bluuebunny/crossref_metadata_2025 huggingface dataset:
Accepting the Aging Body: Protective Factors of Body Acceptance in Persons of Advanced Age
Authors: Jenull Brigitte , Mayer Carlotta , Awenius Lisa , Bostjancic Gabriele , Kollitsch Karin , Knobel Phil
Published: January 2023

Introduction: Physical attractiveness, productivity, religiosity, meaningfulness, and relationships are important characteristics of successful aging. To maintain psychological flexibility, acceptance and values-directed interventions have been effective in managing difficulties with aging. Objectives: The present paper aimed to investigate body acceptance and individual values in healthy individuals over the age of 50 living in Austria. Methods: In addition to sociodemographic variables, subjective age, attractiveness, and desire for body changes were assessed in our survey. The Austrian Value Questionnaire was used to record values, and the German Version of the Quality of Marriage scale assessed partnership quality. Data from 187 older adults were recruited via snowball sampling. Analyses were performed in SPSS and R, using a structural equation modeling approach. Results: The results indicate that as age increases and subjective attractiveness decreases, body acceptance declines. Materialism seems to support the desire for cosmetic surgery (β = .230, p = .016). A negative association between conservatism and changes in desires for body change (β = −.221, p = .044) suggests that greater value commitment and conservative attitudes are related to fewer change desires. Conclusion: These findings underpin the necessity for encouraging individuals early on to be in touch with their values to promote psychological flexibility.
In plain sight: Oppressive dynamics and learning challenges in adult ESOL programs in the United States
Authors: Housel David A
Published: January 2023

A previous convergent mixed methods study conducted by the author revealed that, based on their preservice preparation and access to in-service professional development, instructors of adult emergent bi/multilingual learners in the United States often felt ill-equipped to address the oppressive dynamics and learning challenges that might manifest in their adult ESOL classrooms. This follow-up interview study explored the prevalence of these oppressive dynamics, such as racism, sexism, and linguicism, and learning challenges, such as neurodiversity, and investigated how preservice preparation, continuous professional development, program administration, and the field of TESOL might address these issues more consistently and equitably. Semi-structured interviews were conducted via Zoom or over the telephone with 10 randomly selected volunteers. The findings revealed that oppressive dynamics and learning challenges are commonplace in adult ESOL programs in the United States. Recommendations included either routinely incorporating discussions and content related to these issues throughout preservice coursework and continuous professional development or creating postgraduate certificate programs to do so. Participants also felt that the field of TESOL should address these issues on a regular versus ad hoc basis through its conferences, publications, and research literature. Limitations of the study and areas for future research were also identified.
Transcriptomic profiling reveals differences in the adaptation of two Tetragenococcus halophilus strains to a lupine moromi model medium
Authors: Link Tobias , Ehrmann Matthias A.
Published: January 2023

Background

Tetragenococcus (T.) halophilus is a common member of the microbial consortia of food fermented under high salt conditions. These comprises salty condiments based on soy or lupine beans, fish sauce, shrimp paste and brined anchovies. Within these fermentations this lactic acid bacterium (LAB) is responsible for the formation of lactic and other short chain acids that contribute to the flavor and lower the pH of the product. In this study, we investigated the transcriptomic profile of the two T. halophilus strains TMW 2.2254 and TMW 2.2256 in a lupine moromi model medium supplied with galactose. To get further insights into which genomic trait is important, we used a setup with two strains. That way we can determine if strain dependent pathways contribute to the overall fitness. These strains differ in the ability to utilize L-arginine, L-aspartate, L-arabinose, D-sorbitol, glycerol, D-lactose or D-melibiose. The lupine moromi model medium is an adapted version of the regular MRS medium supplied with lupine peptone instead of casein peptone and meat extract, to simulate the amino acid availabilities in lupine moromi.

Results

The transcriptomic profiles of the T. halophilus strains TMW 2.2254 and TMW 2.2256 in a lupine peptone-based model media supplied with galactose, used as simulation media for a lupine seasoning sauce fermentation, were compared to the determine potentially important traits. Both strains, have a great overlap in their response to the culture conditions but some strain specific features such as the utilization of glycerol, sorbitol and arginine contribute to the overall fitness of the strain TMW 2.2256. Interestingly, although both strains have two non-identical copies of the tagatose-6P pathway and the Leloir pathway increased under the same conditions, TMW 2.2256 prefers the degradation via the tagatose-6P pathway while TMW 2.2254 does not. Furthermore, TMW 2.2256 shows an increase in pathways required for balancing out the intracellular NADH/NADH+ ratios.

Conclusions

Our study reveals for the first time, that both versions of tagatose-6P pathways encoded in both strains are simultaneously active together with the Leloir pathway and contribute to the degradation of galactose. These findings will help to understand the strain dependent features that might be required for a starter strain in lupine moromi.
Insights into the phylogeny and chloroplast genome evolution of Eriocaulon (Eriocaulaceae)
Authors: Li Enze , Liu Kangjia , Deng Rongyan , Gao Yongwei , Liu Xinyu , Dong Wenpan , Zhang Zhixiang
Published: January 2023

Background

Eriocaulonis a wetland plant genus with important ecological value, and one of the famous taxonomically challenging groups among angiosperms, mainly due to the high intraspecific diversity and low interspecific variation in the morphological characters of species within this genus. In this study, 22 samples representing 15Eriocaulonspecies from China, were sequenced and combined with published samples ofEriocaulonto test the phylogenetic resolution using the complete chloroplast genome. Furthermore, comparative analyses of the chloroplast genomes were performed to investigate the chloroplast genome evolution ofEriocaulon.

