bluuebunny/crossref_metadata_2025 huggingface dataset:
Q-rung orthopair normal fuzzy Maclaurin symmetric mean aggregation operators based on Schweizer-Skla operations
Authors: Liu Dongwei , Zhu Xiaomin , Zhang Runtong
Published: August 2023

In order to be able to make a good decision, we need to evaluate the uncertainty information of multiple attributes of different alternatives that obey the normal distribution, and the interrelationship among multiple attributes should be considered in the process of evaluating. This paper aims to propose a new multiple attribute decision-making (MADM) method, which uses a new aggregation operator to evaluate the uncertainty information that obey normal distribution comprehensively. We firstly extended Schweizer-Sklar (SS) t-norm (TN) and t-conorm (TCN) to q-rung orthopair normal fuzzy number (q-RONFN) and defined the Schweizer-Skla operational laws of q-rung orthopair normal fuzzy set (q-RONFs). Secondly, we developed q-rung orthopair normal fuzzy Maclaurin symmetric mean aggregation operators based on SS operations considering that the Maclaurin symmetric mean operator can reflect the interrelationship among multiple input variables. Furthermore, we discussed some desirable properties of the above operators, such as monotonicity, commutativity, and idempotency. Lastly, we proposed a novel MADM method based on developed aggregation operators. A numerical example on enterprise partner selection is given to testify the effectiveness of the developed method. The results of analysis indicated that our proposed aggregation operators have stronger information aggregation ability and are more general and flexible for MADM problems.
The emergent behavior of three-dimensional and three-phase thermal network model for the heterogeneous materials
Authors: Tian Jianhui , Wu Jialiang , Bowen Chris R , Sun Jinjuan , Wang Zaishuang , Hu Guangchu
Published: August 2023

The study of the heat transfer properties of heterogeneous materials has been a world-wide research focus, for example in sectors related to thermal management in aerospace, architecture, and geology. In this paper, the emergent behavior and thermal conduction characteristics of three-dimensional and three-phase heterogeneous materials thermal networks are studied using the finite element method. The results show that the existence of percolation paths of each phase has a strong impact on the effective properties of the network when the contrast in thermal conductivities of each phase is high, and percolation also affects the effective thermal conductivity of the whole thermal network system. However, when the contrast in thermal conductivity between the two phases is low, the thermal networks exhibit a more consistent and “emergent” behavior, and the effective thermal conductivity of thermal networks at the same volume fraction changes to a lower extent from network to network. This paper also demonstrates that a logarithmic mixing rule can predict the effective thermal conductivity in the low contrast emergent region in three-dimensional networks, and the modeling method provides new approaches for the design of multi-phase composites and prediction of their thermal conduction properties.
Multi-response optimization for laser transmission welding of PMMA to ABS using Taguchi-based TOPSIS method
Authors: Kucukoglu Ayca , Yuce Celalettin , Sozer Ibrahim Emrah , Karpat Fatih
Published: August 2023

Recently, the usage of laser transmission welding (LTW) technology in the automotive industry has been rising for joining thermoplastic parts regarding its superior properties in comparison to other welding technologies. However, specifying the process parameters is a crucial step to obtain satisfactory welding quality for the vehicle parts. In this context, this paper addresses the LTW process of Polimetil metakrilat (PMMA) to Akrilonitril bütadien stiren (ABS) materials for the production of taillights in an automotive company and proposes a new multi-response Taguchi-Based TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) method to optimize machining parameters in the laser welding process. In the proposed solution methodology, the main effects of the parameters on different outputs are identified by using the [Formula: see text] orthogonal array of the Taguchi method. Regarding the best parameter set for each output, the best parameter set for multi-response is identified by using the TOPSIS method, in which alternatives are evaluated through the interrelated quality measures. To optimize welding process in taillight production, PMMA and ABS samples with the dimensions of [Formula: see text] in width, [Formula: see text] in length, and [Formula: see text] in thickness are used in the experiments. The samples are welded by using LPKF Twinweld 3D 6000® laser welding machine. For the welding process, laser power, welding speed, and pressure force are taken into account as the input parameters to optimize three responses: weld strength, breaking strain, and weld width. To identify the best process parameter values, the Taguchi Method is initially employed to calculate the main effects of LTW parameters for each output. Then, the TOPSIS method is carried out to evaluate a number of alternative parameter sets generated through the Taguchi results. As a consequence of the TOPSIS ranking scores, the best parameter set that jointly optimizes three outputs of the LTW process is identified for the taillight production as [Formula: see text] power, [Formula: see text] speed, and [Formula: see text] pressure force. Based on the conducted experiments, this parameter setting achieves the highest weld strength, breaking strain level, and above-average weld width. The results of the experiments show that the proposed methodology is capable of optimizing LTW parameters for a multi-response with fewer experiments in the joining of plastic vehicle parts.
Understanding the contribution of intellectual disabilities nurses: Paper 3 of 4 - evaluation
Authors: Mafuba Kay , Kiernan Joann , Kudita Chiedza , Chapman Hazel M , Kupara Dorothy , Chester Rebecca
Published: August 2023

