bluuebunny/crossref_metadata_2025 huggingface dataset:
The perspectives of homeless people using the services of a mobile health clinic in relation to their health needs: a qualitative study on community-based outreach nursing
Authors: Paradis-Gagné Etienne , Jacques Marie-Claude , Pariseau-Legault Pierre , Ben Ahmed Houssem Eddine , Stroe Ioana Ruxandra
Published: April 2023

Background:

Significant social and health issues are associated with homelessness. Negative experiences with the healthcare system are also frequent and cause people experiencing homelessness to avoid health services.

Aims:

The purpose of this study was to (1) explore participants’ health needs concerning outreach nursing services and (2) describe the perceptions and preferences of people who access this form of community-based intervention.

Methods:

We conducted a critical ethnography with semi-structured interviews of 12 people experiencing homelessness who receive the services of a nurse-led mobile clinic, and 60 hours of observation during the provision of these services.

Results:

Our results describe the perspectives of people experiencing homelessness in three main categories: (1) worrisome health and social needs, (2) non-use of healthcare and (3) what connects us to health services.

Conclusions:

Timely access to healthcare is an important issue for people experiencing homelessness. Nurse-led clinics meet needs that go far beyond health issues.
Global Nurse Involvement in ethical decision-making during pandemics: a concept analysis
Authors: Alshawish Eman , Benbenishty Julie
Published: April 2023

Background:

During pandemics, there are considerable ethical dilemmas. It is imperative that nurses are involved in ethical decision-making bringing nursing theory, practice and perspectives to better advocate for patients. In order to prepare nurses to be partners in ethical dilemma decision-making during pandemics, it is vital to understand the extent that nurses are involved in such decision-making during the COVID-19 pandemic.

Aim:

The purpose of this concept analysis is to identify nurse involvement in ethical decision-making during pandemics.

Method:

Concept analysis methodology based on literature searches used bibliographic databases: PubMed – 20 papers; Google Scholar – 8120 papers; EMBASE – 25 papers; Science Direct – 246 papers and hand searches.

Results:

Nurse involvement in ethical decision-making during pandemics focused on nurses’ physical and emotional stress, communication challenges, saturation and collapse of limited resources and allocation of scarce resources. Additional dilemmas included, changing nature of nurses’ relationships with patients and families, questionable ethical equipoise preforming COVID-19 research, triage patient decisions receiving scarce resources, partner participation during labour and delivery and end-of-life decisions.

Conclusion:

In order to protect and sustain nurses’ well-being and competency, nurses should establish a framework for nurses’ involvement in ethical policy development in emergencies, pandemics, education and preparedness and decision-making to be able to deal with public health emergencies.
Supporting children’s drama in the on demand age: Assessing the efficacy of forty years of Australian policy frameworks and funding schemes
Authors: Potter Anna
Published: April 2023

This is a case study of 40 years of policy approaches in Australian children’s television during which the children’s television production ecology was profoundly altered by new distribution technologies. For decades Australia used quotas, subsidies and screen organisation The Australian Children’s Television Foundation to safeguard supplies of children’s television including drama. Digitisation has caused enormous industrial disruption while delivering abundant children’s content on demand. The article calls for new approaches to supporting local children’s screen content through increased funding of public service media rather than the ad hoc distribution of resources to an organisation without direct pathways to audiences.
Systematic review and meta-analysis of mesenchymal stromal/stem cells as strategical means for the treatment of COVID-19
Authors: Taufiq Hannah , Shaik Fakiruddin Kamal , Muzaffar Umaiya , Lim Moon Nian , Rusli Syahnaz , Kamaluddin Nor Rizan , Esa Ezalia , Abdullah Syahril
Published: April 2023

Background:

In coronavirus disease 2019 (COVID-19) patients, elevated levels of inflammatory cytokines from over stimulation of immune cells have become a concern due to the potential outburst of cytokine storm that damages the tissues and organs, especially the lungs. This leads to the manifestation of COVID-19 symptoms, such as pneumonia, acute respiratory distress syndrome (ARDS), multiple organ failure, and eventually death. Mesenchymal stromal/stem cells (MSCs) are currently one of hopeful approaches in treating COVID-19 considering its anti-inflammatory and immunomodulatory functions. On that account, the number of clinical trials concerning the use of MSCs for COVID-19 has been increasing. However, the number of systematic reviews and meta-analysis that specifically discuss its potential as treatment for the disease is still lacking. Therefore, this review will assess the safety and efficacy of MSC administration in COVID-19 patients.

Objectives:

To pool evidence on the safety and efficacy of MSCs in treating COVID-19 by observing MSC-related adverse effects as well as evaluating its effects in reducing inflammatory response and improving pulmonary function.

Data Sources and Methods:

Following literature search across six databases and one trial register, full-text retrieval, and screening against eligibility criteria, only eight studies were included for data extraction. All eight studies evaluated the use of umbilical cord-derived mesenchymal stromal/stem cell (UC-MSC), infused intravenously. Of these eight studies, six studies were included in meta-analysis on the incidence of mortality, adverse events (AEs), and serious adverse events (SAEs), and the levels of C-reactive protein (CRP) and interleukin (IL)-6. Meta-analysis on pulmonary function was not performed due to insufficient data.

Results:

MSC-treated group showed significantly lower risk of mortality than the control group ( p = 0.03). No statistical significance was observed on the incidence of AEs ( p = 0.78) and SAEs ( p = 0.44), and the levels of CRP ( p = 0.06) and IL-6 ( p = 0.09).