Results

The 22Eriocaulonchloroplast genomes and the nine published samples were proved highly similar in genome size, gene content, and order. TheEriocaulonchloroplast genomes exhibited typical quadripartite structures with lengths from 150,222 bp to 151,584 bp. Comparative analyses revealed that four mutation hotspot regions (psbK-trnS,trnE-trnT,ndhF-rpl32, andycf1) could serve as effective molecular markers for further phylogenetic analyses and species identification ofEriocaulonspecies. Phylogenetic results supportedEriocaulonas a monophyletic group. The identified relationships supported the taxonomic treatment of sectionHeterochitonandLeucantherae, and the sectionHeterochitonwas the first divergent group. Phylogenetic tree supportedEriocaulonwas divided into five clades. The divergence times indicated that all the sections diverged in the later Miocene and most of the extantEriocaulonspecies diverged in the Quaternary. The phylogeny and divergence times supported rapid radiation occurred in the evolution history ofEriocaulon.

Conclusion

Our study mostly supported the taxonomic treatment at the section level forEriocaulonspecies in China and demonstrated the power of phylogenetic resolution using whole chloroplast genome sequences. Comparative analyses of theEriocaulonchloroplast genome developed molecular markers that can help us better identify and understand the evolutionary history ofEriocaulonspecies in the future.
The psychological and behavioural factors associated with laypeople initiating CPR for out-of-hospital cardiac arrest: a systematic review
Authors: Farquharson Barbara , Dixon Diane , Williams Brian , Torrens Claire , Philpott Melanie , Laidlaw Henriette , McDermott Siobhan
Published: January 2023

Background

Prompt, effective CPR greatly increases the chances of survival in out-of-hospital c ardiac arrest. However, it is often not provided, even by people who have previously undertaken training. Psychological and behavioural factors are likely to be important in relation to CPR initiation by lay-people but have not yet been systematically identified.

Methods

Aim: to identify the psychological and behavioural factors associated with CPR initiation amongst lay-people.

Design: Systematic review

Data sources: Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycInfo and Google Scholar.

Study eligibility criteria: Primary studies reporting psychological or behavioural factors and data on CPR initiation involving lay-people published (inception to 31 Dec 2021).

Study appraisal and synthesis methods: Potential studies were screened independently by two reviewers. Study characteristics, psychological and behavioural factors associated with CPR initiation were extracted from included studies, categorised by study type and synthesised narratively.

Results

One hundred and five studies (150,820 participants) comprising various designs, populations and of mostly weak quality were identified. The strongest and most ecologically valid studies identified factors associated with CPR initiation: the overwhelming emotion of the situation, perceptions of capability, uncertainty about when CPR is appropriate, feeling unprepared and fear of doing harm. Current evidence comprises mainly atheoretical cross-sectional surveys using unvalidated measures with relatively little formal testing of relationships between proposed variables and CPR initiation.

Conclusions

Preparing people to manage strong emotions and increasing their perceptions of capability are likely important foci for interventions aiming to increase CPR initiation. The literature in this area would benefit from more robust study designs.

Systematic review registration

PROSPERO: CRD42018117438.
Effectiveness of a provider and patient-focused intervention to improve hypertension management and control in the primary health care setting in Cuba: a controlled before-after study
Authors: Londoño Agudelo Esteban , Battaglioli Tullia , Díaz Piñera Addys , Rodríguez Salvá Armando , Smekens Tom , Achiong Estupiñán Fernando , Carbonell García Isabel , Van der Stuyft Patrick
Published: January 2023

Background

Implementation research to improve hypertension control is scarce in Latin America. We assessed the effectiveness of an intervention aimed at primary care practitioners and hypertensive patients in a setting that provides integrated care through an accessible network of family practices.

Methods

We conducted in Cardenas and Santiago, Cuba, a controlled before-after study in 122 family practices, which are staffed with a doctor and a nurse. The intervention comprised a control arm (usual care), an arm with a component targeting providers (hypertension management workshops), and an arm with, on top of the latter, a component targeting patients (hypertension schools). To evaluate the effect, we undertook a baseline survey before the intervention and an endline survey sixteen months after its start. In each survey, we randomly included 1400 hypertensive patients. Controlled hypertension, defined as a mean systolic and diastolic blood pressure below 140 and 90 mmHg, respectively, was the primary endpoint assessed. We performed linear and logistic regression with a Generalized Estimating Equations approach to determine if the proportion of patients with controlled hypertension changed following the intervention.