The overall objective of this research was to identify intellectual disability nursing interventions and their impact on the health and healthcare of people with intellectual disability. This is part 3 of a 4-part series. In this paper we report the findings from quantitative questions from an online survey of intellectual disability nurses. The objective of this part of the study was to a evaluate intellectual disability nurses’ confidence in their understanding of the interventions they undertook. Quantitative data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants from 7 countries. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. The evaluation data suggest and demonstrate a lack of clarity among intellectual disability nurses of the interventions they can effectively undertake. There appears to be correlations between lack of role clarity and the types of employer organisations and countries. Further work need to be undertaken by nurse leaders ascertain and address this lack of clarity.
Migration as a Climate Change Adaptation Strategy: What Role do Emotions Play?
Authors: Michael Kavya
Published: August 2023

Climate change intersecting with complex socio-economic and political processes has produced distinctive patterns of crisis migration. However there exists a significant gap in understanding and theorizing these forms of migration creating significant policy challenges. Using a case study of an interstate migrant settlement in Bengaluru, India this article unpacks migration as an adaptation strategy through the lens of emotions. The article offers significant insights into how emotions affect the choice of migration as an adaptation strategy and shapes the differential experiences of risks and vulnerability for different groups of people. Emphasizing such relational aspects of migration, the article calls for more research that develops a nuanced understanding of the emotional landscapes of migrants across migration pathways.
Are Physical Activity Interventions Effective in Improving Health-Related Quality of Life in Children and Adolescents? A Systematic Review and Meta-Analysis
Authors: Bermejo-Cantarero Alberto , Sánchez-López Mairena , Álvarez-Bueno Celia , Redondo-Tébar Andres , García-Hermoso Antonio , Martínez-Vizcaino Vicente
Published: August 2023

Context:

Physical activity (PA) interventions improve well-being and positive mental health in children and adolescents, but the results of previous systematic reviews included participants with chronic medical conditions and did not accurately assess the multidimensional nature of health-related quality of life (HRQoL).

Objective:

The aims of this meta-analysis were to (1) evaluate the effects of PA interventions on several domains of HRQoL in healthy <18-year-olds and (2) examine the effectiveness of interventions on HRQoL according to whether they were successful in increasing PA, the type of intervention delivered, and the duration of the intervention.

Data Sources:

PubMed (Medline), EMBASE, the Cochrane Library, SCIELO, SPORTDiscus, and PEDro databases were systematically searched from inception to September 30, 2022.

Study Selection:

Experimental studies that examined the effectiveness of PA interventions on HRQoL participants aged <18 years.

Study Design:

Systematic review with meta-analysis and meta-regression.

Level of Evidence:

Level 1.

Methods:

Random-effects models were used to calculate pooled effect size (ES) for total HRQoL score and its dimensions. Subgroup analyses were conducted to examine the effect of PA program characteristics.

Results:

A total of 17 studies were included. Pooled ES (95% CI) estimations were as follows: 0.179 (0.045, 0.002) for total HRQoL score, 0.192 (0.077, 0.306) for physical well-being, 0.158 (0.080, 0.237) for psychological well-being, 0.118 (0.044, 0.192) for autonomy and parent relation, 0.135 (0.043, 0.227) for social support and peers, and 0.129 (-0.013, 0.270) for school environment. Subgroup analyses suggested there were no differences in the effectiveness of the interventions by category of PA increase or by type and duration of intervention.

Conclusion:

Exercise interventions are an effective strategy for improving overall HRQoL and its most significant domains in children and adolescents.
Distinguishing bronchoscopically observed anatomical positions of airway under by convolutional neural network
Authors: Chen Chongxiang , Herth Felix JF , Zuo Yingnan , Li Hongjia , Liang Xinyuan , Chen Yaqing , Ren Jiangtao , Jian Wenhua , Zhong Changhao , Li Shiyue
Published: August 2023

Background:

Artificial intelligence (AI) technology has been used for finding lesions via gastrointestinal endoscopy. However, there were few AI-associated studies that discuss bronchoscopy.

Objectives:

To use convolutional neural network (CNN) to recognize the observed anatomical positions of the airway under bronchoscopy.

Design:

We designed the study by comparing the imaging data of patients undergoing bronchoscopy from March 2022 to October 2022 by using EfficientNet (one of the CNNs) and U-Net.

Methods:

Based on the inclusion and exclusion criteria, 1527 clear images of normal anatomical positions of the airways from 200 patients were used for training, and 475 clear images from 72 patients were utilized for validation. Further, 20 bronchoscopic videos of examination procedures in another 20 patients with normal airway structures were used to extract the bronchoscopic images of normal anatomical positions to evaluate the accuracy for the model. Finally, 21 respiratory doctors were enrolled for the test of recognizing corrected anatomical positions using the validating datasets.

