bluuebunny/crossref_metadata_2025 huggingface dataset:
Unusual Progressive Hepatic Echogenicity of the Pediatric Liver Following Intravenous Sonographic Contrast Administration
Authors: Cielma Tara K. , Mirza Sobia , Najim Najla Issa , Wolfe Jaime Liou , Zember Jonathan
Published: March 2023

Contrast-enhanced ultrasound is a valuable tool to evaluate liver lesions in a pediatric patient cohort. Unusual progressive hepatic echogenicity (UPHE) is a self-limiting phenomenon noted in a cohort of children after administration of ultrasonographic contrast agents (UCAs). UPHE appears initially as heterogeneous branching similar to portal venous gas, culminating in a diffuse globular appearance. The etiology of UPHE is unclear and may be from underlying hepatic microvascular disease or altered gut permeability. This case series describes pediatric patients with UPHE following UCA bolus and discusses its potential mechanisms in children.
Chrysoberyl and associated beryllium minerals resulting from metamorphic overprinting of the Maršíkov–Schinderhübel III pegmatite, Czech Republic
Authors: Rybnikova Olena , Uher Pavel , Novák Milan , Chládek Štěpán , Bačík Peter , Kurylo Sergii , Vaculovič Tomáš
Published: March 2023

The Maršíkov–Schinderhübel III pegmatite in the Hrubý Jeseník Mountains, Silesian Domain, Czech Republic, is a classic example of chrysoberyl-bearing LCT granitic pegmatite of beryl–columbite subtype. This thin pegmatite dyke, (up to 1 m in thickness in biotite–amphibole gneiss is characterised by symmetrical internal zoning. Tabular and prismatic chrysoberyl crystals (≤3 cm) occur typically in the intermediate albite-rich unit and rarely in the quartz core. Chrysoberyl microtextures are quite complex; their crystals are irregularly patchy, concentric or fine oscillatory zoned with large variations in Fe content (1.1–5.3 wt.% Fe2O3; ≤0.09 apfu). Chrysoberyl compositions reveal dominant Fe3+ = Al3+ and minor Fe2+ + Ti4+ = 2(Al, Fe)3+ substitution mechanisms in the octahedral sites. Tin, Ga, and V (determined by LA-ICP-MS) are characteristic trace elements incorporated in the chrysoberyl structure, whereas anomalously high Ta and Nb concentrations (thousands ppm) in chrysoberyl are probably caused by nano- to micro-inclusions of Nb–Ta oxide minerals; especially columbite–tantalite. Textural relationships between associated minerals, distinct schistosity of the pegmatite parallel to the host gneiss foliation and fragmentation of the pegmatite body into blocks as a result of superimposed stress are clear evidence for deformation and metamorphic overprinting of the pegmatite. Primary magmatic beryl, albite and muscovite were transformed to chrysoberyl, fibrolitic sillimanite, secondary quartz and muscovite during a high-temperature (~600°C) and medium-pressure (~250–500 MPa) prograde metamorphic stage under amphibolite-facies conditions. A subsequent retrograde, low-temperature (~200–500°C) and pressure (≤250 MPa) metamorphic stage resulted in the local alteration of chrysoberyl to secondary Fe,Na-rich beryl, euclase, bertrandite and late muscovite.
Anti-EGFR conjugated nanoparticles to deliver Alpelisib as targeted therapy for head and neck cancer
Authors: Juan Alberto , Segrelles Carmen , del Campo-Balguerías Almudena , Bravo Iván , Silva Ignacio , Peral Jorge , Ocaña Alberto , Clemente-Casares Pilar , Alonso-Moreno Carlos , Lorz Corina
Published: March 2023

Background

Head and neck squamous cell carcinoma (SCC) is one of the most prevalent and deadly cancers worldwide. Even though surgical approaches, radiation therapy, and therapeutic agents are commonly used, the prognosis of this cancer remains poor, with a tendency towards recurrence and metastasis. Current targeted therapeutic options for these patients are limited to monoclonal antibodies against EGFR or PD-1 receptors. Thus, there is an urgent need to introduce new molecularly targeted therapies for treating head and neck SCC. EGFR can be used as a target to improve the ability of nanoparticles to bind to tumor cells and deliver chemotherapeutic agents. In fact, over 90% of head and neck SCCs overexpress EGFR, and other tumor types, such as colorectal and glioblastoma, show EGFR overexpression. The PI3K/mTOR signaling pathway is one of the most commonly altered oncogenic pathways in head and neck SCC. Alpelisib is a specific PI3Kα inhibitor indicated for PIK3CA mutant advanced breast cancer that showed promising activity in clinical trials in head and neck SCC. However, its use is associated with dose-limiting toxicities and treatment-related adverse effects.