Results

Seventy-three doctors, including substitutes, and 54 nurses from the 61 intervention family practices attended the provider workshops, and 3308 patients −51.6% of the eligible ones- participated in the hypertension schools. Adherence to anti-hypertensive medication improved from 42% at baseline to 63% at the endline in the intervention arms. Under the provider intervention, the proportion of patients with controlled hypertension increased by 18.9%, from 48.7% at baseline to 67.6% at endline. However, adding the component that targeted hypertensive patients did not augment the effect. Compared to patients in the control arm, the adjusted OR of having controlled hypertension was 2.36 (95% CI, 1.73–3.22) in the provider and 2.00 (95% CI, 1.68–2.37) in the provider plus patient intervention arm.

Conclusions

The intervention’s patient component remains to be fine-tuned. Still, we demonstrate that it is feasible to substantially improve hypertension outcomes by intervention at the primary care level, despite an already relatively high control rate.
Machine learning in general practice: scoping review of administrative task support and automation
Authors: Sørensen Natasha Lee , Bemman Brian , Jensen Martin Bach , Moeslund Thomas B. , Thomsen Janus Laust
Published: January 2023

Background

Artificial intelligence (AI) is increasingly used to support general practice in the early detection of disease and treatment recommendations. However, AI systems aimed at alleviating time-consuming administrative tasks currently appear limited. This scoping review thus aims to summarize the research that has been carried out in methods of machine learning applied to the support and automation of administrative tasks in general practice.

Methods

Databases covering the fields of health care and engineering sciences (PubMed, Embase, CINAHL with full text, Cochrane Library, Scopus, and IEEE Xplore) were searched. Screening for eligible studies was completed using Covidence, and data was extracted along nine research-based attributes concerning general practice, administrative tasks, and machine learning. The search and screening processes were completed during the period of April to June 2022.

Results

1439 records were identified and 1158 were screened for eligibility criteria. A total of 12 studies were included. The extracted attributes indicate that most studies concern various scheduling tasks using supervised machine learning methods with relatively low general practitioner (GP) involvement. Importantly, four studies employed the latest available machine learning methods and the data used frequently varied in terms of setting, type, and availability.

Conclusion

The limited field of research developing in the application of machine learning to administrative tasks in general practice indicates that there is a great need and high potential for such methods. However, there is currently a lack of research likely due to the unavailability of open-source data and a prioritization of diagnostic-based tasks. Future research would benefit from open-source data, cutting-edge methods of machine learning, and clearly stated GP involvement, so that improved and replicable scientific research can be done.
Trends in overall mortality among US veterans with primary myelofibrosis
Authors: Tashi Tsewang , Yu Jingbo , Pandya Shivani , Dieyi Christopher , Scherber Robyn , Parasuraman Shreekant
Published: January 2023

Background

Primary myelofibrosis [PMF] is a myeloproliferative neoplasm associated with reduced overall survival (OS). Management strategies for PMF have evolved over the last two decades, including approval of ruxolitinib as the first Janus kinase 1 (JAK1)/JAK2 inhibitor for patients with intermediate or high-risk myelofibrosis. This study assessed changes in mortality before and after ruxolitinib approval, independent of ruxolitinib treatment.

Methods

This retrospective study investigated mortality trends among US veterans with PMF in 2 time periods, pre-ruxolitinib approval (01/01/2007–12/31/2010) and post-ruxolitinib approval (01/01/2015–09/30/2018). Deidentified patient-level data were extracted from US Veterans Health Administration (VHA) databases using PMF diagnosis codes; index was the first PMF diagnosis date. The analysis included adults with ≥2 PMF claims during the analysis periods who were continuously enrolled in the VHA plan 1 calendar year prior to and 6 months post-index and had ≥1 available International Prognostic Scoring System (IPSS) risk factor (available factors were age > 65, hemoglobin < 10 g/dL, and white blood cell count > 25 × 109/L; each counted as one point). Patients with ≥1 MF diagnosis for 12 months before the index period were excluded. Ruxolitinib treatment was not a requirement to be included in the post-ruxolitinib approval cohort. Mortality rates and OS were estimated using the Kaplan-Meier approach; all-cause mortality hazard ratio was estimated using univariate Cox regression.

Results

The pre- and post-ruxolitinib approval cohorts included 193 and 974 patients, respectively, of which 80 and 197 had ≥2 IPSS risk factors. Ruxolitinib use in the post-ruxolitinib cohort was 8.5% (83/974). At end of follow-up, median (95% CI) OS was significantly shorter in the pre-ruxolitinib cohort (1.7 [1.2–2.6] years vs not reached [3.4–not reached]; P < 0.001). Overall mortality rates for the pre- versus post-ruxolitinib approval cohorts were 79.8% versus 47.3%, respectively, and overall risk of death was 53% lower in the post-ruxolitinib period (hazard ratio, 0.47; 95% CI, 0.37–0.58; P < 0.001). Mortality rates were lower among patients with < 2 vs ≥2 IPSS risk factors.

Conclusions

Although veterans with PMF have high overall mortality rates, and results in this population might not be generalizable to the overall population, there was a significant lowering of mortality rate in the post-ruxolitinib period.
Neoadjuvant chemotherapy with weekly cisplatin and paclitaxel followed by chemoradiation for locally advanced cervical cancer
Authors: Li Jing , Li Ya , Wang Huafeng , Shen Lifei , Wang Qun , Shao Siqi , Shen Yuhong , Xu Haoping , Liu Hua , Cai Rong , Feng Weiwei
Published: January 2023

Background

Currently, the standard treatment for locally advanced cervical cancer is concurrent chemoradiation (CCRT). Forty percent of patients present with disease recurrence. This study aims to investigate the feasibility, safety and efficacy of neoadjuvant chemotherapy (NACT) with weekly cisplatin and paclitaxel (TP) followed by CCRT.

