bluuebunny/crossref_metadata_2025 huggingface dataset:
Service Learning in Public Health: A Critical Assessment of Potential Benefits and Unintended Consequences
Authors: Ratnayake Aneeka , Lederer Alyssa
Published: June 2023

Service learning is a pedagogical strategy in which students complete a project at a community-based organization where they can apply classroom skills in a real-world context. Service learning can benefit student learning outcomes and continues to expand in public health education; yet there is the potential for ethical concerns. In particular, service learning may reinforce inequities between academic institutions and community organizations by positioning academic institutions as holding significant power and resources and inadvertently promoting this dynamic to students. This perspective provides an overview of service learning in public health and related fields, discusses the benefits of service learning as well as the gaps in standardization and evaluation, and highlights situations in which inequities may emerge. Recommendations are provided, with the goal of helping future health promotion professionals better meet the objective of fostering social justice through public health.
Seeing Radiology Curricula Through Turkish Medical Students’ Eyes: A Survey of Turkish Medical Schools’ Radiology Education
Authors: Ayas Görkem , Altinmakas Emre , Rohren Scott A , Dogan Hakan , Dogru Omer F , Koselerli Emir Y , Turksanli Orkun , Efe Ege Ö , Badawy Mohamed , Kamel Serageldin , Patel Parth , Elsayes Khaled M
Published: June 2023

INTRODUCTION

Radiology education is essential for nonradiologist specialists and practitioners as well as for radiologists. We conducted a survey to gather the opinions of Turkish medical students from first to sixth grade regarding their radiology curricula, radiology education content, and perceptions of various imaging modalities and to assess the amount, adequacy, and homogeneity of radiology education in various schools.

METHODS

Turkish medical students were reached by student ambassadors from 10 different schools of medicine via social media and email. They were provided with a 20-question survey—via the SurveyMonkey platform—related to their radiology curriculum and their perceptions of the radiology education at their schools and of different imaging modalities. Subjective parameters were scaled by a 4-point Likert scale and the results are reported by percentages of students.

RESULTS

A total of 988 medical students (F/M: 61%/39%) from 41 different medical schools participated in this survey. Of those, 57% were preclinical students (≤ third year of medical school), while 43% were clinical students (> third year). More than half of the students (51%) stated that the amount of radiology education included in their curriculum was too little, while 44% of them stated it was just right and only 5% stated it was too much. Only 31% of the participants stated that they were able to review radiology images on their own. When asked about their level of confidence in identifying the position of lines and tubes, pneumonia, pneumothorax, and pleural effusion on chest radiographs, 41%, 39%, 41%, and 41% of the participants, respectively, stated that they were not confident. Thirty-five percent of the participants had not received any training in comparing normal to abnormal imaging of bone fractures, pneumonia, pleural effusion, subdural hemorrhage, or pneumothorax. The majority of the Turkish medical students in this survey had never heard (57%) nor used (64%) the American College of Radiology Appropriateness Criteria.

CONCLUSIONS

The radiology curriculum in Turkey differs among various schools and most students stated that preclinical radiology course content was inadequate. Further studies and improvements must be conducted to provide high-quality, equitable radiology education that begins during preclinical training with respect to the students’ opinions.
Impact Evaluation of a Resident-Driven Research Training Workshop in Idaho: A Feasibility Study
Authors: Khan Muhammad Arslan , Iqbal Meesha , Mancilla Trevi Ramirez , Grider John , Solomon Justin , Suleta Katie
Published: June 2023

Objectives

Engagement in research activities is a critical component of clinical residency training. It is vital to build research capacity of residents to help interpret evidence-based medicine and design quality improvement projects. A mixed methods study was conducted to assess the impact of a 1-day research training workshop conducted at Eastern Idaho Regional Medical Centre, Idaho in May 2022. The workshop was targeted to improve the research knowledge of current clinical residents of Internal Medicine and Family Medicine.

Methods

Workshop comprised of expert presentations, with assessment of difference in knowledge with a pretest and post-test. The sessions were organized around the core competencies of Institute of Medicine. Suggestions were also gathered from the audience. A pretest and post-test based on 13 questions was administered to the participants to assess change in research-related knowledge. Comments and suggestions of the participants were also recorded. Wilcoxon rank test was applied to determine statistical difference across each question and cumulative knowledge score. Conventional content analysis was applied to explore the comments and feedback.

Results

The mean score of participants improved across all 12 questions. Statistically significant results were observed for the questions about types of studies qualifying as qualitative research. The cumulative score of participants increased in the post-test from 8.57 to 9.35. The participants gained new knowledge (94.3%), and felt more comfortable in application of research methods (74.3%). Encouraging feedback was obtained from the audience. They stated that they had benefited from the workshop and felt more prepared and motivated to indulge in scholarly activities.

