bluuebunny/crossref_metadata_2025 huggingface dataset:
Interventions to reduce loss to follow up in common retinal pathology: A systematic review
Authors: Muste Justin C , Russell Matthew W , Iyer Amogh I , Singh Rishi P
Published: December 2022

Purpose

Loss to follow-up or fragmented follow-up episodes (LTFU) may contribute to suboptimal clinical outcomes, especially when comparing real world data to clinical trials. This systemic review gathers available evidence around interventions meant to decrease the LTFU in AMD, RVO, and DME patients

Patients and methods

PubMed was queried using a literature search strategy and reviewed by the authors. Studies with interventions aimed at reducing lost to follow up were included.

Results

Ten studies were extracted from 89 candidate publications.

Discussion

Telephone interventions featuring assistance in scheduling in improving LTFU in urban, African American populations over 50 years old with diabetic retinopathy. The same interventions have shown promise in glaucoma, but remain understudied in AMD, RVO, and other geographic, ethnic, and socioeconomic demographics.

Conclusion

No sole intervention with efficacy in improving LTFU has been developed. A standardized definition of LTFU, as well as testing interventions across broad age, geography, ethnic, racial, and socioeconomic lines. Longitudinal data would also add credence to the efficacy of purported interventions.

Other

No sources of funding for this article.
Association of paramagnetic rim lesions and retinal layer thickness in patients with multiple sclerosis
Authors: Krajnc Nik , Dal-Bianco Assunta , Leutmezer Fritz , Kasprian Gregor , Pemp Berthold , Kornek Barbara , Berger Thomas , Rommer Paulus Stefan , Hametner Simon , Lassmann Hans , Bsteh Gabriel
Published: December 2022

Background:

Paramagnetic rim lesions (PRLs) are chronic active lesions associated with a more severe disease course in multiple sclerosis (MS). Retinal layer thinning measured by optical coherence tomography (OCT) is a biomarker of neuroaxonal damage associated with disability progression in MS.

Objective:

We aimed to determine a potential association between OCT parameters (peripapillary retinal nerve fiber layer (pRNFL) ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer (INL) thickness), and PRLs in patients with MS (pwMS).

Methods:

In this cross-sectional retrospective study, we included pwMS with both 3T brain MRI and an OCT scan. Regression models were calculated with OCT parameters (pRNFL, GCIPL, INL) as dependent variables, and the number of PRLs as an independent variable adjusted for covariates.

Results:

We analyzed data from 107 pwMS (mean age 34.7 years (SD 10.9), 64.5% female, median disease duration 6 years (IQR 1–13), median EDSS 1.5 (range 0–6.5)). Higher number of PRLs was associated with lower pRNFL (β = −0.18; 95% CI −0.98, −0.03; p = 0.038) and GCIPL thickness (β = −0.21; 95% CI −0.58, −0.02; p = 0.039).

Conclusion:

The association between higher number of PRLs and lower pRNFL and GCIPL thicknesses provides additional evidence that pwMS with PRLs are affected by a more pronounced neurodegenerative process.
The myth of progress
Authors: Castelli Alberto
Published: December 2022

This manuscript stages the West and China as civilizations rooted in contrasting myths. The Western leading paradigm is the Faustian Man whose ambition created modernity and the tragedy of progress. It is a tragedy already condemned by history but, being Faust’s construction site unfinished, it is a tragedy that everyone seems keen to re-enact. On the other hand, China conceived the concept of stability, rather than competition, the key for a durable success. Behind Zheng He’s voyages and the Ming Dynasty’s choice to go westbound, rather than eastbound, lies an anti-Faustian attitude, the essence of Chinese philosophy, to be read not as anti-modernity but the attempt to shape an alternative modernity.
Triangle technique: An effective tool for improving nursing students’ ability to calculate safe pediatric medication dosages
Authors: Suluhan Derya , Yildiz Dilek , Fidanci Berna Eren
Published: December 2022

Calculating the correct medication dosage for pediatric patients can be difficult for nurses to determine, as the pediatric dose is typically a small fraction of the adult dosage. This study aims to examine the impact of the Triangle Technique on the ability of nursing students to calculate low and high safe dosage ranges in children. To evaluate how this educational tool could improve a nurse’s skill in this area, a quasi-experimental pre-/post-test research design was employed including one hundred fifty-eight third-year nursing students. The Pediatric Medication Administration Form and Pediatric Safe Dosage Calculations Quiz (PSDCQ) were used to measure the effectiveness of the Triangle Technique. While <50% ( n < 79) of students gave correct answers to each question in PSDCQ before this intervention, all of the participants ( N = 158, 100%) gave a correct answer to one question, and >89.2% ( n > 141) of the students correctly answered the other four questions of PSDCQ. The change in scores (pre-PSDCQ median score = 0, IQR = 60; post-PSDCQ median score = 100, IQR = 0) post-intervention was statistically significant (z = 10.633, p ≤ .001), indicating that this teaching technique was effective for improving students’ ability to calculate pediatric safe dose ranges. Nursing students ( n = 144, 91.1%) were satisfied with using Triangle Technique. Using the Triangle Technique can increase nursing students’ understanding of how they calculate safe pediatric medication dosages.
Adverse childhood experiences and neurodevelopmental disorders among youth with and without prenatal substance exposure: A longitudinal matched register-based cohort study
Authors: Koponen Anne M. , Nissinen Niina-Maria , Gissler Mika , Autti-Rämö Ilona , Kahila Hanna , Sarkola Taisto
Published: December 2022