Conclusion:

MSCs were safe for use, with lower risk of mortality and no association with AEs. Regarding efficacy, descriptive analysis showed indications of improvement on the inflammatory reaction, lung clearance, and oxygenation status despite the lack of statistical significance in meta-analysis of CRP and IL-6. Nevertheless, more studies are needed for affirmation.

Registration:

This systematic review and meta-analysis was registered on the PROSPERO database (no. CRD42022307730).
Therapeutic eradication choices in Helicobacter pylori infection in children
Authors: Manfredi Marco , Gargano Giancarlo , Gismondi Pierpacifico , Ferrari Bernardino , Iuliano Silvia
Published: April 2023

Current recommendations on Helicobacter pylori ( H. pylori) eradication in children differ from adults. In H. pylori-infected adults, the eradication is always recommended because of the risk to develop gastrointestinal and non-gastrointestinal associated diseases. Instead, before treating infected children, we should consider all the possible causes and not merely focus on H. pylori infection. Indeed, pediatric international guidelines do not recommend the test and treat strategy in children. Therefore, gastroscopy with antimicrobial susceptibility testing by culture on gastric biopsies should be performed before starting the eradication therapy in children to better evaluate all the possible causes of the symptomatology and to increase the eradication rate. Whether antibiotic susceptibility testing is not available, gastroscopy is anyway recommended to better set any possible cause of symptoms and not simply focus on the presence of H. pylori. In children the lower antibiotics availability compared to adults forces to treat based on antimicrobial susceptibility testing to minimize the unsuccessful rates. The main antibiotics used in children are amoxicillin, clarithromycin, and metronidazole in various combinations. In empirical treatment, triple therapy for 14 days based either on local antimicrobial susceptibility or on personal antibiotic history is generally recommended. Triple therapy with high dose of amoxicillin is a valid alternative choice, either in double resistance or in second-line treatment. Moving from therapeutic regimens used in adults, we could also select quadruple therapy with or without bismuth salts. However, all the treatment regimens often entail unpleasant side effects and lower compliance in children. In this review, the alternative and not yet commonly used therapeutic choices in children were also analyzed.
Noninvasive Continuous Glucose Monitoring With a Novel Wearable Dial Resonating Sensor: A Clinical Proof-of-Concept Study
Authors: Handy Consuelo , Chaudhry Mohamed Sabih , Qureshi Muhammad Rafaqat Ali , Love Bradley , Shillingford John , Plum-Mörschel Leona , Zijlstra Eric
Published: April 2023

Background:

A noninvasive, wearable continuous glucose monitor would be a major advancement in diabetes therapy. This trial investigated a novel noninvasive glucose monitor which analyzes spectral variations in radio frequency/microwave signals reflected from the wrist.

Methods:

A single-arm, open-label, experimental study compared glucose values from a prototype investigational device with laboratory glucose measurements from venous blood samples (Super GL Glucose Analyzer, Dr. Müller Gerätebau GmbH) at varying levels of glycemia. The study included 29 male participants with type 1 diabetes (age range = 19-56 years). The study comprised three stages with the following aims: (1) demonstrate initial proof-of-principle, (2) test an improved device design, and (3) test performance on two consecutive days without device recalibration. The co-primary endpoints in all trial stages were median and mean absolute relative difference (ARD) calculated across all data points.

Results:

In stage 1, the median and mean ARDs were 30% and 46%, respectively. Stage 2 produced marked performance improvements with a median and mean ARD of 22% and 28%, respectively. Stage 3 showed that, without recalibration, the device performed as well as the initial prototype (stage 1) with a median and mean ARD of 35% and 44%, respectively.

Conclusion:

This proof-of-concept study shows that a novel noninvasive continuous glucose monitor was capable of detecting glucose levels. Furthermore, the ARD results are comparable to first models of commercially available minimally invasive products without the need to insert a needle. The prototype has been further developed and is being tested in subsequent studies.

Trial registration number:

NCT05023798.
Malpractice Lawsuits Relating to Mechanical Thrombectomy for Acute Ischemic Stroke: A Systematic Review
Authors: Qureshi Kasim , Farooq Muhammad U. , Gorelick Philip B.
Published: April 2023

Background and Purpose

Medical-legal claims for malpractice relating to the use of alteplase for acute ischemic stroke (AIS) are usually for failure to treat rather than for complications. The advent of mechanical thrombectomy (MT) as a standard of AIS treatment has added a new dimension to the medical-legal landscape as there is a need for the delivery of a higher level of care creating the potential for delays and errors associated with such treatment. Information on causes of malpractice related to mechanical thrombectomy (MT) is currently lacking.

Methods

We conducted a systematic review of legal databases (Westlaw, LexisNexis, Google Scholar Case Law, and VerdictSearch) to identify medical malpractice cases with and without verdicts filed in the United States up to March 31, 2021 which pertained to performance or non-performance of MT for AIS. We collected various case characteristics, case outcomes, and root causes for malpractice claims.

Results

We found 25 cases, 16 of which alleged failure to treat with MT, 8 for harm due to delay in treatment and 1 case that alleged complications. Root causes included delay in vascular imaging, communication breakdowns, and transportation delays. Eight cases had an outcome in favor of the defendant, 9 in favor of the plaintiff, and 8 remained to be determined.