Conclusion

The study shows improvement in research-related knowledge of clinical residents attending a 1-day training workshop. We recommend inclusion of such workshops in the curriculum of residents for skill building and enhanced indulgence in research activities in order to prepare them as future leaders in quality improvement, health policy, and hospital administration.
A hybrid estimation of carbon footprints for urban commuting transportation via path reconstruction
Authors: Zhang Jun , Ai Qiannan , Ye Yuling , Deng Shejun
Published: June 2023

The transportation sector is a major source of carbon emissions, and it is of great significance to study the estimation method of carbon emissions from urban commuting traffic for energy conservation and emission reduction. In view of the difficulty of collecting detailed trip trajectory data, this paper first reconstructs the trip paths via an improved modal choice model and a modified path planning model based on the O-D trip matrix, taking seven single traffic modals and two combined modals into account. In order to estimate the carbon footprints with theoretical accuracy, the bottom-up method is adopted considering the trip modal, vehicle type, power source, vehicle occupancy, operation characteristics and traffic conditions. Meanwhile, faced with the converted carbon emissions from electric vehicles, factors like charging efficiency, vehicular load, regional power structure and transmission loss are further considered in the estimation function. A case study of Changzhou City has been performed to verify the feasibility of the proposed models, where the volume distribution of commuting trips is predicted upon a modified network traffic assignment by TransCAD, and the spatial distribution of carbon emission intensity has further expanded to the adjacent areas via ArcMap analysis tools. The total carbon emission and the average link emission intensity of daily commuting in the study area are about 14.7 × 105 kg/day and 870 kg/km respectively. The discussion results indicate that the CO2 emission of fuel-driven vehicles accounts for over 86%, and the equivalent carbon emission of electric vehicles accounts for about 14% under given modal choices. The correlations of carbon emissions to road levels and zone attributes get further revealed and discussed based on the estimation results.
Air quality and respiratory health in children
Authors: Aithal Sathya Swarup , Sachdeva Ishaan , Kurmi Om P.
Published: June 2023

Air pollution is a leading modifiable risk factor for various cardio-respiratory outcomes globally, both for children and for adults. Children are particularly susceptible to the adverse effects of air pollution due to various physiological and behavioural factors. Children are at a higher risk of outcomes such as acute respiratory infections, asthma and decreased lung function due to air pollution exposure; the risk varies in different geographical regions, depending on the source of air pollution, duration of exposures and concentration. Prenatal exposure to air pollution may also contribute to adverse respiratory outcomes later in life.
Current and future developments in the pharmacology of asthma and COPD: ERS seminar, Naples 2022
Authors: Stolz Daiana , Matera Maria Gabriella , Rogliani Paola , van den Berge Maarten , Papakonstantinou Eleni , Gosens Reinoud , Singh Dave , Hanania Nicola , Cazzola Mario , Maitland-van der Zee Anke-Hilse , Fregonese Laura , Mathioudakis Alexander G. , Vestbo Jørgen , Rukhadze Maia , Page Clive P.
Published: June 2023

Pharmacological management of airway obstructive diseases is a fast-evolving field. Several advances in unravelling disease mechanisms as well as intracellular and molecular pathways of drug action have been accomplished. While the clinical translation and implementation ofin vitroresults to the bedside remains challenging, advances in comprehending the mechanisms of respiratory medication are expected to assist clinicians and scientists in identifying meaningful read-outs and designing clinical studies. This European Respiratory Society Research Seminar, held in Naples, Italy, 5–6 May 2022, focused on current and future developments of the drugs used to treat asthma and COPD; on mechanisms of drug action, steroid resistance, comorbidities and drug interactions; on prognostic and therapeutic biomarkers; on developing novel drug targets based on tissue remodelling and regeneration; and on pharmacogenomics and emerging biosimilars. Related European Medicines Agency regulations are also discussed, as well as the seminar's position on the above aspects.
Genome-wide investigation of NLP gene family members in alfalfa (Medicago sativa L.): evolution and expression profiles during development and stress
Authors: Yu Jinqiu , Yuan Yuying , Dong Linling , Cui Guowen
Published: June 2023

Background

NIN-like protein (NLP) transcription factors (TFs) compose a plant-specific gene family whose members play vital roles in plant physiological processes, especially in the regulation of plant growth and the response to nitrate-nitrogen. However, no systematic identification or analysis of the NLP gene family has been reported in alfalfa. The recently completed whole-genome sequence of alfalfa has allowed us to investigate genome-wide characteristics and expression profiles.

Results

53 MsNLP genes were identified from alfalfa and renamed according to their respective chromosome distributions. Phylogenetic analysis demonstrated that these MsNLPs can be classified into three groups on the basis of their conserved domains. Gene structure and protein motif analyses showed that closely clustered MsNLP genes were relatively conserved within each subgroup. Synteny analysis revealed four fragment duplication events of MsNLPs in alfalfa. The ratios of nonsynonymous (Ka) and synonymous (Ks) substitution rates of gene pairs indicated that the MsNLP genes underwent purifying selection during evolution. Examination of the expression patterns of different tissues revealed specific expression patterns of the MsNLP genes in the leaves, indicating that these genes are involved in plant functional development. Prediction of cis-acting regulatory elements and expression profiles further demonstrated that the MsNLP genes might play important roles in the response to abiotic stress and in phytohormone signal transduction processes.