Results:

In all, 1527 bronchoscopic images of 200 patients with nine anatomical positions of the airway, including carina, right main bronchus, right upper lobe bronchus, right intermediate bronchus, right middle lobe bronchus, right lower lobe bronchus, left main bronchus, left upper lobe bronchus, and left lower lobe bronchus, were used for supervised machine learning and training, and 475 clear bronchoscopic images of 72 patients were used for validation. The mean accuracy of recognizing these 9 positions was 91% (carina: 98%, right main bronchus: 98%, right intermediate bronchus: 90%, right upper lobe bronchus: 91%, right middle lobe bronchus 92%, right lower lobe bronchus: 83%, left main bronchus: 89%, left upper bronchus: 91%, left lower bronchus: 76%). The area under the curves for these nine positions were >0.98. In addition, the accuracy of extracting the images via the video by the trained model was 94.7%. We also conducted a deep learning study to segment 10 segment bronchi in right lung, and 8 segment bronchi in Left lung. Because of the problem of radial depth, only segment bronchi distributions below right upper bronchus and right middle bronchus could be correctly recognized. The accuracy of recognizing was 84.33 ± 7.52% by doctors receiving interventional pulmonology education in our hospital over 6 months.

Conclusion:

Our study proved that AI technology can be used to distinguish the normal anatomical positions of the airway, and the model we trained could extract the corrected images via the video to help standardize data collection and control quality.
Conservative Management of Duodenal Penetration by Inferior Vena Cava Filter: Case Report and Review
Authors: Ramachandran Rajarajeshwari , Kumar Vikash , Grantham Tyler , Etienne Denzil , Reddy Madhavi
Published: August 2023

Duodenal penetration is a late complication associated with the placement of inferior vena cava (IVC) filters. In this case report, we are presenting a case of asymptomatic duodenal penetration by IVC filter that was managed conservatively.
Capturing Visual Attention With Perturbed Auditory Spatial Cues
Authors: Valzolgher Chiara , Alzaher Mariam , Gaveau Valérie , Coudert Aurélie , Marx Mathieu , Truy Eric , Barone Pascal , Farnè Alessandro , Pavani Francesco
Published: August 2023

Lateralized sounds can orient visual attention, with benefits for audio-visual processing. Here, we asked to what extent perturbed auditory spatial cues—resulting from cochlear implants (CI) or unilateral hearing loss (uHL)—allow this automatic mechanism of information selection from the audio-visual environment. We used a classic paradigm from experimental psychology (capture of visual attention with sounds) to probe the integrity of audio-visual attentional orienting in 60 adults with hearing loss: bilateral CI users ( N = 20), unilateral CI users ( N = 20), and individuals with uHL ( N = 20). For comparison, we also included a group of normal-hearing (NH, N = 20) participants, tested in binaural and monaural listening conditions (i.e., with one ear plugged). All participants also completed a sound localization task to assess spatial hearing skills. Comparable audio-visual orienting was observed in bilateral CI, uHL, and binaural NH participants. By contrast, audio-visual orienting was, on average, absent in unilateral CI users and reduced in NH listening with one ear plugged. Spatial hearing skills were better in bilateral CI, uHL, and binaural NH participants than in unilateral CI users and monaurally plugged NH listeners. In unilateral CI users, spatial hearing skills correlated with audio-visual-orienting abilities. These novel results show that audio-visual-attention orienting can be preserved in bilateral CI users and in uHL patients to a greater extent than unilateral CI users. This highlights the importance of assessing the impact of hearing loss beyond auditory difficulties alone: to capture to what extent it may enable or impede typical interactions with the multisensory environment.
Book review: James Borton, Dispatches from the South China Sea: Navigating to Common Ground
Authors: Xue Ruikai
Published: August 2023

James Borton, Dispatches from the South China Sea: Navigating to Common Ground. Universal-Publishers, 2022, 270 pp. (eBook). ISBN: 978-1627343701.
Segregated by design? Street network topological structure and the measurement of urban segregation
Authors: Knaap Elijah , Rey Sergio
Published: August 2023

Racial residential segregation is a longstanding topic of focus across the disciplines of urban social science. Classically, segregation indices are calculated based on areal groupings (e.g., counties or census tracts), with more recent research exploring ways that spatial relationships can enter the equation. Spatial segregation measures embody the notion that proximity to one’s neighbors is a better specification of residential segregation than simply who resides together inside the same arbitrarily drawn polygon. Thus, they expand the notion of “who is nearby” to include those who are geographically close to each polygon rather than a binary inside/outside distinction. Yet spatial segregation indices often resort to crude measurements of proximity, such as the Euclidean distance between observations, given the complexity and data requirements of calculating more theoretically appropriate measures, such as distance along the pedestrian travel network. In this paper, we examine the ramifications of such decisions. For each metropolitan region in the U.S., we compute both Euclidean and network-based spatial segregation indices. We use a novel inferential framework to examine the statistical significance of the difference between the two measures and following, we use features of the network topology (e.g., connectivity, circuity, throughput) to explain this difference using a series of regression models. We show that there is often a large difference between segregation indices when measured by these two strategies (which is frequently significant). Further, we explain which topology measures reduce the observed gap and discuss implications for urban planning and design paradigms.
The role of BDNF in the clinical course of primary headaches
Authors: Holmuratova Bahtigul , Rashidova Nilufar , Khalimova Khanifa , Matmurodov Rustam , Rakhmatullaeva Gulnora
Published: August 2023

Objective:

Brain-derived neurotrophic factor (BDNF) is associated with the pathophysiology of primary headaches. The present study aimed to investigate interictal and ictal BDNF levels and its association with clinical parameters in patients with primary headaches.