Conclusions

As with alteplase, malpractice allegations regarding MT for AIS are largely for failure to treat or delay in treatment as opposed to complications. Addressing root causes of diagnostic delay, communication breakdowns, and transportation delays may reduce subsequent malpractice risk.
Picturing Your Life: The Role of Imagery Perspective in Personal Photos
Authors: Niese Zachary Adolph , Libby Lisa K. , Eibach Richard P.
Published: April 2023

When photographing moments in their lives, people can use a first-person (capturing the scene as they saw it) or third-person (capturing the scene with themselves in it) perspective. Past research suggests third-person (vs. first-person) images better depict the meaning (vs. physical experience) of events. The current work suggests the use and impact of perspective in personal photography follow this representational function. Across six studies ( N = 2,113), we find that the goal to capture meaning (vs. physical experience) causes people to be more likely to use third-person (vs. first-person) photos, that people are reminded more of the meaning (vs. physical experience) when viewing their own actual third-person (vs. first-person) photos, and that people like their photos better when the perspective matched (vs. mismatched) their goal for taking the photo. Discussion focuses on theoretical and practical implications of extending the representational function of imagery perspective to everyday uses of photographic imagery.
Incremental diagnostic yield and clinical outcomes of lateral decubitus CT myelogram immediately following negative lateral decubitus digital subtraction myelogram
Authors: Shlapak Darya P , Mark Ian T , Kim Dong Kun , Benson John C , Diehn Felix E , Kissoon Narayan R , Liebo Greta B , Madhavan Ajay A , Morris Jonathan M , Morris Pearse P , Oien Michael P , Verdoorn Jared T , Carr Carrie M
Published: April 2023

Introduction

Spontaneous intracranial hypotension (SIH) caused by a spinal cerebrospinal fluid (CSF) leak classically presents with orthostatic headache. Digital subtraction myelography (DSM) has a well-established diagnostic yield in the absence of extradural spinal collection. At our institution, DSM is followed by lateral decubitus CT myelogram (LDCTM) in the same decubitus position to increase diagnostic yield of the combined study. We evaluated the incremental diagnostic yield of LDCTM following negative DSM and reviewed patient outcomes.

Methods

Retrospective review of consecutive DSMs with subsequent LDCTM from April 2019 to March 2021 was performed. Combined reports were reviewed, and studies with positive DSMs were excluded. Of the exams with negative DSM, only studies with LDCTM reports identifying potential leak site were included. Interventions and follow-up clinical notes were reviewed to assess symptoms improvement following treatment.

Results

Of the 83 patients with negative DSMs, 11 (13.2%) had positive leak findings on LDCTMs, and 21 (25.3%) were equivocal. Of 11 positive LDCTMs, 6 leaks were nerve sheath tears (NSTs) and 5 were CSF-venous fistulas (CVFs). 10/11 (90.9%) had intervention and follow-up, with 9/10 (90%) having positive clinical outcome. Of the 21 equivocal LDCTM patients (19 CVFs and 2 NSTs), 15 (71.4%) had interventions and follow-up, with 3/15 (20.0%) with positive clinical outcomes.

Conclusion

LDCTM following negative DSM has an incremental diagnostic yield up to 38.6%, with up to 14.5% of positive patient outcomes following treatment. LDCTM should be considered after DSM to maximize diagnostic yield of the combined exam.
The criminalisation of travel as a global paradigm of preventive (In)justice: Lessons from the EU response to ‘foreign terrorist fighters’
Authors: Mitsilegas Valsamis
Published: April 2023

This article aims to evaluate critically the evolution of the preventive paradigm of security law by focusing on the criminalisation and surveillance of mobility which has been labelled as ‘terrorist travel.’ The article will highlight the impact of the political imperative of tackling the phenomenon of ‘foreign terrorist fighters’ on the emergence of a global preventive paradigm of criminalisation of travel. The article will focus on the establishment of a preventive paradigm of criminalisation of travel in EU law, and its interactions with the global governance of counter-terrorism as renewed by the fight against ‘foreign terrorist fighters.’ The first part of the article will focus on the emergence of a multi-level paradigm of criminalisation of ‘terrorist travel’, while the second part will focus on the surveillance of travel through the collection, transfer and analysis of passenger name record (PNR) data. The article will cast light on the role of the political rhetoric on the fight against ‘foreign terrorist fighters’ in the evolution of this paradigm and highlight the challenges that this multi-faceted system of criminalisation and surveillance of travel pose for fundamental rights and the rule of law. A key challenge in this context is the extent to which the European Union is able to uphold its internal fundamental rights and rule of law safeguards in the evolution of a global paradigm of criminalisation of travel.
Spontaneous Hemopericardium Complicated by Tamponade in a Child With Moderate Hemophilia A: Case-Based Review
Authors: Zayani Seyfeddine , Thabet Farah , Ben Massoud Majdi , Chouchane Chokri , Gamra Habib , Chouchane Slaheddine
Published: April 2023

