bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of vitamin D in individuals with periodontitis: an updated systematic review and meta-analysis
Authors: Liang Fangfang , Zhou Yuanzhu , Zhang Zhenyu , Zhang Zheng , Shen Jing
Published: June 2023

Background

There are differences in vitamin D levels between periodontitis and healthy individuals, but the effect of vitamin D on periodontitis is controversial. The purpose of this Meta-analysis is twofold: (1) compare vitamin D levels in individuals with or without periodontitis; (2) assess the effects of vitamin D supplementation during scaling and root planing (SRP) on periodontal clinical parameters in individuals with periodontitis.

Methods

A systematic search was conducted in five databases (PubMed, Web of Science, MEDLINE, EMBASE, and Cochrane library), published from the database inception to 12 September 2022. The Cochrane Collaboration Risk of bias (ROB) assessment tool, the risk of bias in non-randomized studies of intervention (ROBINS-I) tool, the Newcastle–Ottawa Quality Assessment Scale (NOS), and Agency for Healthcare Quality and Research (AHRQ) were used to evaluate randomized controlled trial (RCT), non-RCT, case–control study, and cross-sectional study, respectively. Statistical analysis was performed using RevMan 5.3 and Stata 14.0 software, with weighted mean difference (WMD), standardized mean difference (SMD) and 95% confidence intervals (CI) as the effect measures, and heterogeneity was tested by subgroup analysis, sensitivity analysis, Meta-regression.

Results

A total of 16 articles were included. The results of Meta-analysis showed that periodontitis was associated with lower serum vitamin D levels compared to normal population (SMD = -0.88, 95%CI -1.75 ~ -0.01, P = 0.048), while there was no significant difference in serum or saliva 25(OH)D levels between periodontitis and normal population. Additionally, the Meta-analysis showed that SRP + vitamin D and SRP alone had a statistically significant effect on serum vitamin D levels in individuals with periodontitis (SMD = 23.67, 95%CI 8.05 ~ 32.29, P = 0.003; SMD = 1.57, 95%CI 1.08 ~ 2.06, P < 0.01). And SRP + vitamin D could significantly reduce clinical attachment level compared to SRP alone (WMD = -0.13, 95%CI -0.19 ~ -0.06, P < 0.01), but had no meaningful effect on probing depth, gingival index, bleeding index, respectively.

Conclusion

The evidence from this Meta-analysis suggests that the serum vitamin D concentration of individuals with periodontitis is lower than that of normal people, and SRP along with vitamin D supplementation has been shown to play a significant role in improving periodontal clinical parameters. Therefore, vitamin D supplementation as an adjuvant to nonsurgical periodontal therapy has a positive impact on the prevention and treatment of periodontal disease in clinical practice.
The association of intimate Partner violence and decision making power on nutritional status of married women in Ethiopia: a multilevel mixed-effect analysis
Authors: Tiruneh Fentanesh Nibret , Ntenda Peter Austin Morton , Tamir Tinebeb
Published: June 2023

Background

A growing body of research has established a link between intimate partner violence (IPV) and decision-making autonomy on women’s mental, physical, and reproductive health consequences, as well as child nutritional status. However, there is a scarcity of research on the effects of IPV and decision-making autonomy on women’s nutritional status. To date, no research has been conducted in Ethiopia to investigate the impact of IPV and decision-making autonomy on women’s nutritional status. Therefore, the purpose of this study was to investigate the relationship between IPV and decision-making power at both the individual and community levels on women’s nutritional status.

Methods

We analyzed data from the 2016 Ethiopian demographic and health survey. Our study focused on 3,660 married non-pregnant women of reproductive age. We used the chi-squared test and spearman correlation coefficients for bivariate analysis. The relationship between IPV and decision making power with nutritional status was evaluated using multilevel binary logistic regression models while controlling other determinants.

Results

Around 28% of women reported at least one of the four types of IPV. Approximately 32% of women had no decision-making power at home. About 27.1% of women were underweight (BMI < 18.5), while 10.6% were overweight/obese (BMI ≥ 25). Women who had sexual IPV had a higher chance of being underweight (AOR = 2.97; 95% CI: 2.02–4.38) than women who had no sexual IPV. While women who had decision-making power at home were at lower odds of being underweight (AOR = 0.83; 95% CI: 0.69–0.98) than their counterparts. The findings also revealed a negative relationship between being overweight/obese and community-level women’s decision-making autonomy (AOR = 0.75; 95% CI 0.34–0.89).

Conclusions

Our findings show the presence of a significant association between IPV & decision-making autonomy with women’s nutritional status. Therefore, effective policies and programs to end violence against women and encourage women to participate in decision-making are required. This will help to improve the nutritional status of women as well as the nutritional outcomes of their families. This study suggests that efforts to achieve Sustainable Development Goal (SDG5) may have an impact on other SDGs particularly SDG2.
Reactions and perspectives of medical students on workplace violence during clinical training in Ardabil, Iran, 2020
Authors: Sadeghi Saber , Shadman Atefeh , Mardi Afrouz , Hackett Daniel
Published: June 2023

Background

Workplace violence continues among medical students in training. This study aimed to determine the reactions and perspectives of medical students against workplace violence during clinical training in Ardabil University of Medical Sciences in Iran, 2020.