Background: Previous research has shown an association between adverse childhood experiences (ACEs) and secondary mental health problems in youth with prenatal substance exposure (PSE), but the association between ACEs and neurodevelopmental disorders is less clear. Methods: This longitudinal register-based cohort study investigated relationships between health at birth, ACEs (out-of-home care (OHC) and maternal adversities), and neurodevelopmental disorders among youth with PSE (alcohol/drugs, n = 615) and matched unexposed controls ( n = 1787). Hospital medical records and register data were merged and analysed using Cox regression models. Results: Conduct and emotional disorders (International Statistical Classification of Diseases and Related Health Problems ICD-10, F90–F94) were more common among the exposed than the controls but only when the exposed and controls with no OHC were compared. The difference appeared in hyperkinetic disorders (ADHD, F90), mixed disorders of conduct and emotions (F92) and emotional disorders with onset specific to childhood (F93). Among the exposed and controls with OHC, over 40% had received an F90–F94 diagnosis. Regarding specific developmental disorders (F80–F83, e.g., impairments in speech and language and scholastic skills) the moderate difference between the exposed and controls attenuated after adjustment for OHC. Again, the rates were highest among the exposed with OHC and the controls with OHC. OHC and maternal risks were interrelated and, together with male sex and low birth weight, were associated with neurodevelopmental disorders both among the exposed and controls and decreased the difference between them. Conclusions: A strong association between ACEs and neurodevelopmental disorders was found. Brain research is needed to examine whether ACEs worsen neurodevelopmental outcomes caused by PSE.
New Graduate Nurses’ Incivility Experiences: The Roles of Workplace Empowerment, Nursing Leadership and Areas of Worklife
Authors: Blackstock Sheila , Cummings Greta G. , Glanfield Florence , Yonge Olive
Published: December 2022

Aims

To determine what extent are workplace empowerment, New Graduate Nurses’ (NGN) perceptions of nurse leaders, trust in management, and areas of worklife predict coworker incivility experiences?

Background

NGNs’ perceptions of nursing leaderships’ control over workload contribute to coworker incivility experiences were tested. The relationship between workplace empowerment, authentic leadership, and areas of work life (workload control and fair resource allocation) to coworker incivility experiences were examined.

Design

Secondary analysis of Starting Out, national survey, Time 1 dataset. Select factors of workplace empowerment, authentic leadership, areas of worklife, trust in management and NGNs’ co- worker incivility experiences were situated within an ecological approach. Multiple linear regression was used to test whether a negative relationship of workplace empowerment, areas of worklife and authentic leadership to NGNs co-worker incivility experiences and important new findings were discovered.

Results

First, NGNs’ perceptions of workplace empowerment predict coworker incivility experiences when controlling for authentic leadership and trust in management. Second, NGNs’ perceptions of areas of worklife predict coworker incivility experiences when controlling for authentic leadership, trust in management, and workplace empowerment. Third, NGNs’ perceptions of authentic leadership do not predict coworker incivility experiences when controlling for workplace empowerment and trust in management. Finally, NGNs’ perceptions of authentic leadership do predict coworker incivility experiences when trust in management and workplace empowerment are not controlled.

Conclusions

NGNs’ perceptions of authentic leadership would benefit from workplace empowerment of the nurse leader in workplace environments to mitigate coworker incivility experiences.
Green composites from vanillin-based benzoxazine and silane surface modified chopped carbon fibers
Authors: Derradji Mehdi , Khiari Karim , Mehelli Oussama , Abdous Slimane , Amri Bouchra , Belgacemi Raouf , Ramdani Noureddine , Zegaoui Abdeljalil , Liu Wenbin
Published: December 2022

By following the rules of green chemistry, a novel composite is developed from a renewable and ecofriendly resource, namely, vanillin. The latter was used as a phenolic precursor for the microwave synthesis of a bio-based benzoxazine resin (Va-BZ). Afterward, high-performance green composites were developed by reinforcing Va-BZ with various amounts of chopped silane surface modified carbon fibers (CFs). The chemical structure of the Va-BZ monomers was confirmed by 1H NMR and Fourier transform infrared spectroscopy. The grafting of the silane moiety on the CF surface was assessed by FTIR and TGA analyses. The autocatalytic ring opening polymerization of the Va-BZ monomers was confirmed by DSC analysis. The mechanical performances of the developed green composites were studied by flexural and tensile investigations. The findings suggested that the maximum amount of 20 wt. CFs afforded the best results, with flexural and tensile strengths of 450 and 462 MPa, respectively. The SEM was used to study the fractured tensile surfaces and elucidated the toughening mechanism. Meanwhile, the TGA showed that the introduction of the CFs markedly improved the thermal stability of the benzoxazine matrix. Overall, this study confirmed that greener approaches can also result in high-performance composites satisfying the needs of exigent applications.
Medicinal cannabis for Australian patients with chronic refractory pain including arthritis
Authors: Schubert Elise A , Johnstone Masego T , Benson Melissa J , Alffenaar Johannes C , Wheate Nial J
Published: December 2022

Objectives

To examine the tolerability and effectiveness of medicinal cannabis prescribed to patients for chronic, refractory pain, with a subset analysis on arthritis.