Methods:

Three groups of headache patients enrolled in this study: patients with episodic migraine with and without aura, cluster headaches, and tension-type headaches according to the current criteria of the International Headache Society. In migraine patients and cluster headache patients, venous blood samples were collected twice: outside and during attacks. In patients with tension-type headaches and healthy controls, one single blood sample was taken. The research comprised 120 patients (males and females) suffering from primary headaches. The control group consisted of 30 healthy volunteers.

Results:

This is the first study to show that there is no gender difference BDNF levels in Uzbek patients with primary headaches. Migraine and cluster headache patients revealed significantly higher BDNF serum levels during headache attacks compared with attack-free periods ( p < 0.02).

Conclusion:

This reinforces the view that BDNF may be implicated in the pathophysiology of primary headaches.
Osteochondral Allograft and High Tibial Osteotomy With Patient-Specific Instrumentation
Authors: Selley Ryan , Itthipanichpong Thun , Menta Samarth Venkata , Ranawat Anil S.
Published: August 2023

Background:

Medial compartment osteoarthritis in young active patients presents a unique challenge with regard to joint preservation. Interventions, including cartilage restoration procedures, in the setting of high tibial osteotomy (HTO) have the potential to obviate or delay joint replacement if performed with a high degree of accuracy and avoidance of complications.

Indications:

The procedure is indicated in patients less than 65 years with isolated medial knee arthrosis, good range of motion, and no ligamentous instability.

Technique Description:

We present our technique for valgus producing opening wedge HTO with patient-specific instrumentation and implant with concomitant osteochondral allograft of the medial femoral condyle and tibial microfracture.

Results:

The goal of this intervention is to provide a minimally painful knee with durable (>10 year) outcome while minimizing the risk of perioperative complications including iatrogenic fracture and nonunion.

Discussion/Conclusion:

High tibial osteotomy with concomitant cartilage repair techniques can lead to high satisfaction and return to sport rates in appropriately selected patients.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Climate change and homeland security nexus: Proposal for a comprehensive conceptual framework
Authors: Asaka Jeremiah Ogonda
Published: August 2023

Climate change is a significant security concern in the 21st century. This study is specifically focused on the interplay between climate change and domestic security within the U.S. context but is of relevance to other countries that are vulnerable to climate change impacts. The study comparatively explores mainstream environmental security literature and U.S. homeland security academic literature on climate-security nexus and establishes three things as follows. First, there is a relatively small but growing body of literature that explores the nexus between climate change and U.S. homeland security. Second, contemporary homeland security academic literature primarily frames climate change as a threat multiplier but does not account for maladaptation, which this article argues is a key aspect of the climate-security nexus including within the U.S. context. Third, maladaptation is already increasingly being accounted for within mainstream environmental security literature in addition to the threat multiplier aspect of the nexus. The article advances knowledge on climate-security nexus within homeland security field by proposing a comprehensive conceptual framework that would enable U.S. homeland security academics to account for both threat multiplier and maladaptation aspects of the climate change problem in their analysis. The article concludes with recommendations for future research.
Shared decision-making experiences in child long-term ventilation: a systematic review
Authors: Peat George , Delaney Sally-Ann , Gibson Faith , Fraser Lorna K. , Brierley Joe
Published: August 2023

Introduction:

Recent decades have seen an increase in children receiving long-term ventilation. To ensure that long-term ventilation decisions incorporate the perspectives of stakeholders, it is vital that empirical evidence is gathered to substantiate frameworks and guidance on shared decision-making for long-term ventilation. This systematic review and qualitative evidence synthesis aimed to clarify what shared decision-making constitutes in relation to long-term ventilation initiation for children and young people (<21 years).

Methods:

A systematic review of qualitative research was undertaken. Searches were conducted in MEDLINE, Embase, CINAHL, PsycINFO and Web of Science.

Results:

Findings from 13 studies were included representative of 363 caregivers and 143 healthcare professional experiences. Components that support shared decision-making included acknowledging the unique positionality of caregivers and ensuring caregivers were informed about the implications of long-term ventilation. Beneficial qualities of engagement between stakeholders included honest, clear and timely dialogue using lay, tactful and sensitive language.

Conclusion:

Our findings clarify components and approaches supportive of shared decision-making in discussions about long-term ventilation. This review therefore provides a valuable resource to implement shared decision-making practices in the context of long-term ventilation decisions for children and young people.
“Sharing the matrix” – a cooperative strategy for survival in Salmonella enterica serovar Typhimurium
Authors: R. Kavi Bharathi , S. Srinandan C. , N Sai Subramanian
Published: August 2023

Background

Bacteria in nature live together in communities called biofilms, where they produce a matrix that protects them from hostile environments. The components of this matrix vary among species, with Salmonella entericaserovar Typhimurium (STm- WT) primarily producing curli and cellulose, which are regulated by the master regulator csgD. Interactions between bacteria can be competitive or cooperative, with cooperation more commonly observed among the kin population. This study refers to STm- WT as the generalist which produces all the matrix components and knockout strains that are defective in either curli or cellulose as the specialists, which produces one of the matrix components but not both. We have asked whether two different specialists will cooperate and share matrix components during biofilm formation to match the ability of the generalist which produces both components.