Conclusion

This study represents the first genome-wide characterization of MsNLP in alfalfa. Most MsNLPs are expressed mainly in leaves and respond positively to abiotic stresses and hormonal treatments. These results provide a valuable resource for an improved understanding of the characteristics and biological roles of the MsNLP genes in alfalfa.
Magnitude and associated factors of dyslipidemia among patients with severe mental illness in dire Dawa, Ethiopia: neglected public health concern
Authors: Fentie Dilnessa , Yibabie Shegaye
Published: June 2023

Background

Lipid metabolism abnormalities are an emerging risk factor for cardiovascular diseases. Due to the nature of the condition and their unhealthy lifestyles, patients with mental illnesses have a doubled risk of morbidity and mortality from dyslipidemia compared to the general population. To our knowledge the magnitude of dyslipidemia in patients with mental illnesses in the eastern Ethiopia has not been reported in the literature to date. Therefore, the aim of the study was to assess and compare the magnitude of dyslipidemia and its predictors among patients with severe mental illnesses and non-mentally ill control patients.

Methods

Nighty six subjects with serious psychiatric disorders and nighty six matched non-psychiatric control subjects who had no history of psychiatric illness were underwent a lipid profile test in Dire Dawa referral hospital, Ethiopia. The mentally ill clients were 18 years of age and older with schizophrenia, major depression, and bipolar disorders. Exposed study subjects were matched to control by age and sex. The data were cleaned and analyzed using SPSS software. A binary logistic regression model was used to determine the factors related to the magnitude of dyslipidemia. Both the crude odds ratio and the adjusted odds ratio with a 95% confidence interval were estimated.

Results

The magnitude of dyslipidemia among mentally ill patients was significantly higher (63.54%) compared to non-exposed controls (31.9%) in the subjects studied. In multiple logistic regression, urban dwellers were six times (AOR = 6.14, 95% CI: 1.2, 16) more likely at risk of developing dyslipidemia compared to rural participants. Similarly, physically inactive participants were nearly two-times (AOR = 1.8, 95% CI: 1.1, 12.9) more likely to develop dyslipidemia compared to physically active study participants. Moreover, study participants who had raised body mass index were 2.1 times (AOR = 2.1, 95% CI: 1.17, 15.3) more likely having dyslipidemia than their counterparts.

Conclusions

This study revealed that the prevalence of dyslipidemia is higher among mentally ill patients compared to non-mentally ill control study participants. Place of residence, physical inactivity, and raised BMI were significantly associated with dyslipidemia. Therefore, intensive screening of patients for dyslipidemia and its components is necessary during follow-up.
Prognosis and mortality within 90 days in community-acquired acute kidney injury in the Southwest of Sweden
Authors: Gross Christel , Miao Jonasson Junmei , Buchebner David , Agvall Björn
Published: June 2023

Background

Community-acquired acute kidney injury (CA-AKI) is common among hospitalized patients and has a poor prognosis. Research is scarce on the impact of a CA-AKI episode among patients without preexisting kidney disease and has not previously been investigated in Sweden. The aim was to describe the outcomes of patients with normal pre-hospitalization kidney function, admitted with community-acquired AKI and to investigate the association between AKI severity with outcomes.

Methods

A retrospective population-based study was applied including patients with CA-AKI according to KDIGO classification, admitted via emergency department (ED) 2017–2019 and with a 90-day follow-up period from the ED-admission, collecting data from the Regional Healthcare Informative Platform. Age, gender and AKI stages, mortality and follow-up regarding recovery and readmission was registered. Hazard ratio (HR) and 95% confidence Interval (CI) for mortality was analyzed using Cox regression adjusted for age, comorbidities, and medication.

Results

There were 1646 patients included, mean age was 77.5 years. CA-AKI stage 3 occurred in 51% of patients < 65 years of age and 34% among those > 65 years. In this study, 578 (35%) patients died and 233 (22%) recovered their kidney function. Mortality rate peaked within the first two weeks and among those at AKI stage 3. Nephrology referral post discharge occurred in 3% and 29% were readmitted. HRs for mortality was 1.9 (CI 1.38–2.62) for those who are > 65 years, 1.56 (CI 1.30–1.88) for atherosclerotic-cardiovascular disease. Medication with RAASi related to a decreased HR 0.27 (95% CI 0.22–0.33).

Conclusions

CA-AKI is associated with high mortality within 90 days, increased risk for developing chronic kidney disease (CKD) and only one fifth recover their kidney function after hospitalization with an AKI. Nephrology referral was sparse. Patient follow-up after a hospitalization with AKI should be carefully planned during the first 90 days and focused on identifying those with a higher risk of developing CKD.
Non-typical persistent hyperplastic primary vitreous: a rare case report and review of the literature
Authors: Yu Yinhui , Qiao Yue , Chen Silong , Hu Jianghua , Li Jinyu , Yao Ke , Yu Yibo
Published: June 2023

Background

Persistent hyperplastic primary vitreous (PHPV), also known as persistent fetal vasculature (PFV), is a clinical entity that traditionally presents with leukocoria, microphthalmia, retinal dysplasia, or eyeball shrinkage which is associated with poor vision. However, there is a dearth of literature on cases of PHPV in adulthood or with asymptomatic occurrence. This report presents the clinical and pathological findings of a non-typical PHPV case and discuss the current knowledge for this condition.