Methods

This was an interim analysis of the CA Clinics Observational Study investigating self-reported adverse events (AEs) and changes in health-related quality of life (HRQoL) outcomes over time after commencing medicinal cannabis. Patients were prescribed medicinal cannabis by a medical practitioner, containing various ratios of Δ9-tetrahydrocannabinol (THC) and/or cannabidiol (CBD).

Results

The overall chronic pain cohort, and specifically the balanced CBD:THC products, were associated with significantly reduced pain intensity scores ( p = 0.003, p = 0.025), with 22% of patients reporting a clinically meaningful reduction in pain intensity. Patients in the arthritis subset ( n = 199) reported significantly reduced pain intensity scores ( p = 0.005) overall, and specifically for those taking CBD-only ( p = 0.018) and balanced products ( p = 0.005). Other HRQoL outcomes, including pain interference and pain impact scores were significantly improved depending on the CBD:THC ratio. Products that contained a balanced ratio of CBD:THC were associated with improvements in the most number of PROMIS-29 domains. Approximately half ( n = 364; 51%) of the chronic pain cohort experienced at least one AE, the most common being dry mouth (24%), somnolence (19%) or fatigue (12%). These findings were similar in the arthritis subset.

Discussion

Medicinal cannabis was observed to improve pain intensity scores and HRQoL outcomes in patients with chronic, refractory pain, providing real-world insights into medicinal cannabis’ therapeutic potential.
Pre-pregnancy migraine diagnosis, medication use, and spontaneous abortion: a prospective cohort study
Authors: Crowe Holly M. , Wesselink Amelia K. , Wise Lauren A. , Jick Susan S. , Rothman Kenneth J. , Mikkelsen Ellen M. , Sørensen Henrik T. , Hatch Elizabeth E.
Published: December 2022

Background

Migraine is common among females of reproductive age (estimated prevalence:17–24%) and may be associated with reproductive health through underlying central nervous system excitability, autoimmune conditions, and autonomic dysfunction. We evaluated the extent to which pre-pregnancy migraine diagnosis and medication use are associated with risk of spontaneous abortion (SAB).

Methods

We analyzed data from a preconception study of pregnancy planners (2013–2021). Eligible participants self-identified as female, were aged 21–45 years, resided in the USA or Canada, and conceived during follow-up (n = 7890). Participants completed baseline and bimonthly follow-up questionnaires for up to 12 months or until a reported pregnancy, whichever occurred first. Pregnant participants then completed questionnaires during early (~ 8–9 weeks) and late (~ 32 weeks) gestation. We defined migraineurs as participants who reported a migraine diagnosis or use of a medication to treat migraine. Preconception questionnaires elicited migraine medication use during the past 4 weeks, and SAB on follow-up and pregnancy questionnaires. We used Cox regression models with gestational weeks as the time scale to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations among preconception migraine, migraine medication use, and SAB, controlling for potential demographic, medical, and lifestyle confounders.

Results

Nineteen percent of study pregnancies ended in SAB. History of migraine before conception was not appreciably associated with SAB risk (HR = 1.03, 95% CI: 0.91–1.06). Use of any migraine medication was associated with a modest increase in SAB risk overall (HR = 1.14, 95% CI: 0.96–1.36). We observed the greatest increase in risk among those taking migraine medications daily (HR = 1.38, 95% CI: 0.81–2.35) and those taking prescription migraine prophylaxis (HR = 1.43, 95% CI: 0.72–2.84) or combination analgesic and caffeine medications (HR = 1.42, 95% CI: 0.99–2.04).

Conclusions

Migraine medication use patterns suggesting greater underlying migraine severity were associated with increased risk of SAB. This research adds to the limited information available on the reproductive effects of migraine.
Provider and patient perspectives to improve lung cancer screening with low-dose computed tomography 5 years after Medicare coverage: a qualitative study
Authors: Martinez Meghan C. , Stults Cheryl D. , Li Jiang
Published: December 2022

Lung cancer remains the leading cause of cancer-related deaths for both men and women in the U.S., yet uptake of preventive cancer screening for people with a heavy smoking history remains low. This qualitative interview study of patients and providers from a large ambulatory healthcare system in northern and central California reevaluated perceptions of lung cancer screening with low-dose computed tomography (LCS-LDCT) 5 years after Medicare coverage. We hypothesized that initial attitudes and barriers within the LCS-LDCT discussion and process have likely persisted with little change since Medicare coverage and we sought to understand how these attitudes continue to impact effective implementation and uptake of screening with the goal of identifying opportunities for improvement. Between 2019 and 2020, interviews were conducted with 10 primary care physicians and 30 patients using semi-structured interview guides. Providers and patients expressed that they were both aware and supportive of LCS-LDCT, a change from earlier studies, but continued to report little to no shared decision making nor use of a decision aid despite being Medicare requirements. Creation and incorporation of a single-page, graphic heavy decision aid may help address many of the persistent barriers around implementation for both providers and patients. Given recently expanded guidelines from the U.S. Preventive Services Task Force for LCS-LDCT screening and their coverage by Medicare, it is important for healthcare systems to understand provider and patient perceptions to further improve the implementation of LCS-LDCT to ultimately reduce lung cancer mortality.
Association of low-carbohydrate-diet score and cognitive performance in older adults: National Health and Nutrition Examination Survey (NHANES)
Authors: Wang Huiqin , Lv Yan , Ti Gang , Ren Gang
Published: December 2022

Background

To investigate the association between low-carbohydrate-diet (LCD) score and cognitive performance based on a nationally representative sample aged ≥ 60 years from National Health and Nutrition Examination Survey (NHANES) database.

