intravitreal injections increase the treatment burden for patients. The VVV study aims to explore whether PPV combined with ILM peeling could become an initial treatment option for treatment-naïve DME patients.

Trial registration

ClinicalTrials.gov NCT05728476. Registered on 15 February 2023.
Point of care obstetric ultrasound training for midwives and nurses: implementation and experiences of trainees at a rural based hospital in Sub-saharan Africa: a qualitative study
Authors: Mubuuke Aloysius G. , Erem Geoffrey , Nassanga Rita , Kiguli-Malwadde Elsie
Published: October 2023

Background

Point of care ultrasound training has been successfully implemented in some settings. This has been done due to a shortage of radiology human resource gap especially in the rural areas of low-resource settings. The purpose of the study was to implement a point of care obstetric ultrasound training program for midwives and nurses and explore their experiences following the training at a rural based hospital in Uganda.

Methods

It was an exploratory qualitative study with some elements of implementation research design involving midwives and nurses that had undergone obstetric ultrasound training at Kiwoko hospital, a rural-based hospital in Uganda. Purposive sampling was used to select twenty-five midwives and nurses. These participants underwent a 6-weeks training in point of care obstetric ultrasound. Following the training, in-depth interviews were conducted to obtain the experiences of the participants.

Results

The training was conducted by qualified radiologists and sonographers and it involved both didactic sessions and rigorous practical and clinical demonstrations and eventually real-time scanning of the women. Three key themes emerged from the interviews: (1) Gaining important obstetric ultrasound skills, (2) Improving management of pregnant women and (3) Positive for task-shifting.

Conclusion

The point of care obstetric ultrasound training program was successfully implemented at Kiwoko Hospital. The trainees reported positive experiences from the training and while only conducted at one rural health facility, the overwhelmingly positive experience from trainees underscores the importance of point of care obstetric ultrasound in delivering imaging services.