Hemophilia A is the most common severe innate bleeding disorder. It is an X-linked recessive inherited bleeding disorder characterized by a qualitative and/or quantitative deficiency of factor VIII. The clinical manifestation of this disease is hemorrhaging that can affect every organ, in particular joints (hemarthrosis) and muscles (hematoma). Some serious but rare hemorrhages can be life-threatening, in particular hemorrhage of the central nervous system and hemopericardium. We report a rare case of spontaneous hemopericardium complicated by tamponade in a child with moderate hemophilia A treated with Factor VIII replacement infusion and pericardial drainage, with a favorable outcome. To our knowledge, this is the second case described in the literature of spontaneous hemopericardium occurring in a child with hemophilia A. Our case suggests that a dose of 50 IU/kg/8 h of factor VIII maintained for up to one day after removal of the pericardial drain seems to be sufficient to ensure correct hemostasis, though further evidence is needed to confirm this impression.
Student-Centered Education: A Meta-Analysis of Its Effects on Non-Academic Achievements
Authors: Li Yin-Die , Ding Guo-Hua
Published: April 2023

Non-academic achievement refers to the positive learning quality, personality, and social adaptability students develop during the learning process, which is essential for growth and social development. Can popular student-centered education assume the responsibility of cultivating learners with excellent learning qualities and extraordinary social competencies, as expected by educators globally? Using a meta-analysis, we reviewed and summarized 65 effect sizes from 31 quantitative research papers on the impact of student-centered education on students’ non-academic achievements, published from January 2010 to April 2021. The results showed that student-centered education had a positive impact on students’ non-academic achievements. The impact was greatest at the secondary and higher education levels and over a 3-month experimental period; however, no significant differences were found in curricula, teaching models, teaching strategies, or learning forms. Our results confirm that student-centered education should be widely adopted and accepted in the long term, at secondary and higher education levels.
RETRACTED: Anti-fungal efficacy of Miswak Extract (Salvadora Persica) and commercial cleaner against Candida albicans on heat cured polymethylmethacrylate denture base
Authors: Wajdan Nadia , Aslam Kashif , Amin Rafat , Khan Sadaf , Ahmed Naseer , Lal Abhishek , AlHamdan Eman M , Vohra Fahim , Abduljabbar Tariq , Heboyan Artak
Published: April 2023

Denture-induced stomatitis is the most common pathogenic reaction of denture-bearing mucosa, caused by Candida albicans. Miswak is naturally available oral hygiene tool and have been showed to have antifungal activity against Candida albicans in oral cavity.

Aim:

The aim of the study was to compare the antifungal efficacy between commercial cleaner (Corega) and Miswak extract ( Salvadora persica) against Candida albicans on heat cured Polymethyl methacrylate (PMMA) acrylic denture base resin.

Materials and methods:

Forty-eight samples of heat cured PMMA acrylic denture base resin were fabircated in the study. The sterile acrylic resin specimens were immersed in standardized cell suspension of Candida albicans and incubated for 60 min at 370°C for cell adhesion and 2 h at 370°C for biofilm formation. After 24 h biofilm was evaluated by cell viability (CFUs) on SDA and cell counting of Candida albicans under light microscope at 400× magnification. The fungicidal effect of commercial cleaner and Miswak extract on Candida albicans biofilm was then evaluated by colony-forming units on SDA and cell counting under light microscope at 400× magnification.

Results:

Screening test agar disk-diffusion assay showed mean inhibitory zone of 3 mm for commercial cleaner as compared to Miswak extract, which showed mean inhibitory zone of 2 and 1 mm for different concentrations. Broth microdilution method showed 31 mg/ml MIC and 62.5 mg/ml Minimal Fungicidal Concentration (MFC) values for commercial cleaner as compared to Miswak extract that showed 125 mg/ml MIC and 250 mg/ml MFC values against Candida albicans. A significant difference ( p < 0.05) was observed between pre and post treatment of both commercial cleaner and Miswak extract, for CFUs and cell count for Candida albicans.

Conclusion:

Commercial denture cleaner (Corega) showed better antifungal ( C albicans) activity than Miswak extract ( Salvadora persica) on heat cured PMMA acrylic denture base resin.
Comparison of Care Provided to Underserved Patients With Diabetes by a Telementoring Model of Care to Care Provided by a Specialty Clinic: Endo ECHO Versus an Academic Specialty Clinic
Authors: Berry Carolyn A. , Dávila Saad Andrea , Blecker Saul , Billings John , Bouchonville Matthew F. , Arora Sanjeev , Paul Margaret M.
Published: April 2023

Purpose:

The purpose of the study was to examine differences among adult patients with diabetes who receive care through a telementoring model versus care at an academic specialty clinic on guideline-recommended diabetes care and self-management behaviors.

Methods:

Endocrinology-focused Extension for Community Healthcare Outcomes (ECHO Endo) patients completed surveys assessing demographics, access to care, health care quality, and self-management behaviors at enrollment and 1 year after program enrollment. Diabetes Comprehensive Care Center (DCCC) patients completed surveys at comparable time points.

Results:

At baseline, ECHO patients were less likely than DCCC patients to identify English as their primary language, have postsecondary education, and private insurance. One year postenrollment, ECHO patients visited their usual source of diabetic care more frequently. There were no differences in A1C testing or feet checking by health care professionals, but ECHO patients were less likely to report eye exams and smoking status assessment. ECHO and DCCC patients did not differ in consumption of high-fat foods and soda, physical activity, or home feet checks. ECHO patients were less likely to space carbohydrates evenly and test glucose levels and more likely to have smoked cigarettes.