Methods

This cross-sectional study included 2,537 eligible older adults from the NHANES database 2011–2014. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) word learning subtest, Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST) were used to assess the cognitive performance. All participants were categorized into the low and normal cognitive performance groups. The univariate and multivariate logistic regression analyses were utilized to evaluate the association of LCD score with cognitive performance. Stratified analyses based on age, body mass index (BMI), gender, marital status, education level was conducted.

Results

After adjusting age, education level, marital status, household income, history of diabetes, history of hypertension, history of congestive heart failure, history of coronary heart disease, history of heart disease, history of stroke, magnesium and the using of psychotropic medication, LCD score was correlated with the CERAD word learning subtest. The associations between LCD score and AFT, DSST were not statistically significant. Moreover, LCD score was also related to cognitive performance among individuals who were aged < 65 years or BMI 25–30 kg/m2or was married/separated, or had an education level of high school or above.

Conclusion

The adherences to LCD might be associated with the risk of cognitive performance among older adults. Further large-scale cohort studies are needed to test the causal relationship of LCD and cognitive performance.
Treatment outcomes of cetuximab-containing regimen in locoregional recurrent and distant metastatic head and neck squamous cell carcinoma
Authors: Chen Tien-Hua , Pan Yi-Ying , Lee Tsung-Lun , Wang Ling-Wei , Tai Shyh-Kuan , Chu Pen-Yuan , Lo Wen-Liang , Wu Cheng-Hsien , Yang Muh-Hwa , Chang Peter Mu-Hsin
Published: December 2022

Background

Recurrent/ metastatic squamous cell carcinoma of head and neck (R/M SCCNH) is still a difficult-to-treat disease with poor clinical outcomes and limited treatment choices. In view of locoregional recurrent versus distant metastatic SCCHN, the therapeutic efficacy of cetuximab-containing regimen and relevant prognostic factors for these two groups may be different. Thus, the aim of this study was to explore the treatment outcomes of cetuximab-containing regimen in locoregional recurrent and distant metastatic SCCHN groups, and to identify clinical factors correlated with better survival outcomes.

Methods

From 2016 to 2020, patients with R/M SCCHN who received cetuximab-containing regimen in our institute were enrolled in this study. Clinical outcomes including overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR) were evaluated in both locoregional recurrence and distant metastasis groups. Exploratory analysis were conducted to investigate major clinical features associated with better outcomes.

Results

A total of 107 patients with locoregional recurrent SCCHN (N = 66) and distant metastatic SCCNH (N = 41) who received cetuximab-containing regimen were enrolled in this retrospective study. Patients with oral cavity cancer and patients with disease recurrence within 6 months after radiation therapy were significantly increased in locoregional recurrence group. The median OS (15.6 vs. 9.7 months, P = 0.004) and PFS (5.8 months vs. 4.2 months, P = 0.008) were longer in locoregional recurrence group than in distant metastasis group. In multivariate analysis of clinical features, locoregional recurrence was still an important risk factor associated with better OS (Hazzard ratio (HR) 0.64, p = 0.06) and PFS (HR 0.67, p = 0.075). In addition, a trend of favorable disease control rate (DCR; 62.5% vs. 45.0%, p = 0.056) was noted in locoregional recurrence group. In locoregional recurrence group, prior salvage surgery was associated with longer OS (HR = 0.24, P = 0.008) and PFS (HR = 0.30, P = 0.005).

Conclusion

SCCHN with locoregional recurrence is associated with better disease control and survival outcomes comparing to distant metastatic SCCHN when treated with cetuximab-containing regimen. Salvage surgery for locoregional recurrence may further improves clinical outcome.
Videoconferencing-delivered psychological intervention for the treatment of COVID-19 related psychological distress in University students: study protocol for a randomised controlled trial in India
Authors: Keyan Dharani , Dawson Katie , Azevedo Suzanna , Yadav Srishti , Choi-Christou Jasmine , Maliakkal Deepthi J. , Pillai Mohan K. , Thomas Elizabeth , George Tony S , Bryant Richard A.
Published: December 2022

Background

The mental health impacts of the COVID-19 pandemic have been profound. This paper outlines the study protocol for a trial that tests the efficacy of a brief group-based psychological intervention (Coping with COVID; CWC), relative to Supportive Counselling, to reduce distress associated with COVID-19 in a young adult population in Bangalore, India.