Methods

We are conducting a phase III trial comparing the efficacy and side effects of patients with cervical cancer (FIGO 2018 stage IIB to IVA) who were assigned to four cycles of NACT with cisplatin (40 mg/m2) and paclitaxel (60 mg/m2) weekly followed by CCRT or CCRT alone. In this report, we studied the medium-term effect of 50 patients enrolled in the NACT + CCRT arm. The primary endpoints were the response rate post-NACT and 12 weeks post-CCRT evaluated by MR/CT based on RECIST v 1.1. The secondary endpoints were 3-year OS (overall survival) and PFS (progression-free survival) measured by the Kaplan–Meier method.

Results

Among 50 patients enrolled in the NACT + CCRT arm, the complete and partial response rates were 10.4% and 68.8%, post-NACT. Twelve weeks after treatment completion, the complete response rate was 72.0%, whereas the total response rate (complete and partial response) was 90.0%. After a median follow-up of 28 months, the 3-year OS rate was 83.9%, and the 3-year PFS rate was 73.6%. NACT response was related to superior PFS and OS compared with NACT nonresponse (P < 0.01). Late AEs were exiguous, while early AEs mainly included myelosuppression and gastrointestinal AEs.

Conclusions

This study showed a good response rate achieved by dose-dense weekly cisplatin and paclitaxel followed by standard CCRT. The treatment regimen is feasible, as evidenced by the acceptable toxicity of NACT and by the high compliance with radiotherapy.

Trial registration

Protocol version number and date.

Chinese clinical trial registry, ChiCTR1900025327; http://www.chictr.org.cn. Registered 24 August 2019. Retrospectively registered, medresman.org.cn/ChiCTR1900025326.

The date recruitment began 01–01-2019.
Disclosing common biological signatures and predicting new therapeutic targets in schizophrenia and obsessive–compulsive disorder by integrated bioinformatics analysis
Authors: Ghanbarzehi Abdolhakim , Sepehrinezhad Ali , Hashemi Nazanin , Karimi Minoo , Shahbazi Ali
Published: January 2023

Schizophrenia (SCZ) is a severe mental illness mainly characterized by a number of psychiatric symptoms. Obsessive–compulsive disorder (OCD) is a long-lasting and devastating mental disorder. SCZ has high co-occurrence with OCD resulting in the emergence of a concept entitled “schizo-obsessive disorder” as a new specific clinical entity with more severe psychiatric symptoms. Many studies have been done on SCZ and OCD, but the common pathogenesis between them is not clear yet. Therefore, this study aimed to identify shared genetic basis, potential biomarkers and therapeutic targets between these two disorders. Gene sets were extracted from the Geneweaver and Harmonizome databases for each disorder. Interestingly, the combination of both sets revealed 89 common genes between SCZ and OCD, the most important of which were BDNF, SLC6A4, GAD1, HTR2A, GRIN2B, DRD2, SLC6A3, COMT, TH and DLG4. Then, we conducted a comprehensive bioinformatics analysis of the common genes. Receptor activity as the molecular functions, neuron projection and synapse as the cellular components as well as serotonergic synapse, dopaminergic synapse and alcoholism as the pathways were the most significant commonalities in enrichment analyses. In addition, transcription factor (TFs) analysis predicted significant TFs such as HMGA1, MAPK14, HINFP and TEAD2. Hsa-miR-3121-3p and hsa-miR-495-3p were the most important microRNAs (miRNAs) associated with both disorders. Finally, our study predicted 19 existing drugs (importantly, Haloperidol, Fluoxetine and Melatonin) that may have a potential influence on this co-occurrence. To summarize, this study may help us to better understand and handle the co-occurrence of SCZ and OCD by identifying potential biomarkers and therapeutic targets.
Health-oriented leadership, gender-differences and job satisfaction: results from a representative population-based study in Germany
Authors: Lutz Regina , Jungbäck Nicola , Wischlitzki Elisabeth , Drexler Hans
Published: January 2023

Background

In recent years, the topic of health-oriented leadership (HoL) has often been investigated with health-related outcomes like general health, strain, depression, and anxiety symptoms. In contrast, research which considers the gender of leaders and employees in connection to HoL as well as studies on relationships between HoL and job satisfaction, are scarce. The aim of this paper is to explore the relationships between HoL and health status assessed by employees and leaders, to analyse the relationships between HoL and job satisfaction as a non-health-related outcome for employees and leaders and to examine differences in the assessment of HoL between men and women in a representative dataset of the working population in Germany.

Methods

Data were collected via an access panel as a cross-sectional survey. The quota sample included 643 German workers (managers and employees). We focused on staff-care as a core component of HoL. Statistical analyses were performed using Pearson correlations and regression analyses as well as t-tests and Mann-Whitney-U-Tests.