Conclusions:

Endo ECHO is a suitable alternative to specialty care for patients in underserved communities with restricted access to specialty care. Results support the value of the Project ECHO telementoring model in addressing barriers to high-quality care for underserved communities.
Investigating Racial and Ethnic Differences in Diabetes Self-Management Education Among Adults With Diabetes
Authors: Akyirem Samuel , Choa Elizabeth , Poghosyan Hermine
Published: April 2023

Purpose:

The purpose of this study was to examine racial and ethnic differences in diabetes self-management education (DSME) participation among adults with diabetes.

Methods:

Population-based, cross-sectional data from the 2020 Behavioral Risk Factor Surveillance System diabetes module were analyzed. Study cohort included 9881 adults age 18 years or older with self-reported diabetes living in 11 US states, Washington, DC, and Puerto Rico. The outcome variable was participation in DSME. Weighted descriptive statistics and multivariable logistic regression were computed to investigate the association between race and ethnicity and participation in DSME, adjusting for self-reported social determinants of health factors (eg, sex, education, employment, health insurance).

Results:

Overall, 19.3% self-identified as non-Hispanic Black, 16.5% as Hispanic, and 59.9% as non-Hispanic White. Of participants, 44.3% were between 66 and 80 years old, and 50.4% were women. Half (50.1%) reported participating in DSME, and 78.5% had seen clinicians for diabetes-related care 1 to 5 times in the past year. Hispanic participants were less likely to report participation in DSME (28.5%) compared to non-Hispanic Black (60.3%) and non-Hispanic White (53.4%) participants ( P < .001). Adults with diabetes who were less likely to participate in DSME tend to be unmarried, have high school or lower-level education, and not exercise regularly.

Conclusions:

Racial and ethnic differences exist in DSME participation. Because DSME has been shown to improve diabetes outcomes, there is a need to develop strategies promoting equity in DSME participation, particularly among Hispanic populations, to reduce health disparities in diabetes care.
Nicotine promotes e-cigarette vapour-induced lung inflammation and structural alterations
Authors: Roxlau Elsa T. , Pak Oleg , Hadzic Stefan , Garcia-Castro Claudia F. , Gredic Marija , Wu Cheng-Yu , Schäffer Julia , Selvakumar Balachandar , Pichl Alexandra , Spiegelberg David , Deutscher Janik , Bednorz Mariola , Schäfer Katharina , Kraut Simone , Kosanovic Djuro , Zeidan Esraa M. , Kojonazarov Baktybek , Herold Susanne , Strielkov Ievgen , Guenther Andreas , Wilhelm Jochen , Khalifa Mohamed M.A. , Taye Ashraf , Brandes Ralf P. , Hecker Matthias , Grimminger Friedrich , Ghofrani Hossein A. , Schermuly Ralph T. , Seeger Werner , Sommer Natascha , Weissmann Norbert
Published: April 2023

Background

Electronic cigarette (e-cigarette) vapour is gaining popularity as an alternative to tobacco smoking and can induce acute lung injury. However, the specific role of nicotine in e-cigarette vapour and its long-term effects on the airways, lung parenchyma and vasculature remain unclear.

Results

In vitroexposure to nicotine-containing e-cigarette vapour extract (ECVE) or to nicotine-free e-cigarette vapour extract (NF ECVE) induced changes in gene expression of epithelial cells and pulmonary arterial smooth muscle cells (PASMCs), but ECVE in particular caused functional alterations (e.g.a decrease in human and mouse PASMC proliferation by 29.3±5.3% and 44.3±8.4%, respectively). Additionally, acute inhalation of nicotine-containing e-cigarette vapour (ECV) but not nicotine-free e-cigarette vapour (NF ECV) increased pulmonary endothelial permeability in isolated lungs. Long-termin vivoexposure of mice to ECV for 8 months significantly increased the number of inflammatory cells, in particular lymphocytes, compared to control and NF ECV in the bronchoalveolar fluid (BALF) (ECV: 853.4±150.8 cells·mL−1; control: 37.0±21.1 cells·mL−1; NF ECV: 198.6±94.9 cells·mL−1) and in lung tissue (ECV: 25.7±3.3 cells·mm−3; control: 4.8±1.1 cells·mm−3; NF ECV: 14.1±2.2 cells·mm−3). BALF cytokines were predominantly increased by ECV. Moreover, ECV caused significant changes in lung structure and function (e.g.increase in airspace by 17.5±1.4% compared to control), similar to mild tobacco smoke-induced alterations, which also could be detected in the NF ECV group, albeit to a lesser degree. In contrast, the pulmonary vasculature was not significantly affected by ECV or NF ECV.

Conclusions

NF ECV components induce cell type-specific effects and mild pulmonary alterations, while inclusion of nicotine induces significant endothelial damage, inflammation and parenchymal alterations.
MDSi: Multi-omics Database for Setaria italica
Authors: Li Xukai , Hou Siyu , Feng Mengmeng , Xia Rui , Li Jiawei , Tang Sha , Han Yuanhuai , Gao Jianhua , Wang Xingchun
Published: April 2023

Background

Foxtail millet (Setaria italica) harbors the small diploid genome (~ 450 Mb) and shows the high inbreeding rate and close relationship to several major foods, feed, fuel and bioenergy grasses. Previously, we created a mini foxtail millet, xiaomi, with an Arabidopsis-like life cycle. The de novo assembled genome data with high-quality and an efficient Agrobacterium-mediated genetic transformation system made xiaomi an ideal C4 model system. The mini foxtail millet has been widely shared in the research community and as a result there is a growing need for a user-friendly portal and intuitive interface to perform exploratory analysis of the data.