Methods

A single-blind, parallel, randomized controlled trial will be carried out via video conferencing in a small group format. Following informed consent, adults that screen positive for levels of psychological distress (Kessler 10 (K-10 score ≥ 20) and have access to a videoconferencing platform will be randomised to an adapted version of CWC (n = 90) or Supportive Counselling (SC) (n = 90). The primary outcome will be reduction in psychological distress including anxiety and depression at 2-months post treatment. Secondary outcomes include worry, positive wellbeing, and stress in relation to COVID-19.

Discussion

This treatment trial will assess whether CWC will result in reduced distress relative to Supportive Counselling in a young adult population in Bangalore, India. This study will yield important insights into the role of nonspecific factors versus the intervention’s components in impacting COVID-19 related distress.

Trial registration

This trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12621001064897).

Ethics and dissemination

Ethics approval has been obtained from the participating institution, CHRIST University in Bangalore. Results of the trial will be submitted for publication in peer reviewed journals and findings presented at scientific conferences and to key service providers and policy makers.
High reliability and accuracy of dynamic magnetic resonance imaging in the diagnosis of cervical Spondylotic myelopathy: a multicenter study
Authors: Park Wook-Tae , Min Woo-Kie , Shin Ji-Hoon , Ko Sang-Bong , Son Eun-Seok , Kim Jiyoun , Jang Jihoon , Lee Gun Woo
Published: December 2022

Background

Cervical spondylotic myelopathy (CSM) is a critical condition that results in significant neurologic deterioration. An accurate diagnosis is essential for determining its outcome and prognosis. The pathology is strongly associated with dynamic factors; therefore, dynamic magnetic resonance (MR) image could be crucial to accurately detect CSM. However, very few studies have evaluated the reliability and accuracy of dynamic MR in CSM. In this study, we aimed to compare intra- and interobserver reliabilities and accuracy of dynamic MR in detecting CSM using sagittal MR scans of the neck in the flexed, neutral, and extended position.

Methods

Out of 131 patients who underwent surgical treatments for CSM, 107 were enrolled in this study. The patient underwent three-types of sagittal MR scans that were obtained separately in different neck positions (neutral, flexion, and extension postures). The MR scans of the cervical spine were evaluated independently by three spine professionals, on the basis of tabled questionnaires. For accuracy, we performed a receiver operator characteristic analysis, and the overall discriminating ability of each method was measured by calculating the area under the ROC curve. The Cohen’s kappa coefficient and the Fleiss-generalized kappa coefficient was used to the inter- and intra-observer reliabilities.

Results

The intraobserver reliability (using the Cohen’s kappa coefficient) and interobserver reliability (using the Fless kappa coefficient) were respectively 0.64 and 0.52 for the neutral sagittal MR. The accuracy of neutral sagittal MR in detecting CSM was 0.735 (95% CI, 0.720 to 0.741) while that of extension sagittal MRI was 0.932 (96% CI, 0.921 to 0.948).

Conclusions

Dynamic MR significantly showed better diagnostic reliability and accuracy in detecting CSM compared to conventional MR. In particular, extension MR scans could provide a more accurate diagnosis than other images.
Assessing self-reported core competencies of public health practitioners in Lebanon using the WHO-ASPHER validated scale: a pilot study
Authors: Iskandar Katia , Haddad Chadia , Hajj Aline , Sacre Hala , Zeenny Rony M. , Akel Marwan , Salameh Pascale
Published: December 2022

Background

The World Health Organization and the Association of Schools of Public Health in the European Region recommend the self-assessment of public health core competencies to strengthen the proficiency of the public health workforce and prepare them for future challenges. A framework for these competencies is lacking and highly needed in Lebanon. This study aims to validate the WHO-ASPHER self-declared scale and evaluate the perceived competency level of the different categories of Lebanese public health practitioners.

Methods

This population-based cross-sectional study conducted online between July and September 2021 involved 66 public health practitioners who graduated from different universities in Lebanon. Data were collected using the snowball technique via a self-report questionnaire that assessed public health proficiency, categorized into 1) content and context, 2) relationship and interactions, and 3) performance and achievements. The rotated component matrix technique was used to test the construct validity of the scales. Bivariate and multivariate analyses were performed after ensuring the adequacy of the models. Significance was set at a p-value < 0.05.

Results

The factor analysis for scale domains showed that the Barlett test sphericity was significant (p < 0.001), high loadings of items on factors, and Cronbach’s alpha values of more than 0.9 in all three categories, showing an appropriate scale validity and reliability. The perceived level of competencies was significantly different between public health professionals and other health professionals with public health activities. All respondents scored low in most public health categories, mainly science and practice.

Conclusion

Data findings showed variability of self-declared gaps in knowledge and proficiency, suggesting the need to review the national public health education programs. Our study offers a valuable tool for academia and public health professionals to self-assess the level of public health proficiency and guide continuous education needs for professional development.
The impact of the transition from flipped classroom to online lectures on learning outcomes and student satisfaction in a rehabilitation medicine clerkship during the COVID-19 pandemic
Authors: Khanittanuphong Phichamon , Iamthanaporn Khanin , Bvonpanttarananon Jongdee
Published: December 2022

Background

The flipped classroom (FC) is a well-known active learning module that activates the prior knowledge of students and promotes their cognitive skills during in-class activities. However, most on-site teaching during the COVID-19 pandemic had to be conducted online. The FC in our rehabilitation medicine clerkship curriculum was also shifted to online asynchronous lectures (OLs), without real-time interactions. There is no previous comparison of effectiveness between these two methods. Therefore, this study aimed to compare learning outcomes and student satisfaction in both FC and OL models.