Results

In this study, the response of the specialists and generalist to physical, chemical, and biological stress during biofilm formation is also studied to assess their abilities to cooperate and produce biofilms like the generalist. STm WT colony biofilm which produces both the major biofilm matrix component were protected from stress whereas the non-matrix producer (∆csgD), the cellulose, and curli alone producers ∆csgA, ∆bcsArespectively were affected. During the exposure to various stresses, the majority of killing occurred in ∆csgD. Whereas the co-culture (∆csgA: ∆bcsA) was able to resist stress like that of the STm WT. Phenotypic and morphological characteristics of the colonies were typed using congo red assay and the Influence of matrix on the architecture of biofilms was confirmed by scanning electron microscopy.

Conclusion

Our results show that matrix aids in survival during antibiotic, chlorine, and predatory stress. And possible sharing of the matrix is occurring in co-culture, with one counterbalancing the inability of the other when confronted with stress.
Antibacterial activity of exopolysaccharide produced by bee gut-resident Enterococcus sp. BE11 against marine fish pathogens
Authors: Zaghloul Eman H. , Ibrahim Mohamed I. A. , Zaghloul Heba A. H.
Published: August 2023

Background

In recent years, the demand for innovative antimicrobial agents has grown, considering the growing problem of antibiotic resistance in aquaculture. Adult Apis mellifera honeybees’ gut represents an outstanding habitat to isolate novel lactic acid bacteria (LAB) able to produce prominent antimicrobial agents.

Methods

In the current study, twelve LAB were isolated and purified from the gut of adult Apis mellifera. The isolates were screened for exopolysaccharide (EPS) production. The most promising isolate BE11 was identified biochemically and molecularly using 16 S rRNA gene sequence analysis as Enterococcus sp. BE11 was used for the mass production of EPS. The partially purified BE11-EPS features were disclosed by its physicochemical characterization. Moreover, the antimicrobial activity of BE11 cell free supernatant (CFS) and its EPS was investigated against some fish pathogens namely, Pseudomonas fluorescens, Streptococcus agalactiae, Aeromonas hydrophila, Vibrio sp. and Staphylococcus epidermidis using well-cut diffusion method.

Results

The physicochemical characterization of BE11-EPS revealed that the total carbohydrate content was estimated to be ~ 87%. FTIR and NMR analysis ascertained the presence of galactose and glucose residues in the EPS backbone. Moreover, the GC-MS analysis verified the heterogeneous nature of the produced BE11-EPS made up of different monosaccharide moieties: galactose, rhamnose, glucose, arabinose sugar derivatives, and glucuronic acid. BE11 CFS and its EPS showed promising antimicrobial activity against tested pathogens as the inhibition zone diameters (cm) ranged from 1.3 to 1.7 and 1.2–1.8, respectively.

Conclusion

The bee gut-resident Enterococcus sp. BE11, CFS, and EPS were found to be promising antimicrobial agents against fish pathogens and biofilm producers affecting aquaculture. To the best of our knowledge, this is the first study to purify and make a chemical profile of an EPS produced by a member of the bee gut microbiota as a potential inhibitor for fish pathogens.
Comparison of frontal QRS-T angle of patients with nasal septal deviation with healthy controls
Authors: Kapıcı Olga Bayar , Abuş Sabri , Ayhan Selçuk , Koparal Mehtap , Kaya Hakan
Published: August 2023

Background

This study compares frontal QRS-T angle (fQRS-T) in electrocardiogram (ECG) examinations of people with nasal septal deviation (NSD) with healthy controls (HC).

Methods

Eighty-two patients whom a radiologist with paranasal computed tomography definitively diagnosed with NSD were included in the study. 101 individuals without NSD were selected as HC.

Results

Compared to the HC group, the fQRS-T in was considerably wider in patients with NSD (p < .001). According to Spearman correlation analysis, fQRS-T and NSD angle, and platelet lymphocyte ratio (PLR) were significantly correlated (p = .021, p < .001, and p = .003, respectively). In linear regression analysis where the fQRS-T was taken as a dependent variable, NSD angle and PLR predicted the fQRS-T significantly and positively (F(5.76) = 8.451, R2 = 0.357, Adjusted R2 = 0.315 and p < .001).

Conclusion

In this study, fQRS-T was significantly higher in patients with NSD. In future studies, fQRS-T can be compared before and after septoplasty in NSD patients.
Social isolation and loneliness among older adults living in rural areas during the COVID-19 pandemic: a scoping review
Authors: Pickering John , Wister Andrew V. , O’Dea Eireann , Chaudhury Habib
Published: August 2023

Background

The causes and consequences of social isolation and loneliness of older people living in rural contexts during the COVID-19 pandemic were systematically reviewed to describe patterns, causes and consequences.

Methods

Using the Arksey and O’Malley (2005) scoping review method, searches were conducted between March and December 2022, 1013 articles were screened and 29 were identified for data extraction.