Case presentation

A 68-year-old healthy male was referred to our outpatient department for evaluation of age-related cataract without other visual symptoms. Preoperative fundus examination occasionally detected an isolated stalk-like band extending to the posterior pole of the eye with normal central vitreous and retina. Other ocular examinations including b-mode ultrasonography, optical coherence tomography did not unveil any abnormalities, which caused diagnostic uncertainty. We referred to cataract surgery along with histopathological study, that revealed characteristics of PHPV including fibrous connective tissues mainly composed of fibrocyte proliferation and a very few capillary vessels. Thereafter, a definitive diagnosis of non-typical PHPV was established.

Conclusion

Our case is unique due to it was not discovered until adulthood, presence with only age-related cataract, and accompanied with normal central vitreous and retina. Histopathological explorations lead to an accurate diagnosis of the condition. Those results broaden the phenotype spectrums of PHPV and further provide clinical clues for the cognition of the disease.
Empirically derived dietary patterns and postpartum depression symptoms in a large sample of Iranian women
Authors: Dehghan-Banadaki Shima , Hosseinzadeh Mahdieh , Madadizadeh Farzan , Mozaffari-Khosravi Hassan
Published: June 2023

Background

Postpartum Depression (PPD) is a major depressive disorder that mainly begins within one month after delivery. The present study aimed to determine the relationship between dietary patterns and the occurrence of high PPD symptoms in women participating in the initial phase of the Maternal and Child Health cohort study, Yazd, Iran.

Methods

This cross-sectional study was carried out in the years 2017–2019 included 1028 women after childbirth The Food Frequency Questionnaire (FFQ) and the Edinburgh Postnatal Depression Scale (EPDS) were study tools. The EPDS questionnaire was used to measure postpartum depression symptoms and a cut-off score of 13 was considered to indicate high PPD symptoms. The baseline data related to dietary intake was collected at the beginning of the study at the first visit after pregnancy diagnosis and the data related to depression, were collected in the second month after delivery. Dietary patterns were extracted by exploratory factor analysis (EFA). Frequency (percentage) and mean (SD) were used for description. Chi-square test, Fisher’s exact test, independent sample t-test, and multiple logistic regression (MLR) were used for data analysis.

Results

The incidence of high PPD symptoms was 24%. Four posterior patterns were extracted including prudent pattern, sweet and dessert pattern, junk food pattern and western pattern. A high adherence to the western pattern was associated with a higher risk of high PPD symptoms than a low adherence (ORT3/T1: 2.67; p < 0.001). A high adherence to the Prudent pattern was associated with a lower risk of high PPD symptoms than a low adherence (ORT3/T1: 0.55; p = 0.001). There are not any significant association between sweet and dessert and junk food patterns and high PPD symptoms risk (p > 0.05).

Conclusion

High adherence to prudent patterns was characterized by high intake of vegetables, fruit and juice, nuts and beans, low-fat dairy products, liquid oil, olive, eggs, fish, whole grains had a protective effect against high PPD symptoms, but the effect of western pattern was characterized by high intake of red and processed meats and organs was reverse. Therefore, it is suggested that health care providers have a particular emphasis on the healthy food patterns such as the prudent pattern.
Does long-term care insurance reduce the disability among middle-aged and older adults? Evidence from China
Authors: Cao Na , Shi Tong , Pan Chaoping
Published: June 2023

This study aimed to examine whether the implementation of Long-Term Care Insurance (LTCI) policy could reduce the disability among middle-aged and older adults in China, and to test the heterogeneity of the effects. Data came from four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). The Difference-In-Differences (DID) method and the panel data fixed effect model were used to estimate the effect of implementation of LTCI policy on disability among individuals aged 45 years and above. The LTCI policy had a positive impact on reducing disability among middle-aged and older people. Females, younger adults, city dwellers, and individuals living alone benefited the most from LTCI policy. The results provided empirical evidence for the implementation of LTCI policy in China and other similar countries as China. The implementation of LTCI policy should also pay more attention to inequity of the effects on reducing disability among different demographic groups.
Characteristics of Chinese women in need of enhanced sexual health attention and at risk of hypoactive sexual desire disorder
Authors: Luo Lan , Huang Jingjing , Li Huafang
Published: June 2023

Background

The target population for women’s sexual health services in China was unclear. To identify high-risk individuals with psychological barriers to sexual health-seeking behaviors and those at high risk of hypoactive sexual desire disorder (HSDD), we investigated correlates of Chinese women’s unwillingness to communicate sexual health, the shame of sexual health-related disorders, sexual distress, and HSDD.

Methods

An online survey was conducted from April to July 2020.