Methods

The study design was a historically controlled study. A physical modality was chosen for the content. The FC group (n = 233), in the academic years 2018 and 2019, was assigned to perform a pre-class activity consisting of reading study materials. Thereafter, the in-class activity comprised a small-group case-based discussion. The OL group (n = 240) in the academic years 2020 and 2021 followed an online model during the COVID-19 lockdown. They were also asked to read the online materials and then watch a self-paced recorded lecture video on Learning Management Systems. The learning outcomes, including their multiple-choice questions (MCQs) scores, final exam scores, grade points, and letter grades, were evaluated. Their overall course satisfaction ratings were also collected.

Results

The OL group had an overall higher MCQ score for the physical modality portion than the FC group (p = 0.047). The median (lower quartile, upper quartile) of the total 50-MCQ scores were 34 (31, 37) in the OL group and 33 (29, 36) in the FC group (p = 0.007). The median final exam scores of the OL and FC groups were 69.5 and 68.3, respectively (p = 0.026). The median grade points and the letter grades were not significantly different between the groups. The proportions of satisfaction were significantly higher in the FC group than in the OL group.

Conclusions

The OL group revealed significantly higher learning outcomes than the FC group. However, the FC group showed more satisfaction with interactivity than the OL group. The authors are of the view that a combination of both FC and OL methods will likely result in better outcomes.
Discussion on machine learning technology to predict tacrolimus blood concentration in patients with nephrotic syndrome and membranous nephropathy in real-world settings
Authors: Yuan Weijia , Sui Lin , Xin Haili , Liu Minchao , Shi Huayu
Published: December 2022

Background

Given its narrow treatment window, high toxicity, adverse effects, and individual differences in its use, we collected and sorted data on tacrolimus use by real patients with kidney diseases. We then used machine learning technology to predict tacrolimus blood concentration in order to provide a basis for tacrolimus dose adjustment and ensure patient safety.

Methods

This study involved 913 hospitalized patients with nephrotic syndrome and membranous nephropathy treated with tacrolimus. We evaluated data related to patient demographics, laboratory tests, and combined medication. After data cleaning and feature engineering, six machine learning models were constructed, and the predictive performance of each model was evaluated via external verification.

Results

The XGBoost model outperformed other investigated models, with a prediction accuracy of 73.33%, F-beta of 91.24%, and AUC of 0.5531.

Conclusions

Through this exploratory study, we could determine the ability of machine learning to predict TAC blood concentration. Although the results prove the predictive potential of machine learning to some extent, in-depth research is still needed to resolve the XGBoost model’s bias towards positive class and thereby facilitate its use in real-world settings.
Emerging roles of mechanosensitive ion channels in acute lung injury/acute respiratory distress syndrome
Authors: Jia Qi , Yang Yiyi , Chen Xiangdong , Yao Shanglong , Hu Zhiqiang
Published: December 2022

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a devastating respiratory disorder with high rates of mortality and morbidity, but the detailed underlying mechanisms of ALI/ARDS remain largely unknown. Mechanosensitive ion channels (MSCs), including epithelial sodium channel (ENaC), Piezo channels, transient receptor potential channels (TRPs), and two-pore domain potassium ion (K2P) channels, are highly expressed in lung tissues, and the activity of these MSCs can be modulated by mechanical forces (e.g., mechanical ventilation) and other stimuli (e.g., LPS, hyperoxia). Dysfunction of MSCs has been found in various types of ALI/ARDS, and MSCs play a key role in regulating alveolar fluid clearance, alveolar epithelial/endothelial barrier function, the inflammatory response and surfactant secretion in ALI/ARDS lungs. Targeting MSCs exerts therapeutic effects in the treatment of ALI/ARDS. In this review, we summarize the structure and functions of several well-recognized MSCs, the role of MSCs in the pathogenesis of ALI/ARDS and recent advances in the pharmacological and molecular modulation of MSCs in the treatment of ALI/ARDS. According to the current literature, targeting MSCs might be a very promising therapeutic approach against ALI/ARDS.
Increased expression of miR-194-5p through the circPVRL3/miR-194-5p/SOCS2 axis promotes proliferation and metastasis in pancreatic ductal adenocarcinoma by activating the PI3K/AKT signaling pathway
Authors: Chi Bojing , Zheng Yao , Xie Fuming , Fu Wen , Wang Xianxing , Gu Jianyou , Yang Jiali , Yin Jingyang , Cai Lei , Tang Peng , Li Jianbo , Guo Shixiang , Wang Huaizhi
Published: December 2022

Background

MicroRNAs (miRNAs), as an indispensable type of non-coding RNA (ncRNA), participate in diverse biological processes. However, the specific regulatory mechanism of certain miRNAs in pancreatic ductal adenocarcinoma (PDAC) remains unclear.