Results

The results showed no significant differences between male and female employees or leaders in assessing HoL. Regarding HoL we found relationships between self-rated health status or job satisfaction, both for the self-rated assessment of leaders and employees.

Conclusions

Our findings indicate relationships between HoL and well-being as well as job satisfaction at the workplace. For interventions of any kind, the lack of gender effects leaves a wide scope for the implementation of health-promoting measures. In particular, the findings on the relationship between HoL and job satisfaction through leaders’ self-assessment could be used for salutogenic approaches to strengthen resources in leadership trainings.
A situation analysis on postmenopausal women’s self-care needs and priorities in Tehran: a population-based study
Authors: Simbar Masoumeh , Nazarpour Soheila , KhodaKarami Nahid , Nasiri Zeinab , Rashidi Fakari Farzaneh , Kiani Zahra , Keyvanfar Sepideh , Alavi Majd Hamid
Published: January 2023

Background

Women need special care during and after menopause. Due to the emphasis of the World Health Organization on promoting self-care in postmenopausal women, this study aims to analyze the situation and prioritize the self-care needs of postmenopausal women in the Tehran-Iran.

Methods

This was a descriptive-analytical study on 486 postmenopausal women aged 46–85 years living in Tehran in 2021. The Subjects were recruited using a multi-stage sampling method. Data were collected using a socio-demographic and a valid and reliable questionnaire to assess postmenopausal women’s self-care status with four domains including physical health, psychosocial health, reproductive-sexual health, and screening tests. The data were analyzed by SPSS-24.

Results

The mean age of the participants was 62.58 ± 7.75 years. The mean score of self-care was 44.63 ± 21.64% in the postmenopausal women. The lowest score and highest scores were related to psychosocial health (25.12 ± 28.21%) and periodic tests (50.62 ± 24.40%) respectively. There were significant positive correlations between self-care with women’s education level (r = 0.277;p < 0.001), husband’s education level (r = 0.258;p < 0.001), as well as monthly income (r = 0.153;p = 0.001). There was a negative correlation between self-care with the number of children (r = − 0.215;p < 0.001). The level of self-care was higher in employed women (p = 0.001) and also, in women whose husbands were employed (p = 0.012). Multiple linear regression test showed the level of education of the husband (B = 2.72,p = 0.038) and the family size (B = -1.54,p = 0.023) are predictors of the self-care of postmenopausal women.

Conclusion

The findings showed more than 55% of challenges in the self-care behaviors of postmenopausal women in Tehran. The most and least challenging self-care behaviors were related to psychosocial health and performing periodic tests. The priorities were in psychosocial health and reproductive-sexual health dimensions. Self-care promotion is necessary, especially in postmenopausal women, who need special care due to various physical, psychological, and social changes.
Discharge to inpatient rehabilitation following arthroplasty is a strong predictor of persistent opioid use 90 days after surgery: a prospective, observational study
Authors: Jenkin Deanne E. , Harris Ian A. , Descallar Joseph , Naylor Justine M.
Published: January 2023

Background

Total knee and hip arthroplasty are considered a clinically and cost-effective intervention, however, persistent pain post-surgery can occur, and some continue to take opioid medications long-term. One factor which has infrequently been included in prediction modelling is rehabilitation pathway, in particular, one which includes inpatient rehabilitation. As discharge to inpatient rehabilitation post-arthroplasty is common practice, we aimed to identify whether rehabilitation pathway (discharge to in-patient rehabilitation or not) predicts continued use of opioids at 3 months (90 days) post- total knee arthroplasty (TKA) and total hip arthroplasty (THA) whilst controlling for other covariates.

Methods

The study was nested within a prospective observational study capturing pre-operative, acute care and longer-term data from 1900 osteoarthritis (OA) patients who underwent primary TKA or THA. The larger study involved a part-random, part-convenience sample of 19 high-volume hospitals across Australia. Records with complete pre-and post-operative analgesic (35 days and 90 days) use were identified [1771 records (93% of sample)] and included in logistic regression analyses.

Results

Three hundred and thirteen people (17.8%) reported ongoing opioid use at 90 days post-operatively. In the adjusted model, admission to inpatient rehabilitation after surgery was identified as an independent and significant predictor of opioid use at 90-days. Inpatient rehabilitation was associated with almost twice the odds of persistent opioid use at 90-days compared to discharge directly home (OR = 1.9 (1.4, 2.5), p < .001).

Conclusion

The inpatient rehabilitation pathway is a strong predictor of longer-term opioid use (90 days) post-arthroplasty, accounting for many known and possible confounders of use including sex, age, insurance status, major complications, smoking status and baseline body pain levels.

Trial registration

The study was nested within a prospective cohort observational study capturing pre-operative, acute-care and longer-term data from patients undergoing primary TKA or THA for osteoarthritis (ClinicalTrials.gov NCT01899443).
Feasibility, use and benefits of patient-reported outcome measures in palliative care units: a multicentre observational study
Authors: Müller Evelyn , Mayer-Steinacker Regine , Gencer Deniz , Keßler Jens , Alt-Epping Bernd , Schönsteiner Stefan , Jäger Helga , Couné Bettina , Elster Luise , Keser Muhammet , Rauser Julia , Marquardt Susanne , Becker Gerhild
Published: January 2023

Background

Research has shown that routinely assessed, patient-reported outcome measures (PROMs) have positive effects in patients with advanced oncologic diseases. However, the transferability of these results to specialist palliative care is uncertain because patients are more impaired and staff doubt the feasibility and benefits. The aim of this study is to evaluate the feasibility of patient self-assessment of PROMs, their use by staff and the benefits in palliative care wards.