Results

We generated polylactide (PLA) polymeric nanoparticles conjugated to anti-EGFR antibodies via chemical cross-linking to a polyethyleneimine (PEI) coating. Antibody-conjugated nanoparticles (ACNP) displayed low polydispersity and high stability. In vivo, ACNP showed increased tropism for EGFR-expressing head and neck tumors in a xenograft model compared to non-conjugated nanoparticles (NP). Alpelisib-loaded nanoparticles were homogeneous, stable, and showed a sustained drug release profile. Encapsulated Alpelisib inhibited PI3K pathway activation in the different cell lines tested that included wild type and altered PIK3CA. Alpelisib-NP and Alpelisib-ACNP decreased by 25 times the half-maximal inhibitory concentration compared to the free drug and increased the bioavailability of the drug in the cells. Herein we propose an efficient strategy to treat head and neck SCC based on nanotechnology.

Conclusions

Anti-EGFR-conjugated polymeric nanoparticles are an effective delivery system to increase drug efficiency and bioavailability in head and neck cancer cells. This strategy can help reduce drug exposure in disease-free organs and decrease drug-associated unwanted side effects.
Antibiofilm activity from endophyte bacteria, Vibrio cholerae strains, and actinomycetes isolates in liquid and solid culture
Authors: Michael  , Waturangi Diana Elizabeth
Published: March 2023

Background

Biofilm-associated infections are a global threat to our economy and human health; as such, development of antibiofilm compounds is an urgent need. Our previous study identified eleven environmental isolates of endophyte bacteria, actinomycetes, and two strains ofVibrio choleraeas having strong antibiofilm activity, but only tested crude extracts from liquid culture. Here we grew the same bacteria in solid culture to induce the formation of colony biofilms and the expression of genes that may ultimately produce antibiofilm compounds. This research aimed to compare antibiofilm inhibition and destruction activities between liquid and solid cultures of these eleven environmental isolates against the biofilms of representative pathogenic bacteria.

Results

We measured antibiofilm activity using the static antibiofilm assay and crystal violet staining. The majority of our isolates exhibited higher inhibitory antibiofilm activity in liquid media, including all endophyte bacteria,V. choleraeV15a, and actinomycetes strains (CW01, SW03, CW17). However, forV. choleraestrain B32 and two actinomycetes bacteria (TB12 and SW12), the solid crude extracts showed higher inhibitory activity. Regarding destructive antibiofilm activity, many endophyte isolates andV. choleraestrains showed no significant difference between culture methods; the exceptions were endophyte bacteria isolate JerF4 andV. choleraeB32. The liquid extract of isolate JerF4 showed higher destructive activity relative to the corresponding solid culture extract, while forV. choleraestrain B32 the solid extract showed higher activity against some biofilms of pathogenic bacteria.

Conclusions

Culture conditions, namely solid or liquid culture, can influence the activity of culture extracts against biofilms of pathogenic bacteria. We compared the antibiofilm activity and presented the data that majority of isolates showed a higher antibiofilm activity in liquid culture. Interestingly, solid extracts from three isolates (B32, TB12, and SW12) have a better inhibition or/and destruction antibiofilm activity compared to their liquid culture. Further research is needed to characterize the activities of specific metabolites in solid and liquid culture extracts and to determine the mechanisms of their antibiofilm actions.
Uptake of pharmacist recommendations by patients after discharge: Implementation study of a patient-centered medicines review service
Authors: Basger Benjamin Joseph , Moles Rebekah Jane , Chen Timothy Frank
Published: March 2023

Background

Polypharmacy and potentially inappropriate medicine use is common in older people, resulting in harm increased by lack of patient-centred care. Hospital clinical pharmacy services may reduce such harm, particularly prevalent at transitions of care. An implementation program to achieve such services can be a complex long-term process.

Objectives

To describe an implementation program and discuss its application in the development of a patient-centred discharge medicine review service; to assess service impact on older patients and their caregivers.