Results

Findings were summarized using thematic analysis separated into four major themes: prevalence of social isolation and loneliness; rural-only research; comparative urban-rural research; and technological and other interventions. Core factors for each of these themes describe the experiences of older people during the COVID-19 pandemic and related lockdowns. We observed that there are interrelationships and some contradictory findings among the themes.

Conclusions

Social isolation and loneliness are associated with a wide variety of health problems and challenges, highlighting the need for further research. This scoping review systematically identified several important insights into existing knowledge from the experiences of older people living in rural areas during the COVID-19 pandemic, while pointing to pressing knowledge and policy gaps that can be addressed in future research.
A network analysis of nutritional markers and maternal perinatal mental health in the French EDEN cohort
Authors: Knox Bethany , Galera Cédric , Sutter-Dallay Anne-Laure , Heude Barbara , de Lauzon-Guillain Blandine , van der Waerden Judith
Published: August 2023

Background

Perinatal maternal depression and anxiety are associated with adverse maternal outcomes, and nutrition may play an important role in their emergence. Previous research shows that certain micro and macronutrients found in different dietary patterns may associate with perinatal mood disorders. This study aims to explore relationships between nutrition during pregnancy and perinatal maternal depression and anxiety symptoms using network analyses.

Methods

Using data from the French EDEN mother-child cohort, the sample consisted of 1438 women with available mental health outcomes (CES-D, STAI and EPDS) and nutritional markers collected from food frequency questionnaires. Four networks were constructed to explore the relationships between prenatal nutrient status, dietary patterns, and perinatal mental health, while accounting for important confounders.

Results

The Healthy dietary pattern was associated with the presence of vital micronutrients, while the Western dietary pattern was consistently associated with poorer intake of specific micronutrients and contained an excess of certain macronutrients. Western dietary pattern and symptoms of postnatal depression were connected by a positive edge in both the macronutrient and micronutrient networks. Lower education levels were associated with higher Western dietary pattern scores, from which a positive edge linked to postnatal depression symptoms in both models.

Conclusions

A Western dietary pattern was associated with increased symptoms of postnatal depression in our adjusted network models; The Healthy dietary pattern was associated with essential micronutrients but not with symptoms of depression or anxiety. Perinatal mental health might be impacted by specific dietary patterns in the context of psychosocial and physical stress associated with pregnancy.
Comparing biweekly single-dose actinomycin D with multiday methotrexate therapy for low-risk gestational trophoblastic neoplasia (FIGO Score 0–4): study protocol for a prospective, multicentre, randomized trial
Authors: Jiang Fang , Mao Ming-yi , Xiang Yang , Lu Xin , Guan Chong-li , Jiao Lan-zhou , Wan Xi-Run , Feng Feng-Zhi , Ren Tong , Yang Jun-Jun , Zhao Jun
Published: August 2023

Background

Single-agent chemotherapy using methotrexate or actinomycin D is the first-line treatment for patients with low-risk gestational trophoblastic neoplasia. Various methotrexate-based and actinomycin D-based single-agent regimens can be used. However, there is insufficient evidence to determine the superior regimen. To guide doctors in selecting a single-agent chemotherapy regimen for patients with low-risk gestational trophoblastic neoplasia, we will compare two regimens.

Methods

We will conduct a multicentre, randomized, prospective clinical trial. Selected low-risk gestational trophoblastic neoplasia patients (FIGO score 0–4) will be randomized 1:1 to a biweekly single-dose actinomycin D group or a multiday methotrexate therapy group. The actinomycin D group will receive IV pulse actinomycin D (1.25 mg/m2) every 14 days, and the methotrexate group will receive methotrexate (50 mg) intramuscularly on days 1, 3, 5, and 7 (4 doses per cycle) and leucovorin (15 mg) intramuscularly on days 2, 4, 6, and 8. This process will be repeated every 14 days. The primary endpoints will include the complete remission rate by single-agent therapy and the overall complete remission rate. The secondary endpoints will include the duration needed to achieve complete remission after single-agent chemotherapy, number of courses needed to achieve complete remission after single-agent chemotherapy, incidence and severity of adverse effects, effects on menstrual conditions and ovarian function based on the anti-Mullerian hormone level, and patient-reported quality of life.

Discussion

Previous clinical trials comparing biweekly single-dose actinomycin D with multiday methotrexate therapy for treating low-risk gestational trophoblastic neoplasia patients failed to meet the expected case number. Through this multicentre study, the complete remission ratio and efficacy difference between biweekly single-dose actinomycin D and multiday methotrexate therapy will be obtained. This study will also provide the basis for formulating a preferred regimen for treating patients with low-risk gestational trophoblastic neoplasia.

Trial registration

ClinicalTrials.gov: NCT04562558, Registered on 13 September 2020 (Protocol version 2020–9-24, version 1.0).
Comparison of clinical outcomes among cancer patients treated in and out of clinical trials
Authors: Duenas Jose A. Carreno , Sanchez P. Natalia , Bonilla Carlos E.
Published: August 2023

Background

It is unknown if participation in a cancer clinical trial confers clinical benefits to patients. There is not enough scientific evidence in this regard and the available publications are scarce and provide ambiguous and limited information.