Method

A multicentre observational study was conducted in the context of the implementation of the Integrated Patient Outcome Scale (IPOS) in three specialist palliative care wards at university hospitals in Germany. All admitted patients who screened positive regarding their ability to complete questionnaires were asked to participate and complete the IPOS on paper weekly, with assistance if necessary. Feasibility of questionnaire completion (e.g. proportion of patients able to complete them), use (e.g. involvement of different professional groups) and benefit (e.g. unexpected information in IPOS as rated by treating physicians) were assessed. Staff members’ opinion was obtained in a written, anonymous evaluation survey, patients’ opinion in a short written evaluation.

Results

A total of 557 patients were screened for eligibility, 235 were assessed as able to complete the IPOS (42.2%) and 137 participated in the study (24.6%). A majority needed support in completing the IPOS; 40 staff members and 73 patients completed the evaluation.

Unexpected information was marked by physicians in 95 of the 137 patient questionnaires (69.3%). The staff differed in their opinions on the question of whether this also improved treatment. A majority of 32 staff members (80.0%) were in favour of continuing the use of IPOS (4 against continuation, 4 no answer); 43 (58.9%) patients rated their overall experience of IPOS use as ‘positive’, 29 (39.7%) as ‘neutral’ and 1 (1.4%) as ‘negative’.

Conclusions

While most staff wished to continue using IPOS, it was a challenge to integrate the effort to support the completion of IPOS into daily practice. Digital implementation was not successful, despite various attempts. To explore the effects on care and patient outcomes, multicentre cluster-randomised trials could be employed.

Trial registration

German Clinical Trials Register DRKS-ID: DRKS00016681 (24/04/2019).
The educational paradigm shift—a phenomenographic study of medical teachers’ experiences of practices
Authors: Brauer Sanna , Kettunen Jaana , Levy Anna , Merenmies Jussi , Kulmala Petri
Published: January 2023

Background

This paper proposes a novel approach to the development of competence-oriented higher education, a national transformation aimed at harmonising and digitising undergraduate medical and dental education in Finland.

Methods

We apply phenomenography as a viable qualitative method for medical education research. To better understand medical teachers’ expectations towards the change in the educational paradigm, we need to study teachers’ experiences of the current practices in undergraduate medical and dental education. The phenomenographic approach facilitates solid links between research, educational development, and change.

Results

The phenomenographic study maps the qualitatively different ways in which medical teachers experience undergraduate medical and dental education practices. The answers reflect the changing educational paradigm in medical schools, suggesting practical implications for further development of medical and dental education and training. Core content analysis is preferred instructional scaffold for both teachers and students to prioritise the extensive medical education objectives. The change towards competence-based orientation is in progress and national co-operation accelerates its impact.

Conclusion

There is an obvious need to enrich the content of the current curriculum with national guidelines that aim for congruence in assessment and objectives. Our results suggest an assessment application for the theoretical concepts presented and promote the competence orientation of education throughout the curricula of medical and dental undergraduate education. Moreover, our results contribute to current European discourses on competence-based approaches in higher education. Up-to-date pedagogical faculty development programmes are a key prerequisite for teacher empowerment and future orientation in teaching and learning for healthcare professions.
Cross-cultural adaptation and validation of the Hospital Survey on Patient Safety Culture 2.0 – Brazilian version
Authors: Reis Claudia Tartaglia , Laguardia Josué , Bruno de Araújo Andreoli Paola , Nogueira Júnior Cassimiro , Martins Mônica
Published: January 2023

Background

Patient safety culture concerns the values, beliefs and standards shared by an organisation’s health staff and other personnel which influence their care provision actions and conduct. Several countries have made a priority of strengthening patient safety culture to improve the quality and safety of health care. In this direction, measuring the patient safety culture through validated instruments is a strategy applied worldwide. The purpose of this study was to adapt transculturally and validate the HSOPSC 2.0 to Brazilian Portuguese and the hospital context in Brazil.

Methods

Of the various validated scales for measuring safety culture, the instrument most used internationally is the Hospital Survey on Patient Safety Culture (HSOPSC) developed by the United States Agency for Healthcare Research and Quality in 2004 and revised in 2019, when version 2.0 was released. Adaptation was conducted on a universalist approach and the adapted instrument was then applied to a sample of 2,702 respondents (56% response rate) comprising staff of a large general hospital in the city of São Paulo. Construct validity was investigated by Exploratory Structural Equation Modelling-within-Confirmatory Factor Analysis (ESEM-within-CFA) and reliability was measured in each dimension by means of Cronbach alpha coefficients.