Results

Here, we built a Multi-omics Database for Setaria italica (MDSi, http://sky.sxau.edu.cn/MDSi.htm), that contains xiaomi genome of 161,844 annotations, 34,436 protein-coding genes and their expression information in 29 different tissues of xiaomi (6) and JG21 (23) samples that can be showed as an Electronic Fluorescent Pictograph (xEFP) in-situ. Moreover, the whole-genome resequencing (WGS) data of 398 germplasms, including 360 foxtail millets and 38 green foxtails and the corresponding metabolic data were available in MDSi. The SNPs and Indels of these germplasms were called in advance and can be searched and compared in an interactive manner. Common tools including BLAST, GBrowse, JBrowse, map viewer, and data downloads were implemented in MDSi.

Conclusion

The MDSi constructed in this study integrated and visualized data from three levels of genomics, transcriptomics and metabolomics, and also provides information on the variation of hundreds of germplasm resources that can satisfies the mainstream requirements and supports the corresponding research community.
Effect of different head-high lateral extubation on adverse reactions in the peri-extubation period of pediatric OSAS surgery under general anesthesia
Authors: Zhou Yun , Lin Zhonglan , Lu Xinlei , Huang Yaqin , Lei Weiping , Sun Jianliang
Published: April 2023

Background

Children with OSAS are prone to various airway complications during tracheal extubation after tonsillectomy and adenoidectomy due to oropharyngeal secretions and oozing blood. However, few studies have examined the effect of position on airway complications after tracheal extubation in children with OSAS. The aim of this study was to investigate the appropriate position for extubation in children with OASA.

Methods

A total of 459 children aged 3–14 years with OSAS who underwent tonsillectomy and adenoidectomy were recruited for this study. All children were treated with the same surgical approach and standard anesthesia methods of induction of anesthesia, tracheal intubation and maintenance of anesthesia. At the end of surgery, the children were delivered to the post anesthesia care unit and randomly divided into three groups: Group A: Head-high 0° in lateral position; Group B: Head-high 15° in lateral position; Group C: Head-high 30° in lateral position. The main outcomes of this study were the pulse oxygen saturation (SpO2) and the Sedation-Agitation Scale (SAS) scores of the children after extubation, the outflow of oral-nasal secretions and the respiratory complications. Secondary outcomes were blood pressure, heart rate, end-respiratory carbon dioxide, respiratory rate, and post-operative awakening time of the children in three groups.

Results

Data from a total of 423 children were statistically analyzed, 141 in Group A, 142 in Group B, and 140 in Group C. The main results showed a significant decrease in choking response after extubation in Group B (46.5%) and Group C (40.7%) compared to Group A (60.3%) (P < 0.05). The SAS score for postoperative agitation was higher in Group A (4.6 $$\pm$$
±
0.9) than in Group B (4.4 $$\pm$$
±
0.7) and Group C (4.3 $$\pm$$
±
0.6) (P < 0.05). Also the SpO2 after extubation was higher in Group B (97.2%) and Group C (97.1%) than in Group A (95.8%) (P < 0.05). In contrast, there was no difference in the occurrence of respiratory complication and postoperative agitation in children between Group B and Group C (all P > 0.05). In addition, there was no difference in the amount of oral-nasal secretions among the children in the three groups (all P > 0.05).

Conclusion

The head-high 15° lateral position and head-high 30° lateral position can reduce the incidence of airway complications and agitation and provide safe and comfortable extubation conditions for children during the peri-extubation period after tonsillectomy and adenoidectomy, which has certain clinical guidance value.

Trial registration

Registration Number: NO.ChiCTR2200055835(20,01,2022)
https://www.chictr.org.cn
Comparing ultrasound-guided modified thoracoabdominal nerves block through perichondrial approach with oblique subcostal transversus abdominis plane block for patients undergoing laparoscopic cholecystectomy: a randomized, controlled trial
Authors: Bilge Ayşegül , Başaran Betül , Altıparmak Başak , Et Tayfun , Korkusuz Muhammet , Yarımoğlu Rafet
Published: April 2023

Background

Laparoscopic cholecystectomy(LC) causes significant postoperative pain. Oblique subcostal transversus abdominis plane(OSTAP) block was described for postoperative analgesia, especially for upper abdominal surgeries. Modified thoracoabdominal nerves block through perichondrial approach(M-TAPA) block is a new technique defined by the modification of the thoracoabdominal nerves through perichondrial approach (TAPA) block, in which local anesthetics are delivered only to the underside of the perichondral surface. The primary aim of this study was to evaluate the effect of M-TAPA and OSTAP blocks as part of multimodal analgesia on postoperative opioid consumption in patients undergoing LC.

Method

The present study was designed as a randomized, controlled, prospective study. Seventy-six adult patients undergoing LC were randomly assigned to receive either bilaterally M-TAPA or OSTAP block after the induction of anesthesia and before surgery using bupivacaine 0.25%, 25 ml. The primary outcome was assessed as postoperative 24 h opioid consumption, between groups were compared. Secondary outcomes were Numerical Rational scale(NRS) scores, time to first opioid analgesia, patient recovery, using the Quality of Recovery-15 (QoR-15) scale, nausea and vomiting, sedation score, metoclopramide consumption, and evaluating the analgesic range of dermatome.