Objective

Compare overall and progression-free survival and response to treatment among those who met the eligibility criteria and accepted to participate and those who refused to participate in cancer clinical trials.

Methods

An observational cross-sectional study with an analytical component was carried out, which included patients diagnosed with cancer who participated in phase III clinical trials and patients who, being eligible, refused to participate. The patients were cared for at the National Institute of Cancerology in Colombia between 2019 and 2022. Analysis of differences in proportions and means of sociodemographic and clinical variables was included; overall survival and progression-free survival time were described and the survival curves between groups were compared. Variables related to survival were determined using a Cox regression model and Hazard Ratios were calculated.

Results

62 women and 50 men were included. In the women group, we found a statistical association between clinical trial participation and non-serious events adverse and progression. The stable disease and complete response were higher in participants than in refusers. The median progression-free survival for refusers was 7,4 m meantime for participants the median was not reached and 74,1% remained without progression at 28 months. In the men group, we also found a statistical association between clinical trial participation and the occurrence of non-serious events adverse meanwhile there were no significant differences in overall response, progression, and death, even though the proportion of progression was minor in participants 20% vs. refusers 26% respectively. The median survival was not reached for any group, even though in the participants group 55,2% were still alive at month 20 and in the refusers group still alive at 56,8% at month 45. Covariables included for the multivariate Cox regression only age had a statistical association with overall survival in the women’s group and the men group any covariables reached statistical association.

Conclusion

It can be considered that participation in clinical trials could give participants a better response to treatment, without increasing the probability of death and with the probability of decreasing the progression of the disease. Participation in trials could improve the outcomes of clinical response rates, no change in overall survival, and progression-free.
Web-based follow-up tool (ePIPARI) of preterm infants—study protocol for feasibility and performance
Authors: Saarinen Tiina , Ylijoki Milla , Lehtonen Liisa , Munck Petriina , Stolt Suvi , Lapinleimu Helena , Rautava Päivi , Haataja Leena , Setänen Sirkku , Leppänen Marika , Huhtala Mira , Saarinen Katriina , Grönroos Linda , Korja Riikka ,   on behalf of the PIPARI Study group, Ekblad Mikael , Ekblad Satu , Ekholm Eeva , Eurola Annika , Haveri Laura , Helin Minttu , Hirvonen Milka , Jaakkola Jere , Joensuu Eveliina , Karukivi Max , Kero Pentti , Lahti Katri , Lehtonen Tuomo , Lind Annika , Maunu Jonna , Mäkilä Eeva , Määttänen Laura , Niemi Pekka , Nyman Anna , Parkkola Riitta , Ripatti Liisi , Salomäki Susanna , Saunavaara Virva , Sillanpää Matti , Tuomikoski Päivi , Uusitalo Karoliina
Published: August 2023

Background

Preterm infants have a risk of health and developmental problems emerging after discharge. This indicates the need for a comprehensive follow-up to enable early identification of these problems. In this paper, we introduce a follow-up tool “ePIPARI – web-based follow-up for preterm infants”. Our future aim is to investigate whether ePIPARI is a feasible tool in the follow-up of preterm infants and whether it can identify children and parents in need of clinical interventions.

Methods

ePIPARI includes eight assessment points (at term age and at 1, 2, 4, 8, 12, 18, and 24 months of corrected age) when the child´s health and growth, eating and feeding, neurodevelopment, and parental well-being are evaluated. ePIPARI consists of several widely used, standardized questionnaires, in addition to questions typically presented to parents in clinical follow-up visits. It also provides video guidance and written information about age-appropriate neurodevelopment for the parents.

Parents of children born before 34 weeks of gestation during years 2019–2022 are being invited to participate in the ePIPARI study, in which web-based follow-up with ePIPARI is compared to clinical follow-up. In addition, the parents of children born before 32 weeks of gestation, who reached the corrected age of two years during 2019–2021 were invited to participate for the assessment point of 24 months of ePIPARI. The parents are asked to fill in the online questionnaires two weeks prior to each clinical follow-up visit.

Discussion

The web-based tool, ePIPARI, was developed to acquire a sensitive and specific tool to detect infants and parents in need of further support and clinical interventions. This tool could allow individualized adjustments of the frequency and content of the clinical visits.

Trial registration

ClinicalTrials.cov, NCT05238168. Registered 11 April 2022 – Retrospectively registered.
Comparison of two novel diagnostic criteria for bronchopulmonary dysplasia in predicting adverse outcomes of preterm infants: a retrospective cohort study
Authors: Wang Xin , Lu Yang-Ke , Wu Yan-Yan , Liu Da-Peng , Guo Jing , Li Ming-Chao , Wang YingYuan , Li Rui , Zhang Xiao-Yuan , Kang Wen-Qing
Published: August 2023

Background

This study aimed to compare the predictive value of two diagnostic criteria for bronchopulmonary dysplasia (BPD) in preterm infants with gestational age (GA) < 32 weeks for death or severe respiratory morbidity at corrected age of 18–24 months.