Results

ESEM fit indexes showed good data fit with the proposed model: χ2 = 634.425 df = 221 χ2/df ratio = 2.9 p-value < 0.0000; RMSEA = 0.045 (90% C.I. = 0.041—0.050) and probability RMSEA <  = .05 = 0.963; CFI = 0.986; TLI = 0.968. However, ten items had loads lower than 0.4. Cronbach alpha values were 0.6 or more for all dimensions, except Handoffs and information exchange ($$\alpha$$
α
= 0.50) and Staffing and work pace ($$\alpha$$
α
= 0.41).

Conclusion

The psychometric properties of the Brazilian version were found to be satisfactory, demonstrating good internal consistency and construct validity as expressed by estimates of reliability and indexes of model fit. However, given factor loadings smaller than 0.4 observed in ten items and considering that the scale translated and adapted to Portuguese was tested on a single sample during the Covid-19 pandemic, the authors recognize the need for it to be tested on other samples in Brazil to investigate its validity.
Antimicrobial activities of graphene oxide against biofilm and intracellular Staphylococcus aureus isolated from bovine mastitis
Authors: Saeed Shamsaldeen Ibrahim , Vivian Liang , Zalati C. W. Salma C. W. , Sani Nani Izreen Mohd , Aklilu Erkihun , Mohamad Maizan , Noor An’ Amt Mohamed , Muthoosamy Kasturi , Kamaruzzaman Nor Fadhilah
Published: January 2023

Background

S. aureus is one of the causative agents of bovine mastitis. The treatment using conventional antimicrobials has been hampered due to the development of antimicrobial resistance and the ability of the bacteria to form biofilms and localize inside the host cells.

Objectives

Here, the efficacy of graphene oxide (GO), a carbon-based nanomaterial, was tested against the biofilms and intracellular S. aureus invitro. Following that, the mechanism for the intracellular antimicrobial activities and GO toxicities was elucidated.

Methods

GO antibiofilm properties were evaluated based on the disruption of biofilm structure, and the intracellular antimicrobial activities were determined by the survival of S. aureus in infected bovine mammary cells following GO exposure. The mechanism for GO intracellular antimicrobial activities was investigated using endocytosis inhibitors. GO toxicity towards the host cells was assessed using a resazurin assay.

Results

At 100 ug/mL, GO reduced between 30 and 70% of S. aureus biofilm mass, suggesting GO’s ability to disrupt the biofilm structure. At 200 ug/mL, GO killed almost 80% of intracellular S. aureus, and the antimicrobial activities were inhibited when cells were pre-treated with cytochalasin D, suggesting GO intracellular antimicrobial activities were dependent on the actin-polymerization of the cell membrane. At < 250 ug/mL, GO enhanced the viability of the Mac-T cell, and cells were only affected at higher dosages.

Conclusion

The in vitro efficacy of GO against S. aureus in vitro suggested the compound could be further tested in Vivo to zrecognize its potential as one of the components of bovine mastitis therapy.
The diagnostic value of staging laparoscopy in gallbladder cancer: a nationwide cohort study
Authors: van Dooren Mike , de Savornin Lohman Elise A. J. , Brekelmans Eva , Vissers Pauline A. J. , Erdmann Joris I. , Braat Andries E. , Hagendoorn Jeroen , Daams Freek , van Dam Ronald M. , de Boer Marieke T. , van den Boezem Peter B. , Koerkamp Bas Groot , de Reuver Philip R.
Published: January 2023

Background

Disseminated disease (DD) is often found at (re-)exploration in gallbladder cancer (GBC) patients. We aimed to assess the yield of staging laparoscopy (SL) and identify predictors for DD.

Methods

This retrospective study included patients from all Dutch academic centres with primary GBC (pGBC) and incidentally diagnosed GBC (iGBC) planned for (re-)resection. The yield of SL was determined. In iGBC, predictive factors for DD were assessed.

Results

In total, 290 patients were included. Of 183 included pGBC patients, 143 underwent laparotomy without SL, and 42 (29%) showed DD perioperatively. SL, conducted in 40 patients, identified DD in eight. DD was found in nine of 32 patients who underwent laparotomy after SL.

Of 107 included iGBC patients, 100 underwent laparotomy without SL, and 19 showed DD perioperatively. SL, conducted in seven patients, identified DD in one. Cholecystitis (OR= 4.25; 95%CI1.51–11.91) and primary R1/R2 resection (OR= 3.94; 95%CI1.39–11.19) were independent predictive factors for DD.

Conclusions

In pGBC patients, SL may identify DD in up to 20% of patients and should be part of standard management. In iGBC patients, SL is indicated after primary resection for cholecystitis and after initial R1/R2 resection due to the association of these factors with DD.
Identification of key pharmacological components and targets for Aidi injection in the treatment of pancreatic cancer by UPLC-MS, network pharmacology, and in vivo experiments
Authors: Wang Haojia , Wu Zhishan , Fan Xiaotian , Wu Chao , Lu Shan , Geng Libo , Stalin Antony , Zhu Yingli , Zhang Fanqin , Huang Jiaqi , Liu Pengyun , Li Huiying , You Leiming , Wu Jiarui
Published: January 2023

Background

Pancreatic cancer is one of the most lethal cancers worldwide. Aidi injection (ADI) is a representative antitumor medication based on Chinese herbal injection, but its antitumor mechanisms are still poorly understood.