Results

The mean tramadol consumption at the postoperative 24th hour was higher in the group OSTAP than in group M-TAPA (P = 0.047). NRS movement score at 12th hour was statistically significantly lower in group M-TAPA than in group OSTAP (P = 0.044). Dermatomes showed intense sensory analgesia between T7-11 in both groups, and it was determined that there was proportionally more involvement in the group M-TAPA. There were no differences between the groups in terms of other results.

Conclusions

After the LC surgery, ultrasound-guided M-TAPA block effectively reduced opioid consumption, postoperative pain, and QoR-15 scores similar to OSTAP block.

Clinical trial registration

The study was registered prospectively at clinicaltrials.gov (trial ID: NCT05108129 on 4/11/2021).
Reporting of flow diagrams in randomised controlled trials published in periodontology and implantology: a survey
Authors: Meyer Hanns-Gustav Julius , Pandis Nikolaos , Seehra Jadbinder , Faggion Clovis Mariano
Published: April 2023

Background

Item 13 of the CONSORT guidelines recommends documentation of the participant flow in randomised clinical trials (RCTs) using a diagram. In the medical literature, the reporting of the flow of participants in RCTs has been assessed to be inadequate. The quality of reporting flow diagrams in periodontology and implantology remains unknown. The aim of this study was to assess the reporting of flow diagrams in RCTs published in periodontology and implantology journals.

Materials and Methods

RCTs published between 15th January 2018 and 15th January 2022 in twelve high-ranked periodontology and implantology journals were identified. Trial characteristics at the RCT level were extracted. The flow diagram included in each RCT was assessed for completeness of reporting in relation to published criteria and the CONSORT flow diagram template.

Results

From the 544 eligible articles, 85% were single-centre, 82% of parallel-group design and 79% investigated surgical interventions. Three-hundred and fifteen (58%) articles were published in CONSORT endorsing journals. A flow diagram was reported in 317 (58%) trials and reporting was more common in periodontology (73.1%). Overall, 56% of publications with a flow diagram reported a complete CONSORT flow diagram, while in 44% of flow diagrams, at least one point from the CONSORT reporting template was missing. Reasons for loss to follow-up (69.7%) and exclusions from the RCT analysis (86.4%) were poorly reported.

Conclusion

The reporting of flow diagrams in periodontology and implantology RCTs was sub-optimal. Greater awareness of the importance of fully completing the participant CONSORT flow diagram is required.
Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study
Authors: Zhou Mingyao , Gu Xiaoxin , Cheng Kangyao , Wang Yin , Zhang Nina
Published: April 2023

Background

Symptom networks can provide empirical evidence for the development of personalized and precise symptom management strategies. However, few studies have established networks of symptoms experienced by older patients on maintenance hemodialysis. Our goal was to examine the type of symptom clusters of older maintenance hemodialysis patients during dialysis and construct a symptom network to understand the symptom characteristics of this population.

Methods

The modified Dialysis Symptom Index was used for a cross-sectional survey. Network analysis was used to analyze the symptom network and node characteristics, and factor analysis was used to examine symptom clusters.

Results

A total of 167 participants were included in this study. The participants included 111 men and 56 women with a mean age of 70.05 ± 7.40. The symptom burdens with the highest scores were dry skin, dry mouth, itching, and trouble staying asleep. Five symptom clusters were obtained from exploratory factor analysis, of which the clusters with the most severe symptom burdens were the gastrointestinal discomfort symptom cluster, sleep disorder symptom cluster, skin discomfort symptom cluster, and mood symptom cluster. Based on centrality markers, it could be seen that feeling nervous and trouble staying asleep had the highest strength, and feeling nervous and feeling irritable had the highest closeness and betweenness.

Conclusions

Hemodialysis patients have a severe symptom burden and multiple symptom clusters. Dry skin, itching, and dry mouth are sentinel symptoms in the network model; feeling nervous and trouble staying asleep are core symptoms of patients; feeling nervous and feeling irritable are bridge symptoms in this symptom network model. Clinical staff can formulate precise and efficient symptom management protocols for patients by using the synergistic effects of symptoms in the symptom clusters based on sentinel symptoms, core symptoms, and bridge symptoms.
Principal component analysis of adipose tissue gene expression of lipogenic and adipogenic factors in obesity
Authors: Jannat Ali Pour Naghmeh , Zabihi-Mahmoudabadi Hossein , Ebrahimi Reyhane , Yekaninejad Mir Saeed , Hashemnia Seyyed Mohammad Reza , Meshkani Reza , Emamgholipour Solaleh
Published: April 2023

Objective

A better understanding of mechanisms regulating lipogenesis and adipogenesis is needed to overcome the obesity pandemic. We aimed to study the relationship of the transcript levels of peroxisome proliferator activator receptor γ (PPARγ), CCAAT/enhancer-binding protein alpha (C/EBP-α), liver X receptor (LXR), sterol regulatory element-binding protein-1c (SREBP-1c), fatty acid synthase (FAS), and acetyl-CoA carboxylase (ACC) in subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) from obese and normal-weight women with a variety of anthropometric indices, metabolic and biochemical parameters, and insulin resistance.

Methods

Real‐time PCR was done to evaluate the transcript levels of the above‐mentioned genes in VAT and SAT from all participants.