Method

An implementation program was begun in 2006. To assess program effectiveness, 100 patients were recruited for follow-up after discharge from a private hospital between July 2019 and March 2020. There were no exclusion criteria other than age less than 65 years. Medicine review and education were provided for each patient/caregiver by a clinical pharmacist, including recommendations for future management, written in lay language. Patients were asked to consult their general practitioner to discuss those recommendations important to them. Patients were followed-up after discharge.

Results

Of 368 recommendations made, 351 (95%) were actioned by patients, resulting in 284 (77% of those actioned) being implemented, and 206 regularly taken medicines (19.7 % of all regular medicines) deprescribed.

Conclusion

Implementation of a patient-centred medicine review discharge service resulted in patient-reported reduction in potentially inappropriate medicine use and hospital funding of this service. This study was registered retrospectively on 12th July 2022 with the ISRCTN registry, ISRCTN21156862, https://www.isrctn.com/ISRCTN21156862.
Factors associated with viral RNA shedding and evaluation of potential viral infectivity at returning to school in influenza outpatients after treatment with baloxavir marboxil and neuraminidase inhibitors during 2013/2014–2019/2020 seasons in Japan: an observational study
Authors: Li Jiaming , Wagatsuma Keita , Sun Yuyang , Sato Isamu , Kawashima Takashi , Saito Tadashi , Shimada Yasushi , Ono Yasuhiko , Kakuya Fujio , Nagata Nobuo , Minato Michiyoshi , Kodo Naoki , Suzuki Eitaro , Kitano Akito , Tanaka Toshihiro , Aoki Satoshi , Chon Irina , Phyu Wint Wint , Watanabe Hisami , Saito Reiko
Published: March 2023

Background

This study assessed the differences in daily virus reduction and the residual infectivity after the recommended home stay period in Japan in patients infected with influenza and treated with baloxavir (BA), laninamivir (LA), oseltamivir (OS), and zanamivir (ZA).

Methods

We conducted an observational study on children and adults at 13 outpatient clinics in 11 prefectures in Japan during seven influenza seasons from 2013/2014 to 2019/2020. Virus samples were collected twice from influenza rapid test-positive patients at the first and second visit 4–5 days after the start of treatment. The viral RNA shedding was quantified using quantitative RT-PCR. Neuraminidase (NA) and polymerase acidic (PA) variant viruses that reduce susceptibility to NA inhibitors and BA, respectively, were screened using RT-PCR and genetic sequencing. Daily estimated viral reduction was evaluated using univariate and multivariate analyses for the factors such as age, treatment, vaccination status, or the emergence of PA or NA variants. The potential infectivity of the viral RNA shedding at the second visit samples was determined using the Receiver Operator Curve based on the positivity of virus isolation.

Results

Among 518 patients, 465 (80.0%) and 116 (20.0%) were infected with influenza A (189 with BA, 58 with LA, 181 with OS, 37 with ZA) and influenza B (39 with BA, 10 with LA, 52 with OS, 15 with ZA). The emergence of 21 PA variants in influenza A was detected after BA treatment, but NA variants were not detected after NAIs treatment. Multiple linear regression analysis showed that the daily viral RNA shedding reduction in patients was slower in the two NAIs (OS and LA) than in BA, influenza B infection, aged 0–5 years, or the emergence of PA variants. The residual viral RNA shedding potentially infectious was detected in approximately 10–30% of the patients aged 6–18 years after five days of onset.

Conclusions

Viral clearance differed by age, type of influenza, choice of treatment, and susceptibility to BA. Additionally, the recommended homestay period in Japan seemed insufficient, but reduced viral spread to some extent since most school-age patients became non-infectious after 5 days of onset.
Spatiotemporal overlapping of dengue, chikungunya, and malaria infections in children in Kenya
Authors: Khan Aslam , Bisanzio Donal , Mutuku Francis , Ndenga Bryson , Grossi-Soyster Elysse N. , Jembe Zainab , Maina Priscilla W. , Chebii Philip K. , Ronga Charles O. , Okuta Victoria , LaBeaud A. Desiree
Published: March 2023