Materials

This descriptive cross-sectional study was conducted on 300 medical students from April to March 2020, in the Ardabil university hospitals. Students with at least one year training in the university hospitals were eligible to participate. Data was collected via questionnaires administered in the health ward. Data was analyzed through SPSS 23 software.

Results

Most respondents had experienced workplace violence in the form of verbal (63%), physical (25.7%), racial (23%) and sexual (3%) violence during clinical training. Men were the aggressors during violence of a physical (80.5%), verbal (69.8%), racial (76.8%) and sexual (100%) nature (p < 0.001). When encountered with violence, 36% of the respondents did not take any action and 82.7% of respondents failed to report the incident. For 67.8% of respondents that did not report of violence incident, this procedure was deemed pointless, while 27% of respondents considered the violent incident insignificant. The main reason for workplace violence was perceived to be a lack of awareness of people about staff duties (67.3% of respondents). According to 92.7% of respondents personnel training was the most important factor in preventing workplace violence.

Conclusions

The findings suggest that the majority of medical students during clinical training in Ardabil Iran (2020) have been exposed to workplace violence. However, most students did not take any action or report the incident. Targeted personnel training, increase awareness of workplace violence, and encouragement of reporting these incidents should be promoted to reduce violence to medical students.
Evaluating machine learning algorithms to Predict 30-day Unplanned REadmission (PURE) in Urology patients
Authors: Welvaars Koen , van den Bekerom Michel P. J. , Doornberg Job N. , van Haarst Ernst P. ,   OLVG Urology Consortium, van der Zee J. A. , van Andel G. A. , Lagerveld B. W. , Hovius M. C. , Kauer P. C. , Boevé L. M. S.
Published: June 2023

Background

Unplanned hospital readmissions are serious medical adverse events, stressful to patients, and expensive for hospitals. This study aims to develop a probability calculator to predict unplanned readmissions (PURE) within 30-days after discharge from the department of Urology, and evaluate the respective diagnostic performance characteristics of the PURE probability calculator developed with machine learning (ML) algorithms comparing regression versus classification algorithms.

Methods

Eight ML models (i.e. logistic regression, LASSO regression, RIDGE regression, decision tree, bagged trees, boosted trees, XGBoost trees, RandomForest) were trained on 5.323 unique patients with 52 different features, and evaluated on diagnostic performance of PURE within 30 days of discharge from the department of Urology.

Results

Our main findings were that performances from classification to regression algorithms had good AUC scores (0.62–0.82), and classification algorithms showed a stronger overall performance as compared to models trained with regression algorithms. Tuning the best model, XGBoost, resulted in an accuracy of 0.83, sensitivity of 0.86, specificity of 0.57, AUC of 0.81, PPV of 0.95, and a NPV of 0.31.

Conclusions

Classification models showed stronger performance than regression models with reliable prediction for patients with high probability of readmission, and should be considered as first choice. The tuned XGBoost model shows performance that indicates safe clinical appliance for discharge management in order to prevent an unplanned readmission at the department of Urology.
Old-age mental telehealth services at primary healthcare centers in low- resource areas in Greece: design, iterative development and single-site pilot study findings
Authors: Politis Antonios , Vorvolakos Theofanis , Kontogianni Evaggelia , Alexaki Maria , Georgiou Eleni-Zacharoula , Aggeletaki Eleutheria , Gkampra Maria , Delatola Maria , Delatolas Antonis , Efkarpidis Apostolos , Thanopoulou Elissavet , Kostoulas Konstantinos , Naziri Vassiliki , Petrou Anna , Savvopoulou Kalliopi , Siarkos Kostas , Soldatos Rigas Filippos , Stamos Vasileios , Nguyen Kim-Huong , Leroi Iracema , Kiosses Dimitrios , Tsimpanis Konstantinos , Alexopoulos Panagiotis
Published: June 2023

Background

Even though communities in low-resource areas across the globe are aging, older adult mental and cognitive health services remain mainly embedded in tertiary- or secondary hospital settings, and thus not easily accessible by older adults living in such communities. Here, the iterative development of INTegRated InterveNtion of pSychogerIatric Care (INTRINSIC) services addressing the mental and cognitive healthcare needs of older adults residing in low-resource areas of Greece is depicted.

Methods

INTRINSIC was developed and piloted in three iterative phases: (i) INTRINSIC initial version conceptualization; (ii) A 5-year field testing in Andros island; and (iii) Extending the services. The INTRINSIC initial version relied on a digital platform enabling videoconferencing, a flexible battery of diagnostic tools, pharmacological treatment and psychosocial support and the active involvement of local communities in service shaping.

Results

Ιn 61% of the 119 participants of the pilot study, new diagnoses of mental and/or neurocognitive disorders were established. INTRINSIC resulted in a significant reduction in the distance travelled and time spent to visit mental and cognitive healthcare services. Participation was prematurely terminated due to dissatisfaction, lack of interest or insight in 13 cases (11%). Based on feedback and gained experiences, a new digital platform, facilitating e-training of healthcare professionals and public awareness raising, and a risk factor surveillance system were created, while INTRINSIC services were extended to incorporate a standardized sensory assessment and the modified problem adaptation therapy.