Methods

In this retrospective cohort study, clinical data from July 2019 to September 2021 were classified by 2018 National Institute of Child Health and Human Development (NICHD) and 2019 Jensen definitions of BPD. Based on the follow-up results, the enrolled population was divided into adverse outcome group and normal outcome group. Logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to explore the risk factors of adverse outcomes and evaluate the predictive value of both diagnostic criteria.

Results

Of 451 infants, 141 (31.3%) had adverse outcomes, which increased with increasing severity of BPD. Logistic regression analysis showed only BPD was an independent risk factor for adverse outcomes in preterm infants. ROC analysis revealed that both diagnostic criteria showed similar predictive values (2018 NICHD definition AUC = 0.771 vs. 2019 Jensen definition AUC = 0.770), with specificities of 93.5% and 96.8%, respectively; however, combining them separately with GA or birth weight did not improve their predictive values.

Conclusions

The two novel definitions of BPD demonstrate similar predictive values in predicting death or severe respiratory morbidity at corrected age of 18–24 months, with higher specificity observed in both.
Dry mouth in patients with a life-limiting condition or frailty: a study protocol for two intervention studies and a nested qualitative sub-study (the Dry mOuth Project, DROP)
Authors: van der Meulen Annelot I. , Neis Evelien P. J. G. , de Nijs Ellen J. M. , Coenegracht Bénédicte J. E. G. , Stoppelenburg Arianne , van den Beuken-van Everdingen Marieke H. J. , van der Linden Yvette M.
Published: August 2023

Background

Despite its prevalent and impactful nature, dry mouth remains an underexposed and undertreated symptom in patients with a life-limiting condition or frailty. The main contributing factors are a lack of awareness and knowledge amongst both healthcare professionals and patients, and a scarcity of effective, evidence-based interventions. In the DRy mOuth Project (DROP), we address these factors by investigating both a non-pharmacological and a pharmacological intervention: a nurse-led patient education program and locally applied pilocarpine.

Methods

This intervention-based research project consists of two parallel studies. The non-pharmacological study is a cluster non-randomized controlled trial in 228 palliative nursing home and hospital patients, investigating the effect of structured use of guidelines and of patient education on dry mouth symptoms. This intervention, a nurse-led patient education program (the Mouth Education Program, MEP), will be compared to care as usual, the control. The pharmacological study is a double-blind placebo-controlled randomized trial that examines the effect of locally applied pilocarpine drops in 120 patients with dry mouth symptoms. Both studies use the same mixed-methods study design, in which the primary outcome is the clinical response to the intervention at 4 weeks, as measured by a dry mouth severity score (numeric rating scale from 0 to 10). Other outcomes, as measured by questionnaires over a 12-week follow-up period, include durability of the effect, impact on quality of life and, adherence and acceptability of the intervention. In addition, the feasibility and cost-effectiveness are evaluated by means of questionnaires and focus groups with healthcare professionals, and interviews with patients.

Discussion

This study investigates the effectiveness and feasibility of two interventions for dry mouth symptoms in patients with life-limiting conditions or frailty. Due to the large-scale and mixed-method nature of the study, this study will also improve our understanding of dry mouth and its relating factors and of the patients’ and healthcare professionals’ experiences with symptoms, care and guidelines of dry mouth, including any perceived barriers and facilitators.

Trial registration

NCT05964959 & NCT05506137.
Effect of Salvia officinalis scent on postmenopausal women’s sexual function and satisfaction: a randomized controlled trial
Authors: Heydarpour Sousan , Sharifipour Foruzan , Heydarpour Fateme
Published: August 2023

Introduction

Sexual function is one of the important aspects of quality of life which is often impaired after menopause. Given the side effects of hormone therapy on postmenopausal women, alternative treatments such as aromatherapy have won popularity. The aim of this study was to investigate the effect of aromatherapy using Salvia officinalis on the sexual function and satisfaction of postmenopausal women.

Methods

This was a double-blind randomized controlled trial conducted on postmenopausal women referring to health centers in Kermanshah, Iran, in 2018. The participants were randomly divided into two groups: Salvia officinalis (n = 32) and control (n = 32). Women in the intervention group received 2 drops of Salvia officinalis essential oil by inhalation twice a day for 5 consecutive days of a week continued for 6 weeks. The control group received almond oil in the same dosage and frequency. Sexual function and satisfaction were evaluated using the Lindberg sexual satisfaction questionnaire and the female sexual function index, respectively before the intervention and 6 weeks after it.

Results

After 6 weeks of intervention, the total mean scores of sexual function (28.8 ± 2.13 vs.17.9 ± 1.59 P < 0.001) and sexual satisfaction (71.53 ± 5.86 vs. 50.44 ± 10.41) were significantly higher in the Salvia officinalis group compared with the control group, respectively.

Conclusion

The findings showed that aromatherapy using Salvia officinalis has a significant effect on improving sexual function and satisfaction in postmenopausal women. Therefore, given the prevalence of sexual disorders in postmenopausal women, aromatherapy using Salvia officinalis is recommended to be used for improving these disorders.

Clinical trial registration

Iranian Registry of Clinical Trials; https://en.irct.ir/user/trial/50212/view (IRCT20160427027633N6), registered (12/08/2020).