Malaria, chikungunya virus (CHIKV), and dengue virus (DENV) are endemic causes of fever among children in Kenya. The risks of infection are multifactorial and may be influenced by built and social environments. The high resolution overlapping of these diseases and factors affecting their spatial heterogeneity has not been investigated in Kenya. From 2014-2018, we prospectively followed a cohort of children from four communities in both coastal and western Kenya. Overall, 9.8% were CHIKV seropositive, 5.5% were DENV seropositive, and 39.1% were malaria positive (3521 children tested). The spatial analysis identified hot-spots for all three diseases in each site and in multiple years. The results of the model showed that the risk of exposure was linked to demographics with common factors for the three diseases including the presence of litter, crowded households, and higher wealth in these communities. These insights are of high importance to improve surveillance and targeted control of mosquito-borne diseases in Kenya.
Qualitative analysis of stakeholder perspectives on engaging Latinx patients in kidney-related research
Authors: Alvarado Flor , Delgado Cynthia , Nicholas Susanne B. , Jaure Allison , Cervantes Lilia
Published: March 2023

Background

Latinx individuals are disproportionally burdened by kidney diseases compared to non-Latinx White individuals and are underrepresented in kidney-related research. We aimed to describe stakeholder perspectives on Latinx patient engagement in kidney-related research.

Methods

We conducted a thematic analysis of two online moderated discussions and an interactive online survey with open-text responses involving participants (i.e. stakeholders), with personal and/or professional experiences with Latinx patients with kidney diseases and their families/caregivers.

Results

Among the eight stakeholders (Female:75%; Latinx ethnicity:88%), there were three physicians, one nurse, one patient with kidney disease who received a kidney transplant, one policy maker, one Doctor of Philosophy, and one executive director of a non-profit health organization. We identified five themes. The majority of themes and their respective subthemes (in parentheses) reflected barriers to engagement: Lack of personal relevance (unable to relate to research staff and marketing resources, and unclear benefit of research to self, family, and community); fear and vulnerability (immigration concerns, stigma with seeking care, skepticism of Western medicine); logistical and financial barriers (limited opportunities to enroll in clinical trials, out-of-pocket costs, transportation issues); and distrust and asymmetry of power (related to limited English proficiency or health literacy, and provider bias). The last theme centered on stimulating interest and establishing trust in the research process.

Conclusions

To overcome barriers to engagement in kidney-related research and establish trust among potential Latinx research participants, stakeholders recommended employing cultural responsiveness and community-based strategies. These strategies can help identify local health priorities, enhance research recruitment and retention strategies, and establish partnerships that continue to elevate research endeavors aiming to enhance the health of Latinx individuals with kidney diseases.
Efficacy and safety of mucous fistula refeeding in preterm infants: an exploratory randomized controlled trial
Authors: Lee Eun Sun , Kim Ee-Kyung , Shin Seung Han , Jung Young Hwa , Song In-Gyu , Kim Yoo-Jin , Kim Hyun Young , Choi Young-Hun , Moon Kyung Chul , Kim Bohyun
Published: March 2023

Background

This study aimed to evaluate whether mucous fistula refeeding (MFR) is safe and beneficial for the growth and intestinal adaptation of preterm infants with enterostomies.

Methods

This exploratory randomized controlled trial enrolled infants born before 35 weeks’ gestation with enterostomy. If the stomal output was ≥ 40 mL/kg/day, infants were assigned to the high-output MFR group and received MFR. If the stoma output was < 40 mL/kg/day, infants were randomized to the normal-output MFR group or the control group. Growth, serum citrulline levels, and bowel diameter in loopograms were compared. The safety of MFR was evaluated.

Results

Twenty infants were included. The growth rate increased considerably, and the colon diameter was significantly larger after MFR. However, the citrulline levels did not significantly differ between the normal-output MFR and the control group. One case of bowel perforation occurred during the manual reduction for stoma prolapse. Although the association with MFR was unclear, two cases of culture-proven sepsis during MFR were noted.

Conclusions

MFR benefits the growth and intestinal adaptation of preterm infants with enterostomy and can be safely implemented with a standardized protocol. However, infectious complications need to be investigated further.

Trial registration

clinicaltrials.gov NCT02812095, retrospectively registered on June 6, 2016.
Relationship between chronotypes and aggression in adolescents: a cross-sectional study
Authors: Wang Yuan , Liu Hao , Wang Yan-rong , Wei Jia , Zhao Ran-ran , Fang Jian-qun
Published: March 2023

Background

This study aimed to investigate the relationship between chronotypes and aggression in adolescents.