Conclusion

The INTRINSIC model may be a pragmatic strategy to improve access of older adults with mental and cognitive disorders living in low-resource areas to healthcare services.
Factors associated to patients’ referral to public or private Covid-19 healthcare centers in Tabriz, Iran
Authors: Jafari Nasrin , Akbari Hossein , Sarbakhsh Parvin , Dorosti Abbasali , Khayatzadeh Simin , Mohammadpoorasl Asghar
Published: June 2023

Background

In Iran, tracking of patients and its associated data recording in private healthcare centers are poor, and thus a majority of patients suffering from Covid-19 are treated without any control on the isolation and quarantine processes. The present study aims to investigate the factors contributed to referral to private or public healthcare centers that provide Covid-19 care services.

Methods

This cross-sectional study was conducted from November 2021 to January 2022 in Tabriz, Iran. We invited a total of 258 and 202Covid-19 patients from governmental and private healthcare centers, respectively, to participate in the study by convenient sampling method. Applying a self-administered questionnaire, we collected data on the reason of referring to the healthcare centers, patient’s waiting time, quality of healthcare services received by the patients, patients’ level of satisfaction, accessibility, insurance coverage, perceived severity of the disease, and the level of staff compliance from health protocols. Logistic regression model was used for data analysis by using SPSS-26 software.

Results

Adjusted for other variables, higher socio-economic status (AOR (Adjusted Odds Ratio) = 6.64), older age (AOR = 1.02), referral of friends and family members (AOR = 1.52), shorter waiting time (AOR = 1.02) and higher satisfaction (AOR = 1.02) were contributed to referral to private centers. Better accessibility (AOR = 0.98) and wider insurance coverage (AOR = 0.99) were also contributed to referral to governmental centers.

Conclusion

Providing more appropriate insurance coverage by private healthcare centers, and promoting their level of accessibility seems to promote patients’ referral to such centers. Moreover, establishing an accurate system for recording patients’ information and follow up in private centers might promote the role of private healthcare centers in managing the overload of patients on healthcare system during such epidemics.
LSM2 is associated with a poor prognosis and promotes cell proliferation, migration, and invasion in skin cutaneous melanoma
Authors: Sun Xiaofang , Zhang Jianping , Hu Jiayuan , Han Qingdong , Ge Zili
Published: June 2023

Background

Skin cutaneous melanoma (SKCM) is an extremely malignant tumor that is associated with a poor prognosis. LSM2 has been found to be related to different types of tumors; however, its role in SKCM is poorly defined. We aimed to determine the value of LSM2 as a prognostic biomarker for SKCM.

Methods

The expression profile of LSM2 mRNA was compared between tumor and normal tissues in public databases, such as TCGA, GEO, and BioGPS. LSM2 protein expression was explored using immunohistochemistry (IHC) on a tissue microarray containing 44 SKCM tissues and 8 normal samples collected at our center. Kaplan-Meier analysis was performed to assess the prognostic value of LSM2 expression in patients with SKCM. SKCM cell lines with LSM2 knockdown were used to determine the effects of LSM2. Cell counting kit-8 (CCK8) and colony formation assays were conducted to assess cell proliferation, whereas wound healing and transwell assays were carried out to assess the migration and invasion abilities of SKCM cells.

Results

LSM2 was more highly expressed at the mRNA and protein levels in SKCM than that in normal skin. Moreover, elevated expression of LSM2 was associated with shorter survival time and early recurrence in patients with SKCM. The in vitro results revealed that the silencing of LSM2 in SKCM cells significantly inhibited cell proliferation, migration, and invasion.

Conclusion

Overall, LSM2 contributes to malignant status and poor prognosis in patients with SKCM and may be identified as a novel prognostic biomarker and therapeutic target.
Regulation of whole-transcriptome sequencing expression in COPD after personalized precise exercise training: a pilot study
Authors: Liu Panpan , Zhang Meilan , Gao Hongchang , Han Shaojun , Liu Jinming , Sun Xingguo , Zhao Lei
Published: June 2023

Background

Chronic obstructive pulmonary disease (COPD) is one of the world’s leading causes of death and a major chronic respiratory disease. Aerobic exercise, the cornerstone of pulmonary rehabilitation, improves prognosis of COPD patients; however, few studies have comprehensively examined the changes in RNA transcript levels and the crosstalk between various transcripts in this context. This study identified the expression of RNA transcripts in COPD patients who engaged in aerobic exercise training for 12 weeks, and further constructions of the possible RNAs networks were made.

Methods

Peripheral blood samples for all four COPD patients who benefited from 12 weeks of PR were collected pre- and post-aerobic exercises and evaluated for the expression of mRNA, miRNA, lncRNA, and circRNA with high-throughput RNA sequencing followed by GEO date validation. In addition, enrichment analyses were conducted on different expressed mRNAs. LncRNA-mRNA and circRNA-mRNA coexpression networks, as well as lncRNA-miRNA-mRNA and circRNA-miRNA-mRNA competing expression networks (ceRNAs) in COPD were constructed.

Results

We identified and analyzed the differentially expressed mRNAs and noncoding RNAs in the peripheral blood of COPD patients’ post-exercise. Eighty-six mRNAs, 570 lncRNAs, 8 miRNAs, and 2087 circRNAs were differentially expressed. Direct function enrichment analysis and Gene Set Variation Analysis showed that differentially expressed RNAs(DE-RNAs) correlated with several critical biological processes such as chemotaxis, DNA replication, anti-infection humoral response, oxidative phosphorylation, and immunometabolism, which might affect the progression of COPD. Some DE-RNAs were validated by Geo databases and RT-PCR, and the results were highly correlated with RNA sequencing. We constructed ceRNA networks of DE-RNAs in COPD.