Materials and methods

In this work, the subcutaneous xenograft model of human pancreatic cancer cell line Panc-1 was established in nude mice to investigate the anticancer effect of ADI in vivo. We then determined the components of ADI using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS) and explored the possible molecular mechanisms against pancreatic cancer using network pharmacology.

Results

In vivo experiments, the volume, weight, and degree of histological abnormalities of implanted tumors were significantly lower in the medium and high concentration ADI injection groups than in the control group. Network pharmacology analysis identified four active components of ADI and seven key targets, TNF, VEGFA, HSP90AA1, MAPK14, CASP3, P53 and JUN. Molecular docking also revealed high affinity between the active components and the target proteins, including Astragaloside IV to P53 and VEGFA, Ginsenoside Rb1 to CASP3 and Formononetin to JUN.

Conclusion

ADI could reduce the growth rate of tumor tissue and alleviate the structural abnormalities in tumor tissue. ADI is predicted to act on VEGFA, P53, CASP3, and JUN in ADI-mediated treatment of pancreatic cancer.
Neurophysiological assessment of cortical activity in DEPDC5- and NPRL3-related epileptic mTORopathies
Authors: Mabika Madora , Agbogba Kristian , Côté Samantha , Lippé Sarah , Riou Émilie , Cieuta Cécile , Lepage Jean-François
Published: January 2023

Background

Mutations in the GATOR1 complex genes, DEPDC5 and NPRL3, play a major role in the development of lesional and non-lesional focal epilepsy through increased mTORC1 signalling. We aimed to assess the effects of mTORC1 hyperactivation on GABAergic inhibitory circuits, in 3 and 5 individuals carrying DEPDC5 and NPRL3 mutations respectively using a multimodal approach including transcranial magnetic stimulation (TMS), magnetic resonance spectroscopy (MRS), and electroencephalography (EEG).

Results

Inhibitory functions probed by TMS and MRS showed no effect of mutations on cortical GABAergic receptor-mediated inhibition and GABA concentration, in both cortical and subcortical regions. However, stronger EEG theta oscillations and stronger and more synchronous gamma oscillations were observed in DEPDC5 and NPRL3 mutations carriers.

Conclusions

These results suggest that DEPDC5 and NPRL3-related epileptic mTORopathies may not directly modulate GABAergic functions but are nonetheless characterized by a stronger neural entrainment that may be reflective of a cortical hyperexcitability mediated by increased mTORC1 signaling.
Repurposing nitric oxide donating drugs in cancer therapy through immune modulation
Authors: Li Chung-Yen , Anuraga Gangga , Chang Chih-Peng , Weng Tzu-Yang , Hsu Hui-Ping , Ta Hoang Dang Khoa , Su Pei-Fang , Chiu Pin-Hsuan , Yang Shiang-Jie , Chen Feng-Wei , Ye Pei-Hsuan , Wang Chih-Yang , Lai Ming-Derg
Published: January 2023

Background

Nitric oxide-releasing drugs are used for cardiovascular diseases; however, their effects on the tumor immune microenvironment are less clear. Therefore, this study explored the impact of nitric oxide donors on tumor progression in immune-competent mice.

Methods

The effects of three different nitric oxide-releasing compounds (SNAP, SNP, and ISMN) on tumor growth were studied in tumor-bearing mouse models. Three mouse tumor models were used: B16F1 melanoma and LL2 lung carcinoma in C57BL/6 mice, CT26 colon cancer in BALB/c mice, and LL2 lung carcinoma in NOD/SCID mice. After nitric oxide treatment, splenic cytokines and lymphocytes were analyzed by cytokine array and flow cytometry, and tumor-infiltrating lymphocytes in the TME were analyzed using flow cytometry and single-cell RNA sequencing.

Results

Low doses of three exogenous nitric oxide donors inhibited tumor growth in two immunocompetent mouse models but not in NOD/SCID immunodeficient mice. Low-dose nitric oxide donors increase the levels of splenic cytokines IFN-γ and TNF-α but decrease the levels of cytokines IL-6 and IL-10, suggesting an alteration in Th2 cells. Nitric oxide donors increased the number of CD8+ T cells with activation gene signatures, as indicated by single-cell RNA sequencing. Flow cytometry analysis confirmed an increase in infiltrating CD8+ T cells and dendritic cells. The antitumor effect of nitric oxide donors was abolished by depletion of CD8+ T cells, indicating the requirement for CD8+ T cells. Tumor inhibition correlated with a decrease in a subtype of protumor macrophages and an increase in a subset of Arg1-positive macrophages expressing antitumor gene signatures. The increase in this subset of macrophages was confirmed by flow cytometry analysis. Finally, the combination of low-dose nitric oxide donor and cisplatin induced an additive cancer therapeutic effect in two immunocompetent animal models. The enhanced therapeutic effect was accompanied by an increase in the cells expressing the gene signature of NK cell.

Conclusions

Low concentrations of exogenous nitric oxide donors inhibit tumor growth in vivo by regulating T cells and macrophages. CD8+ T cells are essential for antitumor effects. In addition, low-dose nitric oxide donors may be combined with chemotherapeutic drugs in cancer therapy in the future.