Results

We received 3443 valid responses online (effective rate 82.6%). Participants were mainly Chinese urban women of childbearing age (median 26 years old, Q1-Q3 23–30). Women who knew little about sexual health knowledge (aOR 0.42, 95%CI 0.28–0.63) and were ashamed (aOR 0.32–0.57) of sexual health-related disorders were less willing to communicate sexual health. Age (aOR 4.29, 95%CI 2.26–8.17), low income (aOR 1.52–2.11), family burden (aOR 1.34–1.43), and living with friends (aOR 1.39, 95%CI 1.02–1.91) were independent correlates of women’s shame about sexual health-related disorders while living with a spouse (aOR 0.66, 95%CI 0.51–0.86) or children (aOR 0.77, 95%CI 0.62–0.96) were correlated with less shame. Age (aOR 0.98, 95%CI 0.96–0.99) and a postgraduate degree (aOR 0.45, 95%CI 0.28–0.71) were linked with less sexual distress of low sexual desire while having children (aOR 1.38–2.10), intense work pressure (aOR 1.32, 95%CI 1.10–1.60) and heavy family burden (aOR 1.43, 95%CI 1.07–1.92) increased women’s odds of having distress. Women with a postgraduate degree (aOR 0.42, 95%CI 0.19–0.90), more knowledge about sexual health (aOR 0.53–0.67), and decreased sexual desire caused by pregnancy, recent childbirth, or menopausal symptoms (aOR 0.60, 95%CI 0.41–0.85) were less likely to have HSDD, while they were more likely to have HSDD when their decreased sexual desire was due to other sexual issues (aOR 2.56, 95%CI 1.84–3.57) and partners’ sexual problems (aOR 1.72, 95%CI 1.23–2.39).

Conclusion

Sexual health education and related services need to focus on psychological barriers of women with older age, insufficient knowledge of sexual health, intense work pressure, and poor economic conditions. The medical staff need to pay attention to the sexual health of women with intense work or life pressure and a history of gynecological disease. Low sexual desire is not equal to the sexual desire problem, which should be noticed in the future.
Factors affecting spiritual care competency of mental health nurses: a questionnaire-based cross-sectional study
Authors: Han Kuei-Hsiang , Hung Kuo-Chuan , Cheng Yu-Shian , Chung Weilun , Sun Cheuk-Kwan , Kao Chia-Chan
Published: June 2023

Background

Although providing spiritual care is an important part of holistic nursing care for psychiatric patients, factors associated with spiritual care competency in mental health nurses remain unclear. The aim of our study was to explore a possible association of personal and external factors with spiritual care competency in mental health nurses.

Methods

This prospective questionnaire-based cross-sectional study was conducted by inviting mental health nurses from mental health hospitals and tertiary referral centers. Personality traits and spiritual care competency were assessed by using [1] “big-five Mini-Markers” questionnaire, and [2] spiritual care competency scale, respectively. From the 250 mental health nurses being invited, 239 valid questionnaires were valid for final analysis. Statistical analyses including descriptive statistics, ANOVAs, t-tests, and hierarchical multiple regression models were used to investigate the associations between personal/external factors and their spiritual care competency in mental health nurses.

Results

The mean age of the 239 participants was 35.96 ± 8.11 and the mean years of working experience was 9.41 ± 7.06. Over 90% of them had no experience of providing spiritual care. There were significant positive correlations of spiritual care competency with the experience of delivering spiritual care (p < 0.001), previous participation in spiritual care education programs (p = 0.045), a longer working experience (p = 0.014), and a higher education level (postgraduate vs. college,p = 0.006), as well as the personality components of “Conscientiousness” (p < 0.001), “Agreeableness” (p < 0.001), “Extraversion” (p = 0.03), and “Openness/Intellect” (p < 0.001).

Conclusions

Both personal and external factors may be related to the self-perception of spiritual care competency among mental health nurses. These findings may help mental health nurses understand the possible positive and negative associations of their personality components with their spiritual care abilities. Moreover, our identification of the positive impacts of educational programs and previous experience of spiritual care on spiritual care competency may underscore the importance of tailoring appropriate training programs to cater for the individual needs of mental health nurses.
A narrative review of refugee & asylum seekers’ transitions into & experiences of working in the United Kingdom National Health Service
Authors: Farnham Derek David Truong , Goldstone Ross
Published: June 2023

Background

The United Kingdom (UK) has a significant and rising population of refugees and asylum seekers, including many who have previously worked as healthcare professionals. Evidence shows they have struggled to join and successfully work in the UK National Health Service (NHS) despite initiatives designed to improve their inclusion. This paper presents a narrative review based on research surrounding this population to describe the barriers that have impeded their integration and possible ways to overcome them.

Methods

We conducted a literature review to obtain peer-reviewed primary research from key databases (PubMed, Web of Science, Medline, EMBASE). The collected sources were individually reviewed against predetermined questions to construct a cohesive narrative.

Results

46 studies were retrieved, of which 13 satisfied the inclusion criteria. The vast majority of literature focussed on doctors with minimal research on other healthcare workers. Study review identified numerous barriers impeding the integration of refugee and asylum seeker healthcare professionals (RASHPs) into the workforce that are unique from other international medical graduates seeking employment in the UK. These include experiences of trauma, additional legal hurdles and restrictions on their right to work, significant gaps in work experience, and financial difficulties. Several work experience and/or training programs have been created to help RASHPs obtain substantive employment, the most successful of which have involved a multifaceted approach and an income for participants.