Conclusions

The systematic understanding of the impact of aerobic exercise on COPD was achieved using transcriptomic profiling. This research offers a number of potential candidates for clarifying the regulatory mechanisms that exercise has on COPD, which could ultimately help in understanding the pathophysiology of COPD.
In vitro fertilization with frozen embryo transfer increased histamine-mediated contractile sensitivity via PKCβ in human umbilical vein
Authors: Tang Jiaqi , Qi Linglu , He Yun , Li Na , Zhang Ze , Zhou Xiuwen , Su Hongyu , Zheng Qiutong , Zhang Yumeng , Tao Jianying , Xu Zhice
Published: June 2023

Objective

In vitro fertilization-embryo transfer (IVF-ET) technologies (especially frozen ET) have been widely used, which might affect maternal and fetal health. Information regarding influence of IVF-ET on the vasoconstriction of human umbilical vein (HUV) is limited. This study determined effects of frozen ET on histamine-mediated vascular responses in HUV and related mechanisms.

Methods and results

HUVs were collected from frozen ET conceived pregnancy and spontaneously conceived pregnancy (control). Histamine concentration in umbilical plasma was higher in frozen ET group than the control. Histamine-mediated contractile response curve was left-shifted in the frozen ET group when comparing with the control. In isolated HUV rings, H1R showed a critical role in regulating vascular constriction, while H2R played little roles in regulating vessel tone. Iberiotoxin and 4-aminopyridine didn’t significantly change histamine-mediated constriction in HUVs. Histamine-induced vasoconstrictions were significantly decreased by nifedipine, KN93, or GF109203X, while the inhibitory effects were significantly greater in the frozen ET group in comparison to the control. The constrictions by Bay K8644, phenylephrine, or PDBu were stronger in frozen ET, respectively. There was a decrease in the protein expressions of H1R and H2R, an increase in protein expressions of BKCaα and PKCβ.

Conclusions

Histamine-induced constriction in HUV was mainly via H1R. The increased sensitivity to histamine in HUV following frozen ET cycles were linked to the enhanced PKCβ protein expression and function. The new data and findings in this study provide important insight into influences of frozen ET on fetal vessel development and potential influence in long-term.
Knockdown of circSOD2 ameliorates osteoarthritis progression via the miR-224-5p/PRDX3 axis
Authors: Li Hao , Cao Yong , Chang Chongfei , Huang Wenping , Su Songchuan , Peng Zhenggang , Zhang Jiajin
Published: June 2023

Background

Although the implications of circular RNAs (circRNAs) with the progression of diverse pathological conditions have been reported, the circRNA players in osteoarthritis (OA) are barely studied.

Methods

In this study, twenty-five OA patients who received arthroplasty were recruited for cartilage tissue collection. Public circRNA microarray data from Gene Expression Omnibus was retrieved for circRNA identification. An in vitro cell model of OA-related damages was constructed by treating human chondrocytes (CHON-001 cell line) with IL-1β, and circSOD2 siRNA was used to silence circSOD2 expression to study its functional role in apoptosis, inflammatory responses, and extracellular matrix (ECM) degradation. Besides, we investigated the functional interactions among circSOD2, miR-224-5p, and peroxiredoxin 3 (PRDX3) by luciferase reporter assay, RNA-immunoprecipitation assay, and quantitative reverse transcription polymerase chain reaction.

Results

Our findings revealed the overexpression of circSOD2 in the OA cartilage and cell samples, and circSOD2 knockdown alleviated ECM degradation, inflammation, and apoptosis in CHON-001 cell model. In addition, our findings suggested the regulatory function of circSOD2 knockdown on miR-224-5p expression, while miR-224-5p was capable of downregulating PRDX3 expression. The co-transfection of miR-224-5p inhibitor or pcDNA-PRDX3 could prevent the effect of circSOD2 knockdown.

Conclusion

Hence, our results demonstrated that knockdown of circSOD2 may serve as an intervention strategy to alleviate OA progression through modulating miR-224-5p/PRDX3 signaling axis.
Activation of angiotensin-converting enzyme 2 produces an antidepressant-like effect via MAS receptors in mice
Authors: Nakagawasai Osamu , Takahashi Kohei , Koyama Taisei , Yamagata Ryota , Nemoto Wataru , Tan-No Koichi
Published: June 2023

Angiotensin (Ang)-converting-enzyme (ACE) 2 converts Ang II into Ang (1–7), which in turn acts on MAS receptors (ACE2/Ang (1–7)/MAS receptors pathway). This pathway has neuroprotective properties, making it a potential therapeutic target for psychiatric disorders such as depression. Thus, we examined the effects of diminazene aceturate (DIZE), an ACE2 activator, on depressive-like behavior using behavioral, pharmacological, and biochemical assays. To determine whether DIZE or Ang (1–7) produce antidepressant-like effects, we measured the duration of immobility of mice in the tail suspension test following their intracerebroventricular administration. Next, we measured the levels of ACE2 activation in the cerebral cortex, prefrontal cortex, hippocampus, and amygdala after DIZE injection, and examined which cell types, including neurons, microglia, and astrocytes, express ACE2 in the hippocampus using immunofluorescence. Administration of DIZE or Ang (1–7) significantly shortened the duration of immobility time in the tail suspension test, while this effect was inhibited by the co-administration of the MAS receptor antagonist A779. DIZE activated ACE2 in the hippocampus. ACE2 was localized to neurons, astrocytes, and microglia in the hippocampus. In conclusion, these results suggest that DIZE may act on ACE2-positive cells in the hippocampus where it increases the activity of ACE2, thereby enhancing signaling of the ACE2/Ang (1–7)/MAS receptor pathway and resulting in antidepressant-like effects.
Insulinoma with peripheral neuropathy: a case report
Authors: Vinhosa Bastos Marco Aurélio , da Silva Caires Iago , Boschi Portella Renata , Nascimento Martins Rogério , Reverdito Ronald , Reverdito Stephen , Moro Nilson
Published: June 2023