Methods

A cross-sectional study was conducted on 755 primary and secondary school students aged 11–16 years in rural areas of Ningxia Province, China. The Chinese version of the Buss-Perry Aggression Questionnaire (AQ-CV) and the Chinese version Morningness-Eveningness Questionnaire (MEQ-CV) were used to assess the aggressive behavior and chronotypes of the study subjects. The Kruskal-Wallis test was then used to compare the differences in aggression among adolescents with different chronotypes, and Spearman correlation analysis to determine the relationship between chronotypes and aggression. Further linear regression analysis was used to investigate the effects of chronotype, personality traits, family environment, and class environment on adolescent aggression.

Results

There were significant differences in chronotypes between different age groups and different sexes. Spearman correlation analysis showed that the MEQ-CV total score was negatively correlated with the AQ-CV total score (r = -0.263) and score of each AQ-CV subscale. In Model 1, chronotypes were negatively associated with aggression when controlling for age and sex, and evening-type adolescents might be more likely to exhibit aggressive behavior (b = -0.513, 95% CI: [-0.712, -0.315], P < 0.001); in Model 2, the negative association remained after controlling for family and class environment on the basis of Model 1 (b = -0.404, 95% CI: [-0.601, -0.208], P < 0.001); and in Model 3, the negative association still existed after controlling for personality traits on the basis of Model 2 (b = -0.383, 95% CI: [-0.577, -0.190], P < 0.001).

Conclusion

Compared to morning-type adolescents, evening-type adolescents were more likely to exhibit aggressive behavior. Given social expectations for MT adolescents, adolescents should be actively guided to develop a good circadian rhythm that may be more conducive to their physical and mental development.
Depression and determinants among diabetes mellitus patients in Ethiopia, a systematic review and meta-analysis
Authors: Tegegne Kirubel Dagnaw , Gebeyehu Natnael Atnafu , Kassaw Mesfin Wudu
Published: March 2023

Introduction

Primary studies have estimated the prevalence of depression and its determinants among diabetes patients. However, studies synthesizing this primary evidence are limited. Hence, this systematic review aimed to determine the prevalence of depression and identify determinants of depression among diabetes in Ethiopia.

Methods

This systematic review and meta-analysis included a search of PubMed, Google Scholar, Scopus, Science Direct, PsycINFO, and Cochrane library. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Data were pooled using a random-effects model. Forest plots, and Egger’s regression test were all used to check for publication bias. Heterogeneity (I)2 was computed. Subgroup analysis was done by region, publication year, and depression screening instrument. In addition, the pooled odds ratio for determinants was calculated.

Results

Sixteen studies, including 5808 participants were analyzed. The prevalence of depression in diabetes was estimated to be 34.61% (95% CI: 27.31–41.91). According to subgroup analysis by study region, publication year, and screening instrument, the highest prevalence was observed in Addis Ababa (41.98%), studies published before 2020 (37.91%), and studies that used Hospital Anxiety and Depression Scale (HADS-D) (42.42%,) respectively. Older age > 50 years (AOR = 2.96; 95% CI: 1.71–5.11), being women (AOR = 2.31; 95% CI: 1.57, 3.4), longer duration with diabetes (above 5 years) (AOR = 1.98; 95% CI: 1.03–3.8), and limited social support (AOR = 2.37; 95% CI: 1.68–3.34), were the determinants of depression in diabetic patients.

Conclusion

The results of this study suggest that the prevalence of depression in diabetes is substantial. This result underscores the importance of paying particular attention to prevent depression among diabetes. Being older, not attending formal education, longer duration with diabetes, having comorbidity, and low adherence to diabetes management were all associated. These variables may help clinicians identify patients at high risk of depression. Future studies focusing on the causal association between depression and diabetes are highly recommended.
Burden of gastroesophageal reflux disease in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of disease study 2019
Authors: Li Na , Yang Wan-Li , Cai Mei-Hong , Chen Xiang , Zhao Ran , Li Meng-Ting , Yan Xia-Lin , Xue Li-Wei , Hong Liu , Tang Ming-Yu
Published: March 2023

Introduction

For effective preventive strategies against GORD (gastro-esophageal reflux disease), we assessed the GORD burden from 1990 to 2019.