Methods

The expression of miR-194-5p in PDAC tissue microarray and cell lines were detected by RNA-scope and real-time quantitative PCR (RT-qPCR). The function of proliferation and migration carried by miR-194-5p in vitro and vivo was observed by several functional experiments. Informatics methods and RNA sequencing data were applied to explore the target of miR-194-5p and the upstream circular RNA (circRNA) of miR-194-5p. RNA-binding protein immunoprecipitation (RIP) assay and dual-luciferase reporter assay confirmed the relationships between miR-194-5p and SOCS2 or miR-194-5p and circPVRL3. The proliferation and migration abilities of SOCS2 and circPVRL3 were accessed by rescue experiments.

Results

In this study, we aimed to clarify the molecular mechanisms of miR-194-5p, which has critical roles during PDAC progression. We found that the expression of miR-194-5p was significantly upregulated in PDAC tissue compared to tumor-adjacent tissue and was highly related to age and nerve invasion according to RNAscope and RT‒qPCR. Overexpression of miR-194-5p accelerated the cell cycle and enhanced the proliferation and migration processes according to several functional experiments in vitro and in vivo. Specifically, circPVRL3, miR-194-5p, and SOCS2 were confirmed to work as competing endogenous RNAs (ceRNAs) according to informatics methods, RIP, and dual-luciferase reporter assays. Additionally, the rescue experiments confirmed the relationship among miR-194-5p, circPVRL3, and SOCS2 mRNA. Finally, the circPVRL3/miR-194-5p/SOCS2 axis activates the PI3K/AKT signaling pathway to regulate the proliferation and metastasis of PDAC.

Conclusion

Our findings indicated that an increase of miR-194-5p caused by circPVRL3 downregulation stimulates the PI3K/AKT signaling pathway to promote PDAC progression via the circPVRL3/miR-194-5p/SOCS2 axis, which suggests that the circPVRL3/miR-194-5p/SOCS2 axis may be a potential therapeutic target for PDAC patients.
Morphologic design of nanostructures for enhanced antimicrobial activity
Authors: Sayed Fatma Al-Zahraa , Eissa Noura G. , Shen Yidan , Hunstad David A. , Wooley Karen L. , Elsabahy Mahmoud
Published: December 2022

Despite significant progress in synthetic polymer chemistry and in control over tuning the structures and morphologies of nanoparticles, studies on morphologic design of nanomaterials for the purpose of optimizing antimicrobial activity have yielded mixed results. When designing antimicrobial materials, it is important to consider two distinctly different modes and mechanisms of activity—those that involve direct interactions with bacterial cells, and those that promote the entry of nanomaterials into infected host cells to gain access to intracellular pathogens. Antibacterial activity of nanoparticles may involve direct interactions with organisms and/or release of antibacterial cargo, and these activities depend on attractive interactions and contact areas between particles and bacterial or host cell surfaces, local curvature and dynamics of the particles, all of which are functions of nanoparticle shape. Bacteria may exist as spheres, rods, helices, or even in uncommon shapes (e.g., box- and star-shaped) and, furthermore, may transform into other morphologies along their lifespan. For bacteria that invade host cells, multivalent interactions are involved and are dependent upon bacterial size and shape. Therefore, mimicking bacterial shapes has been hypothesized to impact intracellular delivery of antimicrobial nanostructures. Indeed, designing complementarities between the shapes of microorganisms with nanoparticle platforms that are designed for antimicrobial delivery offers interesting new perspectives toward future nanomedicines. Some studies have reported improved antimicrobial activities with spherical shapes compared to non-spherical constructs, whereas other studies have reported higher activity for non-spherical structures (e.g., rod, discoid, cylinder, etc.). The shapes of nano- and microparticles have also been shown to impact their rates and extents of uptake by mammalian cells (macrophages, epithelial cells, and others). However, in most of these studies, nanoparticle morphology was not intentionally designed to mimic specific bacterial shape. Herein, the morphologic designs of nanoparticles that possess antimicrobial activities per se and those designed to deliver antimicrobial agent cargoes are reviewed. Furthermore, hypotheses beyond shape dependence and additional factors that help to explain apparent discrepancies among studies are highlighted.

Graphical Abstract
Everywhere and for everyone: proportionate universalism as a framework for equitable access to community drug checking
Authors: Wallace Bruce , van Roode Thea , Burek Piotr , Hore Dennis , Pauly Bernadette
Published: December 2022

Background

Illicit drug overdoses have reached unprecedented levels, exacerbated by the COVID-19 pandemic. Responses are needed that address the increasingly potent and unpredictable drug supply with better reach to a wide population at risk for overdose. Drug checking is a potential response offered mainly within existing harm reduction services, but strategies are needed to increase reach and improve equitable delivery of drug checking services.

Methods

The purpose of this qualitative study was to explore how to extend the reach of drug checking services to a wide population at risk of overdose. We conducted 26 in-depth interviews with potential service users to identify barriers to service use and strategies to increase equitable delivery of drug checking services. Our analysis was informed by theoretical perspectives on equity, and themes were developed relevant to equitable delivery through attention to quality dimensions of service use: accessibility, appropriateness, effectiveness, safety, and respect.

Results

Barriers to equitable service delivery included criminalization and stigma, geographic and access issues, and lack of cultural appropriateness that deter service use for a broad population with diverse needs. Strategies to enhance equitable access include 1ocating services widely throughout communities, integrating drug checking within existing health care services, reframing away from risk messaging, engaging peers from a broad range of backgrounds, and using discrete methods of delivery to help create safer spaces and better reach diverse populations at risk for overdose.