Conclusions

Continual work towards improving the integration of RASHPs into the UK NHS is mutually beneficial. Existing research is significantly limited in quantity, but it provides a direction for future programs and support systems.
Nanomaterials in tumor immunotherapy: new strategies and challenges
Authors: Zhu Xudong , Li Shenglong
Published: June 2023

Tumor immunotherapy exerts its anti-tumor effects by stimulating and enhancing immune responses of the body. It has become another important modality of anti-tumor therapy with significant clinical efficacy and advantages compared to chemotherapy, radiotherapy and targeted therapy. Although various kinds of tumor immunotherapeutic drugs have emerged, the challenges faced in the delivery of these drugs, such as poor tumor permeability and low tumor cell uptake rate, had prevented their widespread application. Recently, nanomaterials had emerged as a means for treatment of different diseases due to their targeting properties, biocompatibility and functionalities. Moreover, nanomaterials possess various characteristics that overcome the defects of traditional tumor immunotherapy, such as large drug loading capacity, precise tumor targeting and easy modification, thus leading to their wide application in tumor immunotherapy. There are two main classes of novel nanoparticles mentioned in this review: organic (polymeric nanomaterials, liposomes and lipid nanoparticles) and inorganic (non-metallic nanomaterials and metallic nanomaterials). Besides, the fabrication method for nanoparticles, Nanoemulsions, was also introduced. In summary, this review article mainly discussed the research progress of tumor immunotherapy based on nanomaterials in the past few years and offers a theoretical basis for exploring novel tumor immunotherapy strategies in the future.
Epidemiological change of influenza virus in hospitalized children with acute respiratory tract infection during 2014−2022 in Hubei Province, China
Authors: Yi Song , Zhang Wan-Xue , Zhou Yi-Guo , Wang Xin-Rui , Du Juan , Hu Xing-Wen , Lu Qing-Bin
Published: June 2023

Purpose

Influenza virus (IFV) causes acute respiratory tract infection (ARTI) and leads to high morbidity and mortality annually. This study explored the epidemiological change of IFV after the implementation of the universal two-child policy and evaluated the impact of coronavirus disease 2019 (COVID-19) pandemic on the detection of IFV.

Methods

Hospitalized children under 18 years with ARTI were recruited from Hubei Maternal and Child Healthcare Hospital of Hubei Province from January 2014 to June 2022. The positive rates of IFV were compared among different periods by the implementation of the universal two-child policy and public health measures against COVID-19 pandemic.

Results

Among 75,128 hospitalized children with ARTI, the positive rate of IFV was 1.98% (1486/75128, 95% CI 1.88–2.01). Children aged 6−17 years had the highest positive rate of IFV (166/5504, 3.02%, 95% CI 2.58−3.50). The positive rate of IFV dropped to the lowest in 2015, then increased constantly and peaked in 2019. After the universal two-child policy implementation, the positive rate of IFV among all the hospitalized children increased from 0.40% during 2014−2015 to 2.70% during 2017−2019 (RR 6.72, 95% CI 4.94−9.13, P < 0.001), particularly children under one year shown a violent increasing trend from 0.20 to 2.01% (RR 10.26, 95% CI 5.47−19.23, P < 0.001). During the initial outbreak of COVID-19, the positive rate of IFV decreased sharply compared to that before COVID-19 (0.35% vs. 3.37%, RR 0.10, 95% CI 0.04−0.28, P < 0.001), and then rebounded to 0.91%, lower than the level before COVID-19 (RR 0.26, 95% CI 0.20−0.36, P < 0.001).

Conclusion

IFV epidemiological pattern has changed after the implementation of the universal two-child policy. More attention should be emphasized to comprehend the health benefits generated by COVID‐19 restrictions on IFV transmission in future.
Impact of the first response unit on prehospital on-scene time among paramedic-suspected stroke patients: a retrospective before–after cohort study in Finland
Authors: Vaajanen Verna K.E. , Vuorinen Pauli E.T. , Setälä Piritta A. , Autio Reija , Hoppu Sanna E.
Published: June 2023

Background

Revascularization of an occluded artery by either thrombolysis or mechanical thrombectomy is a time-critical intervention in ischaemic stroke. Each link in the stroke chain of survival should minimize the delay to definitive treatment in every possible way. In this study, we investigated the effect of routine dispatch of a first response unit (FRU) on prehospital on-scene time (OST) on stroke missions.

Methods

Medical dispatch of FRU together with an emergency medical service (EMS) ambulance was a routine strategy in the Tampere University Hospital area before 3 October 2018, after which the FRU has only been dispatched to medical emergencies on the decision of an EMS field commander. This study presents a retrospective before–after analysis of 2,228 paramedic-suspected strokes transported by EMSs to Tampere University Hospital. We collected data from EMS medical records from April 2016 to March 2021, and used statistical tests and binary logistic regression to detect the associations between the variables and the shorter and longer half of OSTs.