Methods

The burden of GORD between 1990 and 2019 was evaluated globally, regionally, and nationally. Using ASIR (age-standardized incidence), ASYLDs (age-standardized years lived with disabilitys), we compared them to the GBD world population per 100,000. The estimates were based on 95% uncertainty intervals (UIs). The AAPC (average annual percent change) in incidence, YLDs, along with prevalence rates with associated 95% CIs were estimated.

Results

Data to estimate the burden of GORD are scarce till now. The global ASIR of GORD in 2019 was 3792.79 per 100,000, an increase AAPC of 0.112% from 1990. The prevalence of GORD increased with a AAPC of 0.096% to 9574.45 per 100,000. Global ASYLDs in 2019 was 73.63, an increase AAPC of 0.105% from 1990. The GORD burden varies greatly depending on the development level and geographical location. USA demonstrated the most obvious decreasing trend in burden of GORD, while Sweden had an increasing trend. That the increase in GORD YLDs was mediated primarily by the growth and aging of population, was revealed by decomposition analyses. There was an inverse relationship between SDI (socio-demographic index) and GORD-burden. Frontier analyses revealed significant scope of improvement in the status of development at all levels.

Conclusion

GORD is a public health challenge, especially in Latin America. Some SDI quintiles had declining rates, while some countries experienced increased rates. Thus, resources should be allocated for preventative measures based on country-specific estimates.
Exploring culturally-preferred communication approaches for increased uptake of voluntary medical male circumcision (VMMC) services in rural Malawi
Authors: Mphepo Kent Yelemia G. , Muula Adamson Sinjani , Suzi Joel , Phuka Felix , Mfutso-Bengo Joseph
Published: March 2023

Background

In 2007 WHO and UNAIDS recommended communication interventions as a key strategy for creating demand for Voluntary Medical Male Circumcision (VMMC) in Southern Africa. In Malawi, VMMC communication interventions, implemented by health communication agencies, have effectively raised awareness of services. However, high awareness of VMMC has not resulted in increased uptake. Consequently, Malawi has achieved the lowest number of circumcisions in Southern Africa.

Methods

These researchers carried out a study among the traditionally circumcising Yaos of Mangochi in Southern Region and the non-circumcising Chewas in Central Region. Data were collected using FGDs, KIIs, IDIs, Life Histories and Participatory Rural Appraisal methods. Data were analyzed thematically.

Results

This study demonstrates two lessons. First, Laswell’s Theory, which has traditionally been used in politics, is relevant to the health sector where the message delivery continuum also needs to be clear on source, message, audience, channel and intended effects. Secondly, according to informants, allowing communities to give feedback to the VMMC messages delivered by health promoters is fundamental. Therefore, failure by Laswell Theory to emphasize on feedback compromises its efficacy. It weakens its ability to foster a common vision between the source and the audience which is prerequisite for behavioral change.

Conclusion

The study concluded that community engagement and interpersonal communication which provide room for real-time feedback in any communicative event are the most preferred communication interventions for VMMC services among Yaos and Chewas.
Life in lockdown: a qualitative study exploring the experience of living through the initial COVID-19 lockdown in the UK and its impact on diet, physical activity and mental health
Authors: Griffin Tania , Grey Elisabeth , Lambert Jeffrey , Gillison Fiona , Townsend Nick , Solomon-Moore Emma
Published: March 2023

Background

In response to the COVID-19 pandemic, the UK imposed a national lockdown prompting change to daily routines. Among behaviours impacted by the lockdown, diet and physical activity may be particularly important due to their association with mental health and physical health. The aim of this study was to explore people’s experiences of how lockdown impacted their physical activity, dietary behaviours and mental health, with a view to informing public health promotion.

Methods

This phenomenological qualitative study used semi-structured telephone interviews. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was conducted, guided by the Framework Approach.