Background

Insulinomas are rare neuroendocrine tumors that typically present with hypoglycemic crises. Peripheral neuropathy is an uncommon complication of insulinoma. Most clinicians expect peripheral neuropathy symptoms to reverse completely after the insulin-secreting tumor is resected, but this may be a misassumption.

Case report

We report a case of a 16-year-old Brazilian boy with clonic muscle spasms of the lower limbs for almost one year. Disabling paraparesis and confusional episodes had progressively set in as well. There were no sensorial abnormalities in the lower limbs, upper limbs or cranial nerves. An electromyography revealed a motor neuropathy of the lower limbs. The diagnosis of insulinoma was established as serum insulin and C-peptide concentrations were inappropriately normal during spontaneous episodes of hypoglycemia. Following a normal abdominal magnetic resonance scan, the imaging work-up continued with an endoscopic ultrasound, which localized the tumor at the pancreatic body-tail transition. Once localized, a prompt surgical removal (enucleation) of the tumor was undertaken, leading to an immediate and complete resolution of hypoglycemia. The time length between the onset of symptoms and tumor resection was 15 months. After surgery, the symptoms of peripheral neuropathy of the lower limbs showed a slow and only partial improvement. At a two-year follow-up after surgery, although being able to lead a normal and productive life, the patient still reported symptoms of reduced muscular strength in the lower limbs and a new electroneuromyography analysis showed chronic denervation and reinnervation in the legs’ muscles—indicating chronic neuropathic injury.

Conclusion

The events of this case reinforce the importance of an agile diagnostic work-up and spry definitive treatment for patients with this uncommon disease, enabling the cure of neuroglycopenia before permanent bothersome complications ensue.
HVS-inspired adversarial image generation with high perceptual quality
Authors: Xue Yuan , Jin Jian , Sun Wen , Lin Weisi
Published: June 2023

Adversarial images are able to fool the Deep Neural Network (DNN) based visual identity recognition systems, with the potential to be widely used in online social media for privacy-preserving purposes, especially in edge-cloud computing. However, most of the current techniques used for adversarial attacks focus on enhancing their ability to attack without making a deliberate, methodical, and well-researched effort to retain the perceptual quality of the resulting adversarial examples. This makes obvious distortion observed in the adversarial examples and affects users’ photo-sharing experience. In this work, we propose a method for generating images inspired by the Human Visual System (HVS) in order to maintain a high level of perceptual quality. Firstly, a novel perceptual loss function is proposed based on Just Noticeable Difference (JND), which considered the loss beyond the JND thresholds. Then, a perturbation adjustment strategy is developed to assign more perturbation to the insensitive color channel according to the sensitivity of the HVS for different colors. Experimental results indicate that our algorithm surpasses the SOTA techniques in both subjective viewing and objective assessment on the VGGFace2 dataset.
Knowledge, attitude and practice of infection prevention and control precautions among laboratory staff: a mixed-methods systematic review
Authors: Aldhamy Haifa , Maniatopoulos Gregory , McCune Victoria L. , Mansi Ilaf , Althaqafy Majid , Pearce Mark S.
Published: June 2023

Background

Clinical laboratories provide diagnostic testing services to support the effective delivery of care in today’s complex healthcare systems. Processing clinical material and the use of chemicals or radiation presents potential hazard to laboratory workers, from both biological and chemical sources. Nevertheless, the laboratory should be a safe workplace if the identification of possible hazards, clear guidelines, safety rules and infection prevention and control (IPC) precautions are applied and followed. The main aim of this systematic review was to identify, critically appraise and synthesise the research evidence to gain a clear explanation of the implementation and knowledge, attitude and practice (KAP) of IPC guidelines among hospital laboratory staff.

Methods

For this systematic review we searched MEDLINE, EMBASE, Scopus and CINAHL (EBSCO), PubMed, grey literature, reference lists and citations for studies published between database inception and November, 2021. All qualitative, quantitative and mixed-methods studies whose aim was to explore risk perception and KAP of IPC guidelines among laboratory staff in any healthcare setting were included, without language or date restrictions. Evidence was narratively synthesised into group of themes. The quality of the evidence was assessed with Joanna Briggs Institutes Critical Appraisal Tools.

Results

After the full-text screening, a total of 34 articles remained and were included in the final review. Thirty papers were considered to be of high quality and the remaining four were considered to be of low quality. The available evidence shows that there was good knowledge, good attitudes and moderate immunisation status, but there was still poor practice of IPC precautions and an inadequate level of training among laboratory workers.