Conclusions

We propose proportionate universalism in drug checking as a guiding framework for the implementation of community drug checking as an equity-oriented harm reduction intervention and as a population health response. Both a universal equity-oriented approach and multiple tailored approaches are required to facilitate drug checking services that maximize reach and appropriateness to respond to diverse needs.
Survival analysis and prognostic factors of the carcinoma of gallbladder
Authors: Feroz Zainab , Gautam Priyanka , Tiwari Sonia , Shukla Girish C. , Kumar Munish
Published: December 2022

Background

The present study aims to evaluate the survival status of patients with gallbladder cancer (GBC) and explore the prognostic factors for the improvement and preventions.

Methods

The study consists of 176 patients with clinically diagnosed gallbladder cancer; the study was conducted between 2019 and 2021 registered at Kamala Nehru Memorial Cancer Hospital, Prayagraj, India. The survival rates were analyzed by the Kaplan-Meier method; survival rate difference was analyzed by log-rank test, prognosis factors; and hazard ratio for mortality outcomes was estimated using Cox regression method.

Results

The overall median survival time of patients was 5 months with the 1-year, 2-year, and 3-year survival rates of 24.4%, 8.5%, and 4.5%, respectively. The 3-year survival for patients with jaundice was 2.9%, liver infiltration (4.2%), gallstones (0.8%), and with advanced tumor grade (1.4%). Elderly GBC patients had lower survival rates (3.8%), while the 3-year overall survival for patients residing in urban areas dropped to zero. No patients in the tumor stage (T3/T4) and with distance metastasis stage survived in 3 years, while only 1.1% of patients with advanced nodal stage survived. On receiving surgery and radiation therapy, the 3-year survival rate increased to 19.5% and 35%, respectively. The results of multivariate analysis showed that urban region (HR = 1.568, p = 0.040), gallstone or not (1.571, p = 0.049), N stage (HR = 1.468, p = 0.029), and M stage (HR = 2.289, p < 0.0001) were independent risk factors for prognosis, while surgery or not (HR = 0.573, p = 0.030) was the protective factor for the prognosis of GBC.

Conclusion

The overall survival of GBC in the Gangetic belt is poor. The geographical region of patients, gallstones, and N and M stage was the risk factors for prognosis, while surgery or not was the protective factor for the prognosis of GBC.
LINC00629 protects osteosarcoma cell from ER stress-induced apoptosis and facilitates tumour progression by elevating KLF4 stability
Authors: Wang Yuan , Zheng Shuo , Han Jian , Li Na , Ji Renchen , Li Xiaodong , Han Chuanchun , Zhao Wenzhi , Zhang Lu
Published: December 2022

Background

Escaping from ER stress-induced apoptosis plays an important role in the progression of many tumours. However, its molecular mechanism in osteosarcoma remains incompletely understood.

Methods

The molecular mechanism was investigated using RNA sequencing, qRT–PCR and Western blot assays. The relationship between LINC00629 and KLF4 was investigated using RNA pulldown and ubiquitylation assays. The transcriptional regulation of laminin subunit alpha 4 (LAMA4) by KLF4 was identified using bioinformatic analysis, a luciferase assay, and a chromatin immunoprecipitation assay.

Results

Here, we demonstrated that LINC00629 was increased under ER stress treatment. Elevated LINC00629 inhibited ER stress-induced osteosarcoma cell apoptosis and promoted clonogenicity and migration in vitro and in vivo. Further mechanistic studies indicated that LINC00629 interacted with KLF4 and suppressed its degradation, which led to a KLF4 increase in osteosarcoma. In addition, we also found that KLF4 upregulated LAMA4 expression by directly binding to its promoter and that LINC00629 inhibited ER stress-induced apoptosis and facilitated osteosarcoma cell clonogenicity and metastasis by activating the KLF4-LAMA4 pathway.

Conclusion

Collectively, our data indicate that LINC00629 is a critical long noncoding RNA (lncRNA) induced by ER stress and plays an oncogenic role in osteosarcoma cell by activating the KLF4-LAMA4 axis.
Introducing insect- or plant-based dinner meals to families in Denmark: study protocol for a randomized intervention trial
Authors: Maya Cassandra , Cunha Luís Miguel , de Almeida Costa Ana Isabel , Veldkamp Teun , Roos Nanna
Published: December 2022

Background

Plant- and insect-based foods are promising alternative protein sources. Previous studies have shown that introducing plant-based foods to the diet can reduce meat intake, but no such intervention has explored the effects of insect-based foods.

Methods

This study aims to integrate alternative proteins to main meals of 80 Danish families through a 6-week two-arm randomized intervention trial to investigate acceptance, consumption, and potential for meat replacement. The primary outcome is the replacement of dietary meat protein with plant- or insect-based protein from the intervention foods assessed through change in daily meat protein intake, proportion of meat protein to total protein intake, and counts of dinner meals with meat and intervention products.

Conclusion

The results of this study will contribute to research in alternative proteins and explore the effects of long-term exposure of meat replacement.

Trial registration

ClinicalTrials.gov: NCT05156853. Registered 24 December 2021