Results

Using principal component analysis (PCA) results, two significant principal components were identified for adipogenic and lipogenic genes in SAT (SPC1 and SPC2) and VAT (VPC1 and VPC2). SPC1 was characterized by relatively high transcript levels of SREBP1c, PPARγ, FAS, and ACC. However, the second pattern (SPC2) was associated with C/EBPα and LXR α mRNA expression. VPC1 was characterized by transcript levels of SREBP1c, FAS, and ACC. However, the VPC2 was characterized by transcript levels of C/EBPα, LXR α, and PPARγ. Pearson’s correlation analysis showed that unlike SPC2, which disclosed an inverse correlation with body mass index, waist and hip circumference, waist to height ratio, visceral adiposity index, HOMA-IR, conicity index, lipid accumulation product, and weight-adjusted waist index, the VPC1 was positively correlated with above-mentioned obesity indices.

Conclusion

This study provided valuable data on multiple patterns for adipogenic and lipogenic genes in adipose tissues in association with a variety of anthropometric indices in obese subjects predicting adipose tissue dysfunction and lipid accumulation.
Multilevel analysis of women’s education in Ethiopia
Authors: Hussen Nuru Mohammed , Workie Demeke Lakew
Published: April 2023

Background

Women’s education is the base for faster economic growth, longer life expectancy, lower population growth, improved quality of life, and a high rate of investment return in developing countries. Historically, girls were denied opportunities for schooling in most of the regions and societies of Ethiopia. So this study targeted a multilevel analysis of women’s education in Ethiopia using the 2016 Ethiopian Demographic and Health Survey data.

Methods

Secondary data on women’s data sets were obtained from the 2016 Ethiopia Demographic and Health Survey. A population-based cross-sectional study design was used for the survey. The sampling technique used for the survey was the two-stage sampling technique, which is stratified in the first stage and equal probability systematic selection technique in the second stage. The multi-level ordinal logistic regression model was fitted to identify the determinants of women’s education in Ethiopia.

Results

Among the random sample of 17137 women, the majority, 65.6 percent were rural residents. Somali regional state (75.3 percent) and the capital city Addis Ababa (8.6 percent) had the highest and lowest percentages of women illiteracy respectively than the remaining administrative units of Ethiopia. The minimum values for the fit statistics and the indicative value of the intra-class correlation (68.3%) of the multilevel model showed its appropriateness to the data. Among the predictors in the final multilevel ordinal logistic regression analysis, women’s age at first marriage, residence, and family’s wealth index were significant predictors of women’s education in Ethiopia. Moreover, the estimates from the random effect result revealed that there is more variation in women’s education between the enumeration areas than within the enumeration areas.

Conclusion

A multi-level ordinal logistic regression analysis has determined higher-level differences in women's education that could not be addressed by a single-level approach. So, the application of standard models by ignoring this variation ought to embrace spurious results, then for such hierarchical data, multilevel modeling is recommended.
A comparison of 3- and 4-option multiple-choice items for medical subspecialty in-training examinations
Authors: Chen Dandan , Harman Ann E. , Sun Huaping , Ye Tianpeng , Gaiser Robert R.
Published: April 2023

Background

The American Board of Anesthesiology piloted 3-option multiple-choice items (MCIs) for its 2020 administration of 150-item subspecialty in-training examinations for Critical Care Medicine (ITE-CCM) and Pediatric Anesthesiology (ITE-PA). The 3-option MCIs were transformed from their 4-option counterparts, which were administered in 2019, by removing the least effective distractor. The purpose of this study was to compare physician performance, response time, and item and exam characteristics between the 4-option and 3-option exams.

Methods

Independent-samples t-test was used to examine the differences in physician percent-correct score; paired t-test was used to examine the differences in response time and item characteristics. The Kuder and Richardson Formula 20 was used to calculate the reliability of each exam form. Both the traditional (distractor being selected by fewer than 5% of examinees and/or showing a positive correlation with total score) and sliding scale (adjusting the frequency threshold of distractor being chosen by item difficulty) methods were used to identify non-functioning distractors (NFDs).

Results

Physicians who took the 3-option ITE-CCM (mean = 67.7%) scored 2.1 percent correct higher than those who took the 4-option ITE-CCM (65.7%). Accordingly, 3-option ITE-CCM items were significantly easier than their 4-option counterparts. No such differences were found between the 4-option and 3-option ITE-PAs (71.8% versus 71.7%). Item discrimination (4-option ITE-CCM [an average of 0.13], 3-option ITE-CCM [0.12]; 4-option ITE-PA [0.08], 3-option ITE-PA [0.09]) and exam reliability (0.75 and 0.74 for 4- and 3-option ITE-CCMs, respectively; 0.62 and 0.67 for 4-option and 3-option ITE-PAs, respectively) were similar between these two formats for both ITEs. On average, physicians spent 3.4 (55.5 versus 58.9) and 1.3 (46.2 versus 47.5) seconds less per item on 3-option items than 4-option items for ITE-CCM and ITE-PA, respectively. Using the traditional method, the percentage of NFDs dropped from 51.3% in the 4-option ITE-CCM to 37.0% in the 3-option ITE-CCM and from 62.7% to 46.0% for the ITE-PA; using the sliding scale method, the percentage of NFDs dropped from 36.0% to 21.7% for the ITE-CCM and from 44.9% to 27.7% for the ITE-PA.

Conclusions

Three-option MCIs function as robustly as their 4-option counterparts. The efficiency achieved by spending less time on each item poses opportunities to increase content coverage for a fixed testing period. The results should be interpreted in the context of exam content and distribution of examinee abilities.