Conclusion

There is a gap among KAP related to the implementation of IPC guidelines, which indicates that laboratory staff may be at high risk of acquiring infections in the workplace. These findings suggest that training (including IPC precautions, safety policies, safety equipment and materials, safety activities, initial biohazard handling, ongoing monitoring and potential exposure) of laboratory staff to increase their knowledge about IPC precautions could improve their use of these precautions.
Childhood maltreatment, shame, psychological distress, and binge eating: testing a serial mediational model
Authors: O’Loghlen Elyse , Galligan Roslyn , Grant Sharon
Published: June 2023

Objective

Despite evidence of causal relationships between childhood maltreatment and the development of binge eating disorder (BED), research on mediating mechanisms is lacking. The present study sought to understand the childhood maltreatment-binge eating relationship more fully by examining three types of shame (internal, external, body) and psychological distress as mediators in this relationship. There is evidence that shame and psychological distress are associated with both childhood maltreatment and binge eating pathology. It was hypothesised that shame stemming from childhood maltreatment would contribute to psychological distress, and to binge eating as a dysfunctional emotion regulation strategy, in a serial mediational model.

Method

Five hundred and thirty adults with self-reported binge eating symptoms completed an online survey, which included measures of childhood maltreatment, internal shame, external shame, body shame, psychological distress, and binge eating and other eating disorder symptoms.

Results

Path analyses showed three specific relationships: (1) a relationship between childhood emotional maltreatment and binge eating, which was serially mediated by internal shame and psychological distress; (2) a relationship between childhood sexual abuse and binge eating, which was mediated by body shame; and (3) a relationship between childhood physical maltreatment and binge eating, which was mediated by psychological distress. We also found a feedback loop, whereby binge eating might lead to increased overvaluation of body shape and weight (possibly due to increased weight) and then to an increase in internal shame and body shame. The final model showed excellent fit for the data.

Discussion

Findings extend our understanding of the link between childhood maltreatment and BED. Future intervention research should focus on examining the efficacy of interventions for different forms of childhood maltreatment, based on the key mediating factors.
Establishment of the management effectiveness assessment system of world natural heritage and empirical analysis—a case study of Fanjingshan
Authors: Yang Xiaoshuang , Mu Dijin , Hu Mingjian , Xiao Shizhen , Meng Jianan
Published: June 2023

Although there are more than 270,000 protected areas worldwide, there is currently little data on their protection and management effectiveness. As a kind of protected area, natural world heritage (WH) sites are small but represent some of the most important natural landscapes, covering a very large area. But natural WH is threatened by climate change, natural disasters and human activities. Therefore, to achieve the sustainable development of WH sites, it is very important to analyze the management status of WH sites. Based on this, the study extracts inspiration from Enhancing our Heritage Toolkit: Assessing management effectiveness of natural World Heritage sites. An assessment system of the management effectiveness (ME) of natural WH sites has been established, which has three dimensions (including management foundation, management measures, and management performances) and 21 indexes. The reliability and validity of the index system are tested using the exploratory factor analysis method, and the results show that the index system has good reliability and validity. Then principal component analysis and comprehensive assessment methods are used to analyze the ME of the Fanjingshan WH site. The results show that the management effectiveness of the Fanjingshan WH Site is relatively excellent, but it still faces challenges from tourism development and community participation.
Phytopathological and biochemical impacts of Trichoderma harzianum and certain plant resistance inducers on faba bean root rot disease
Authors: Masoud Hassan Mohamed , Megahed Allam Arafat , Helmy Mohamed Salah Eldin , Ibrahim Mahmoud Abdel-Aziz , El-Mougy Nehal Samy , Abdel-Kader Mokhtar Mohamed
Published: June 2023

Background

Faba bean attacked by soil-borne pathogens causing root rot disease. This disease has serious damage to both plant stand and produced yield. The present study aimed to evaluate effectiveness of the bioagents; Trichoderma harzianum and some plant resistance inducers as fungicide alternatives against root rot disease incidence at both pre- and post-emergence growth stages.

Results

Under open greenhouse conditions, the incidence of faba bean root rot in pre- and post-emergence growth phases was considerably reduced by using six inorganic salts and five antioxidants individually or combining with each other or with the bio-stimulator T. harzianum that exceeded the used fungicide, Rhizolex-T. Application of enervit agitated the highest significant defensive impact during pre-emergence stage versus root rot incidence (5.0%), followed by calcium sulfate and [cysteine + T. harzianum] (6.7%). At post-emergence stage, majority of the treatments completely suppressed (100.0%) root rot incidence, except vitamax plus and the fungicide (Rizolex-T) which expressed by 91.7 and 18.8%, respectively. Duplicate irrigations of 23 treatments after faba bean dressing improved the synthesis of different protein contents with the 2nd of which enhanced higher protein contents than the 1st one, except [T. harzianum + vitamin E + vitamin C + enervit + selenium + vitamax plus], [T. harzianum + vitamax plus] and cysteine. Disodium phosphate induced the highest catalase (CAT) activity (1820.8 and 1677.2 U/g FWt) after both irrigations. [T. harzianum + vitamax plus] and vitamin E induced the highest peroxidase (POD) activity 217.4 and 356.9 U/g FWt after 1st and 2nd irrigations, respectively. Disodium phosphate and [T. harzianum + vitamin E + vitamin C + enervit + selenium + vitamax plus] induced the highest chitinase (CHIA) activity 52.8 and 54.4 U/g FWt after 1st and 2nd irrigations, respectively. Application of disodium phosphate, calcium sulfate, potassium metabisulfite, sodium sulfate, cysteine, [cysteine + potash alum], enervit, vitamin E, [vitamin E + vitamin C + enervit + selenium + vitamax plus], [T. harzianum + enervit], [T. harzianum + selenium], [T. harzianum + vitamin E], [T. harzianum + vitamin E + vitamin C + enervit + selenium + vitamax plus] and vitamin C stimulated the formation of new protein bands on SDS-PAGE after the 2nd irrigation treatment.