Results

Forty participants (28 female) completed an interview (mean duration: 36 min) between May and July 2020. The overarching themes identified were (i) Disruption (loss of routines, social interaction and cues to physical activity) and (ii) Adaptation (structuring the day, accessing the outdoor environment, finding new ways for social support). The disruption to daily routines altered people’s cues for physical activity and eating; some participants spoke of comfort eating and increased alcohol intake in the early days of lockdown, and how they consciously tried to change these when restrictions lasted longer than first anticipated. Others spoke of adapting to the restrictions using food preparation and meals to provide both routine and social time for families. Disruptions from the closure of workplaces resulted in flexible working times for some, allowing for physical activity to be built into the day. In later stages of restrictions, physical activity became an opportunity for social interaction and several participants reported intending to continue to replace sedentary means of socialising (e.g., meeting in cafes) with more active, outdoor activities (e.g., walking) once restrictions were lifted. Staying active and building activity into the day was seen as important to support physical and mental health during the challenging times of the pandemic.

Conclusions

Whilst many participants found the UK lockdown challenging, adaptations to cope with the restrictions presented some positive changes related to physical activity and diet behaviours. Helping people sustain their new healthier activities since restrictions have lifted is a challenge but presents an opportunity for public health promotion.
Sex differences in risk factors for metabolic syndrome in middle-aged and senior hospital employees: a population-based cohort study
Authors: Chang Hsu-Chieh , Wu Yi-Syuan , Tzeng Wen-Chii , Wu Hao-Yi , Lee Pai-Ching , Wang Wei-Yun
Published: March 2023

Background

Several cross-sectional studies have reported risk factors for metabolic syndrome (MetS). However, these studies did not focus on sex differences in middle-aged and senior populations or employ a longitudinal design. These study design differences are important, as there are sex differences in lifestyle habits associated with MetS, and middle-aged and senior individuals have increased MetS susceptibility. Therefore, the purpose of this study was to examine whether sex differences influenced MetS risk over a ten-year follow-up period among middle-aged and senior hospital employees.

Methods

This population-based and prospective cohort study enrolled 565 participants who did not have MetS in 2012 for a ten-year repeated-measurement analysis. Data were retrieved from the hospital’s Health Management Information System. Analyses included Student’s t tests, χ2 tests and Cox regression. P < 0.05 indicated statistical significance.

Results

Male middle-aged and senior hospital employees had an elevated MetS risk (hazard ratio (HR) = 1.936, p < 0.001). Men with more than four family history risk factors had an increased risk of MetS (HR = 1.969, p = 0.010). Women who worked shift duty (HR = 1.326, p = 0.020), had more than two chronic diseases (HR = 1.513, p = 0.012), had three family history risk factors (HR = 1.623, p = 0.010), or chewed betel nuts (HR = 9.710, p = 0.002) had an increased risk of MetS.

Conclusions

The longitudinal design of our study improves the understanding of sex differences in MetS risk factors in middle-aged and senior adults. A significantly elevated risk of MetS over the ten-year follow-up period was associated with male sex, shift work, the number of chronic diseases, the number of family history risk factors, and betel nut chewing. Women who chewed betel nuts had an especially increased risk of MetS. Our study indicates that population-specific studies are important for the identification of subgroups susceptible to MetS and for the implementation of hospital-based strategies.
Association between initial in-hospital heart rate and glycemic control in patients with acute ischemic stroke and diabetes mellitus
Authors: Kuo Ya-Wen , Lee Jiann-Der , Lee Chuan-Pin , Huang Yen-Chu , Lee Meng
Published: March 2023

Background

A high resting heart rate (HR) has been associated with an increased risk of diabetes mellitus. This study explored the association between initial in-hospital HR and glycemic control in patients with acute ischemic stroke (AIS) and diabetes mellitus.

Methods

We analyzed data from 4,715 patients with AIS and type 2 diabetes mellitus enrolled in the Chang Gung Research Database between January 2010 and September 2018. The study outcome was unfavorable glycemic control, defined as glycated hemoglobin (HbA1c) ≥ 7%. In statistical analyses, the mean initial in-hospital HR was used as both a continuous and categorical variable. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression analysis. The associations between the HR subgroups and HbA1c levels were analyzed using a generalized linear model.

Results

Compared with the reference group (HR < 60 bpm), the adjusted ORs for unfavorable glycemic control were 1.093 (95% CI 0.786–1.519) for an HR of 60–69 bpm, 1.370 (95% CI 0.991–1.892) for an HR of 70–79 bpm, and 1.608 (95% CI 1.145–2.257) for an HR of ≥ 80 bpm. Even after adjusting for possible confounders, the HbA1c levels after admission and discharge among diabetic stroke patients increased significantly in the subgroups with higher HRs (p < 0.001).