Results

The median OST of stroke missions was 19 min, IQR [14–25] min. The OST decreased when the routine use of the FRU was discontinued (19 [14–26] min vs. 18 [13–24] min, p < 0.001). The median OST with the FRU being the first at the scene (n = 256, 11%) was shorter than in cases where the FRU arrived after the ambulance (16 [12–22] min vs. 19 [15–25] min, p < 0.001). The OST with a stroke dispatch code was shorter than with non-stroke dispatches (18 [13–23] min vs. 22 [15–30] min, p < 0.001). The OST for thrombectomy candidates was shorter than that for thrombolysis candidates (18 [13–23] min vs. 19 [14–25], p = 0.01). The shorter half of OSTs were associated with the FRU arriving first at the scene, stroke dispatch code, thrombectomy transportation and urban location.

Conclusion

The routine dispatch of the FRU to stroke missions did not decrease the OST unless the FRU was first to arrive at the scene. In addition, a correct stroke identification in the dispatch centre and thrombectomy candidate status decreased the OST.
Incidence and risk factors of warfarin therapy complications in community hospitals, central and eastern regions, Thailand: a retrospective, multicenter, cohort study
Authors: Sombat Benyapha , Tongkaew Sarisa , Nilwaranon Aticha , Mungthin Mathirut , Jongcherdchootrakul Kanlaya , Lertwanichwattana Teeraboon
Published: June 2023

Objectives

Warfarin, like many other anticoagulants, has been linked to an elevated risk of bleeding proportional to the amount of anticoagulation used. Not only was the incidence of bleeding raised by the dosage, but the subtherapeutic international normalized ratio (INR) was also associated with increased thrombotic events. This retrospective cohort and multi-center study evaluated the incidence and risk factors of warfarin therapy complications in community hospitals in Thailand’s central and eastern regions from 2016 to 2021.

Results

Among 335 patients (683.90 person-year of follow-up), The incidence rate of warfarin complications was 4.91 events per 100 person-year. The independent factor associated with warfarin therapy complications was propranolol prescription (Adjusted RR: 2.29, 95%CI: 1.12–4.71). The secondary analysis was divided according to the outcome of the major bleeding and thromboembolic event. Major bleeding events, hypertension (Adjusted RR: 0.40, 95%CI: 0.17–0.95), amiodarone prescription (Adjusted RR: 5.11, 95%CI: 1.08–24.15), and propranolol prescription (Adjusted RR: 2.86, 95%CI: 1.19–6.83) were the independent risk factors. While in the major thrombotic event, non-steroidal anti-inflammatory drugs (NSAIDs) prescription was an independent factor (Adjusted RR: 10.65, 95%CI: 1.26–90.35).
Association between polygenic risk for Alzheimer’s disease and brain structure in children and adults
Authors: He Xiao-Yu , Wu Bang-Sheng , Kuo Kevin , Zhang Wei , Ma Qing , Xiang Shi-Tong , Li Yu-Zhu , Wang Zi-yi , Dong Qiang , Feng Jian-Feng , Cheng Wei , Yu Jin-Tai
Published: June 2023

Background

The correlations between genetic risk for Alzheimer’s disease (AD) with comprehensive brain regions at a regional scale are still not well understood. We aim to explore whether these associations vary across different age stages.

Methods

This study used large existing genome-wide association datasets to calculate polygenic risk score (PRS) for AD in two populations from the UK Biobank (N ~ 23 000) and Adolescent Brain Cognitive Development Study (N ~ 4660) who had multimodal macrostructural and microstructural magnetic resonance imaging (MRI) metrics. We used linear mixed-effect models to assess the strength of the association between AD PRS and multiple MRI metrics of regional brain structures at different stages of life.

Results

Compared to those with lower PRSs, adolescents with higher PRSs had thinner cortex in the caudal anterior cingulate and supramarginal. In the middle-aged and elderly population, AD PRS had correlations with regional structure shrink primarily located in the cingulate, prefrontal cortex, hippocampus, thalamus, amygdala, and striatum, whereas the brain expansion was concentrated near the occipital lobe. Furthermore, both adults and adolescents with higher PRSs exhibited widespread white matter microstructural changes, indicated by decreased fractional anisotropy (FA) or increased mean diffusivity (MD).

Conclusions

In conclusion, our results suggest genetic loading for AD may influence brain structures in a highly dynamic manner, with dramatically different patterns at different ages. This age-specific change is consistent with the classical pattern of brain impairment observed in AD patients.
Frailty in randomised controlled trials for dementia or mild cognitive impairment measured via the frailty index: prevalence and prediction of serious adverse events and attrition
Authors: Wightman Heather , Quinn Terry J. , Mair Frances S. , Lewsey Jim , McAllister David A. , Hanlon Peter
Published: June 2023

Background

Frailty and dementia have a bidirectional relationship. However, frailty is rarely reported in clinical trials for dementia and mild cognitive impairment (MCI) which limits assessment of trial applicability. This study aimed to use a frailty index (FI)—a cumulative deficit model of frailty—to measure frailty using individual participant data (IPD) from clinical trials for MCI and dementia. Moreover, the study aimed to quantify the prevalence of frailty and its association with serious adverse events (SAEs) and trial attrition.

Methods

We analysed IPD from dementia (n = 1) and MCI (n = 2) trials. An FI comprising physical deficits was created for each trial using baseline IPD. Poisson and logistic regression were used to examine associations with SAEs and attrition, respectively. Estimates were pooled in random effects meta-analysis. Analyses were repeated using an FI incorporating cognitive as well as physical deficits, and results compared.