Conclusions

Such treatments are considered good and environmentally safe alternatives against root diseases for getting rid of the negative effects of fungicides.
Market, Gift, Everyday Ethics, and Emmanuel Levinas in Patient Care
Authors: Astrow Alan B.
Published: June 2023

A simple, and brief, human gesture may turn a routine visit into a healing encounter. We need a conceptual nudge; otherwise, we are left stranded at the lowest common denominator of value, money. Physicians work long and hard to perfect our craft, but might some element of our therapeutic abilities be seen, like the artist’s native talent, as gift? The beginning lies in a way of thinking that places protection of the vulnerable human person front and center.
Five-year Outcome Between Radiofrequency Ablation vs Surgery for Unilateral Multifocal Papillary Thyroid Microcarcinoma
Authors: Yan Lin , Yang Zhen , Li Yingying , Li Xinyang , Xiao Jing , Jing HaoYu , Luo Yukun
Published: June 2023

Context

Ultrasound (US)-guided radiofrequency ablation (RFA) has been considered as an alternative to surgery or active surveillance for papillary thyroid microcarcinoma (PTMC). However, little is known about the long-term outcomes of RFA in comparison with surgery for unilateral multifocal PTMC.

Objective

This work aims to report the comparison between RFA vs surgery for unilateral multifocal PTMC over a more than 5-year follow-up period.

Methods

This was a retrospective study at a primary care center with a median follow-up period of 72.9 months. A total of 97 patients with unilateral multifocal PTMC were treated with RFA (RFA group, n = 44) or surgery (surgery group, n = 53). In the RFA group, patients were treated by a bipolar RFA generator and an 18-gauge bipolar RF electrode with a 0.9-cm active tip. In the surgery group, patients underwent thyroid lobectomy with prophylactic central neck dissection.

Results

During the follow-up, no statistically significant differences were found in disease progression (4.5% vs 3.8%; P = ≥.999), lymph node metastasis (2.3% vs 3.8%; P = ≥.999), persistent lesion (2.3% vs 0%; P = .272), and RFS rates (97.7% vs 96.2%; P = .673) in the RFA and surgery groups. Patients undergoing RFA had a shorter hospitalization (0 vs 8.0 [3.0] d; P < .001), shorter procedure time (3.5 [2.4] vs 80.0 [35.0] min; P < .001), lower estimated blood loss (0 vs 20.0 [15.0] mL; P < .001), and lower costs ($1768.3 [0.1] vs $2084.4 [1173.8]; P = .001) than those in the surgery group. The complication rate in the surgery group was 7.5%, whereas none of the RFA-treated patients experienced any complications (P = .111).

Conclusion

This study revealed 6-year comparable outcomes between RFA and surgery for unilateral multifocal PTMC. RFA may be a safe and effective alternative to surgery in selected patients with unilateral multifocal PTMC.
Submerged Hostilities
Authors: Macauley Melissa
Published: June 2023

This article explores how the East Asian monsoon exacerbated social tensions in southeastern China and thereby fostered historical transformations in the region. By placing water at the center of late imperial Chinese social history, it demonstrates how disputes and animosities ebbed and flowed with the shifting of the seasonal winds. It also suggests the ways dynamic environmental events might complicate our notions of historical time.
Back to the future through the wormhole: Caenorhabditis elegans as a preclinical model
Authors: Caldwell Guy A.
Published: June 2023

On the 15th Anniversary of Disease Models & Mechanisms as a trailblazing venue for the dissemination of discoveries pertaining to human health involving model systems, we celebrate the journey of this journal, as mirrored through the evolution of research using the nematode roundworm, Caenorhabditis elegans. Driven by the exponential growth of genomic data, worms have advanced from a basic research tool to precise and elegant models for disease and have yielded substantive insights into numerous human disorders. A harbinger of functional genomic analysis since the inception of RNA interference screening, the directed application of C. elegans for identification of disease-modifying factors has revealed new pathways and therapeutic targets to accelerate translational outcomes. Together with advances in gene editing, worm models are now ushering in the era of precision medicine with characteristic expedience.
Artificial intelligence-assisted quantification of COVID-19 pneumonia burden from computed tomography improves prediction of adverse outcomes over visual scoring systems
Authors: Grodecki Kajetan , Killekar Aditya , Simon Judit , Lin Andrew , Cadet Sebastien , McElhinney Priscilla , Chan Cato , Williams Michelle C. , Pressman Barry D. , Julien Peter , Li Debiao , Chen Peter , Gaibazzi Nicola , Thakur Udit , Mancini Elisabetta , Agalbato Cecilia , Munechika Jiro , Matsumoto Hidenari , Menè Roberto , Parati Gianfranco , Cernigliaro Franco , Nerlekar Nitesh , Torlasco Camilla , Pontone Gianluca , Maurovich-Horvat Pal , Slomka Piotr J. , Dey Damini
Published: June 2023

Objective:

We aimed to evaluate the effectiveness of utilizing artificial intelligence (AI) to quantify the extent of pneumonia from chest CT scans, and to determine its ability to predict clinical deterioration or mortality in patients admitted to the hospital with COVID-19 in comparison to semi-quantitative visual scoring systems.