Results

Frailty could be estimated in all trial participants. The mean physical FI was 0.14 (SD 0.06) and 0.14 (SD 0.06) in the MCI trials and 0.24 (SD 0.08) in the dementia trial. Frailty prevalence (FI > 0.24) was 6.9%/7.6% in MCI trials and 48.6% in the dementia trial. After including cognitive deficits, the prevalence was similar in MCI (6.1% and 6.7%) but higher in dementia (75.4%). The 99th percentile of FI (0.31 and 0.30 in MCI, 0.44 in dementia) was lower than in most general population studies. Frailty was associated with SAEs: physical FI IRR = 1.60 [1.40, 1.82]; physical/cognitive FI IRR = 1.64 [1.42, 1.88]. In a meta-analysis of all three trials, the estimated association between frailty and trial attrition included the null (physical FI OR = 1.17 [0.92, 1.48]; physical/cognitive FI OR = 1.16 [0.92, 1.46]), although higher frailty index values were associated with attrition in the dementia trial.

Conclusion

Measuring frailty from baseline IPD in dementia and MCI trials is feasible. Those living with more severe frailty may be under-represented. Frailty is associated with SAEs. Including only physical deficits may underestimate frailty in dementia. Frailty can and should be measured in future and existing trials for dementia and MCI, and efforts should be made to facilitate inclusion of people living with frailty.
Comparative analysis of metaheuristic load balancing algorithms for efficient load balancing in cloud computing
Authors: Zhou Jincheng , Lilhore Umesh Kumar , M Poongodi , Hai Tao , Simaiya Sarita , Jawawi Dayang Norhayati Abang , Alsekait Deema Mohammed , Ahuja Sachin , Biamba Cresantus , Hamdi Mounir
Published: June 2023

Load balancing is a serious problem in cloud computing that makes it challenging to ensure the proper functioning of services contiguous to the Quality of Service, performance assessment, and compliance to the service contract as demanded from cloud service providers (CSP) to organizations. The primary objective of load balancing is to map workloads to use computing resources that significantly improve performance. Load balancing in cloud computing falls under the class of concerns defined as "NP-hard" issues due to vast solution space. Therefore it requires more time to predict the best possible solution. Few techniques can perhaps generate an ideal solution under a polynomial period to fix these issues. In previous research, Metaheuristic based strategies have been confirmed to accomplish accurate solutions under a decent period for those kinds of issues. This paper provides a comparative analysis of various metaheuristic load balancing algorithms for cloud computing based on performance factors i.e., Makespan time, degree of imbalance, response time, data center processing time, flow time, and resource utilization. The simulation results show the performance of various Meta-heuristic Load balancing methods, based on performance factors. The Particle swarm optimization method performs better in improving makespan, flow time, throughput time, response time, and degree of imbalance.
RNA-based amplicon sequencing is ineffective in measuring metabolic activity in environmental microbial communities
Authors: Wang Ya , Thompson Kelsey N. , Yan Yan , Short Meghan I. , Zhang Yancong , Franzosa Eric A. , Shen Jiaxian , Hartmann Erica M. , Huttenhower Curtis
Published: June 2023

Background

Characterization of microbial activity is essential to the understanding of the basic biology of microbial communities, as the function of a microbiome is defined by its biochemically active (“viable”) community members. Current sequence-based technologies can rarely differentiate microbial activity, due to their inability to distinguish live and dead sourced DNA. As a result, our understanding of microbial community structures and the potential mechanisms of transmission between humans and our surrounding environments remains incomplete. As a potential solution, 16S rRNA transcript-based amplicon sequencing (16S-RNA-seq) has been proposed as a reliable methodology to characterize the active components of a microbiome, but its efficacy has not been evaluated systematically. Here, we present our work to benchmark RNA-based amplicon sequencing for activity assessment in synthetic and environmentally sourced microbial communities.

Results

In synthetic mixtures of living and heat-killed Escherichia coli and Streptococcus sanguinis, 16S-RNA-seq successfully reconstructed the active compositions of the communities. However, in the realistic environmental samples, no significant compositional differences were observed in RNA (“actively transcribed — active”) vs. DNA (“whole” communities) spiked with E. coli controls, suggesting that this methodology is not appropriate for activity assessment in complex communities. The results were slightly different when validated in environmental samples of similar origins (i.e., from Boston subway systems), where samples were differentiated both by environment type as well as by library type, though compositional dissimilarities between DNA and RNA samples remained low (Bray–Curtis distance median: 0.34–0.49). To improve the interpretation of 16S-RNA-seq results, we compared our results with previous studies and found that 16S-RNA-seq suggests taxon-wise viability trends (i.e., specific taxa are universally more or less likely to be viable compared to others) in samples of similar origins.

Conclusions

This study provides a comprehensive evaluation of 16S-RNA-seq for viability assessment in synthetic and complex microbial communities. The results found that while 16S-RNA-seq was able to semi-quantify microbial viability in relatively simple communities, it only suggests a taxon-dependent “relative” viability in realistic communities.