Methods:

A deep-learning algorithm was utilized to quantify the pneumonia burden, while semi-quantitative pneumonia severity scores were estimated through visual means. The primary outcome was clinical deterioration, the composite end point including admission to the intensive care unit, need for invasive mechanical ventilation, or vasopressor therapy, as well as in-hospital death.

Results:

The final population comprised 743 patients (mean age 65  ±  17 years, 55% men), of whom 175 (23.5%) experienced clinical deterioration or death. The area under the receiver operating characteristic curve (AUC) for predicting the primary outcome was significantly higher for AI-assisted quantitative pneumonia burden (0.739, p = 0.021) compared with the visual lobar severity score (0.711, p < 0.001) and visual segmental severity score (0.722, p = 0.042). AI-assisted pneumonia assessment exhibited lower performance when applied for calculation of the lobar severity score (AUC of 0.723, p = 0.021). Time taken for AI-assisted quantification of pneumonia burden was lower (38 ± 10 s) compared to that of visual lobar (328 ± 54 s, p < 0.001) and segmental (698 ± 147 s, p < 0.001) severity scores.

Conclusion:

Utilizing AI-assisted quantification of pneumonia burden from chest CT scans offers a more accurate prediction of clinical deterioration in patients with COVID-19 compared to semi-quantitative severity scores, while requiring only a fraction of the analysis time.

Advances in knowledge:

Quantitative pneumonia burden assessed using AI demonstrated higher performance for predicting clinical deterioration compared to current semi-quantitative scoring systems. Such an AI system has the potential to be applied for image-based triage of COVID-19 patients in clinical practice.
Diagnostic value of contrast-enhanced ultrasound combined with MRI for cervical hyperplastic, tuberculosis-infected, and metastatic lymph nodes
Authors: Yu Xiulei , Zhang Wenzhi , He Ning , Su Dongming , Zhao Yang
Published: June 2023

Objective: To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with magnetic resonance imaging (MRI) for cervical abnormal lymph nodes.

Methods: We retrospectively reviewed the clinical records of 150 patients undergoing lymph node examinations at Hangzhou Chest Hospital from January 2017 to December 2019. According to the characteristics of lymph nodes, the patients were divided into three groups: 45 patients had hyperplastic lymph nodes (HLNs; Group-A), 55 had lymph node tuberculosis (LNTB; Group-B), 50 had metastatic lymph nodes (MLN; Group-C). We compared the ultrasonic examination and MRI results between the groups, and compared the diagnostic value of CEUS alone and CEUS plus MRI.

Results: Lower resistance indexes (RI) for Groups-A and B than Group-C(P<0.05). Mixed blood flow type was predominant in Group-A, while the lymphohilum type was predominant in Group-B, and the marginal type was predominant in Group-C(P<0.05). The proportion of non-uniform types in Group-B was significantly higher than that in Groups-A and C(P<0.05). After enhancement, the proportions of non-uniform types in Groups-A and B were higher than Group-C(P<0.05). The results of MRI examination showed that positive reinforcement integral (PEI) and maximum slope of increase (MSI) values increased sequentially from Group-B to Group-A, and then to Group-C(P<0.05); while time to peak (TTP) values increased sequentially from Group-C to Group-A, and then to Group-B(P<0.05). The diagnosis accuracy of CEUS combined with MRI was significantly higher than that of CEUS alone(P<0.05). RI-PEI, RI-MSI, and RI-TTP showed high specificity and sensitivity in the diagnosis and differentiation of HLNs, LNTB, and MLNs(P<0.05).

Conclusion: CEUS combined with MRI can significantly facilitate the differential diagnosis between HLNs, LNTB, and MLNs. The two diagnosis methods combined improve the diagnosis accuracy of cervical lymph node diseases.

doi: https://doi.org/10.12669/pjms.39.4.7572

How to cite this: Yu X, Zhang W, He N, Su D, Zhao Y. Diagnostic value of contrast-enhanced ultrasound combined with MRI for cervical hyperplastic, tuberculosis-infected, and metastatic lymph nodes. Pak J Med Sci. 2023;39(4):950-955. doi: https://doi.org/10.12669/pjms.39.4.7572

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Implementation of the Requirements of the Updated Standard When Introducing New Concepts in Mathematics Lessons
Authors: Vasileva M.
Published: June 2023

The article is based on the main key ideas of the formation of the planned subject and meta-subject results. The article discusses the methodology for implementing the requirements of the updated standard, taking into account the goals of teaching mathematics, under which conditions are created that ensure the possibility of forming students’ planned results in accordance with the requirements of the standard. An approach is proposed to the formation of individual skills of cognitive universal educational actions of students in teaching mathematics, using learning tasks and learning tasks that develop the ability to solve a wide range of problems.
Characteristics of the Skills of Working with Educational Information in Younger Schoolchildren and Ap the Development of Their Diagnostics Development
Authors: Nasser A.
Published: June 2023

The article reveals the essence of the concept of the skill of working with educational information and pedagogical means of monitoring it in younger schoolchildren. The main interpretations of general pedagogical categories are presented through the analysis of “skill” and “educational information”. The periodization of the process of developing the skills of a junior student with educational information is determined, and the indicators of the performance of actions with educational information by younger students on the basis of the Federal State Educational Standard are also determined.