Conclusions

High initial in-hospital HR is associated with unfavorable glycemic control in patients with AIS and diabetes mellitus, particularly in those with an HR of ≥ 80 bpm, compared with those with an HR of < 60 bpm.
Simulation-based learning in palliative care in postgraduate nursing education: a scoping review
Authors: Skedsmo Karoline , Nes Andréa Aparecida Gonçalves , Stenseth Hege Vistven , Hofsø Kristin , Larsen Marie Hamilton , Hilderson Deborah , Smis Dieter , Hagelin Carina Lundh , Olaussen Camilla , Solberg Marianne Trygg , Bingen Hanne Maria , Ølnes Mia Alexandra , Steindal Simen A.
Published: March 2023

Background

Nurses require advanced competence in palliative care, but they face wide variations in education and a shortage in opportunities for clinical placement. Simulation-based learning (SBL) can enable students to develop clinical skills, critical thinking and confidence. No scoping reviews to date have mapped the use of SBL in palliative care within postgraduate nursing education.

Methods

The aim of this scoping review was to systematically map published studies on the use of SBL in palliative care in postgraduate nursing education. A scoping review was conducted using Arksey and O’Malley’s (Int J Soc Res Meth 8(1):19–32, 2005) methodological framework. A systematic and comprehensive search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resources Information Center (ERIC), Ovid MEDLINE, Ovid EMBASE, Allied and Complementary Medicine and PsycINFO was performed for studies published between January 2000 and April 2022. Two authors independently assessed papers for inclusion and extracted data. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The protocol was registered on the Open Science Framework.

Results

This review includes 10 studies. Three thematic groupings were identified: enhanced understanding of the importance of teamwork, interdisciplinarity and interpersonal skills; preparedness and confidence in one’s ability to communicate during emotionally challenging situations; and impact and relevance to one’s own clinical practice.

Conclusions

The use of SBL in palliative care in postgraduate nursing education seems to enhance students’ understanding of the importance of teamwork and interdisciplinarity. The review shows contradictory results regarding whether SBL in palliative care increases students’ confidence in their communication skills. Postgraduate nursing students experienced personal growth after participating in SBL. Because our findings indicate that limited research has been conducted within this field, future research should (1) explore postgraduate nursing students’ experiences with SBL in palliative care with a focus on more practical content such as symptom management, (2) examine the relevance and application of SBL in clinical practice, and (3) be reported in line with recommendations on the reporting of simulation research.
Prevalence and factors associated with condom use among sexually active young women in Haiti: evidence from the 2016/17 Haiti demographic and health survey
Authors: Jean Simon David , Paul Bénédique , Kiragu Ann , Olorunsaiye Comfort Z. , Joseph Fanor , Joseph Ghislaine , N’Gou M’Boh Delphin
Published: March 2023

Background

Young women in Haiti remain vulnerable to sexually transmitted infections and unintended pregnancy. However, little is known about condom use among this population. This study examined the prevalence and the factors associated with condom use among sexually active young women in Haiti.

Methods

Data from the 2016/17 Haiti demographic and health survey were used. The prevalence and the factors associated with condom use among sexually active young women in Haiti were assessed using descriptive statistics and binary logistic regression model.

Results

The prevalence of condom use was 15.4% (95% CI 14.0–16.8). Being teenage (AOR = 1.34; 95% CI: 1.04–1.74), living in urban areas (AOR = 1.41; 95% CI = 1.04–1.90), having higher education level (AOR = 2.39; 95% CI: 1.44–4.00), being in the middle or rich category of household wealth index (AOR = 2.32; 95% CI: 1.53–3.53 and AOR = 2.93; 95% CI: 1.90–4.52), having correct knowledge of ovulatory cycle (AOR = 1.65; 95% CI: 1.30–2.10), having 2–3 lifetime sexual partners and one lifetime sexual partner (AOR = 2.04; 95% CI: 1.36–3.06 and AOR = 2.07; 95% CI: 1.35–3.17) had significantly higher odds of using condom. In addition, sexually active young women whose last partner was their boyfriend (AOR = 4.38; 95% CI: 2.82–6.81), and those whose last partner was a friend/casual acquaintance/commercial sex worker (AOR = 5.29; 95% CI: 2.18–12.85) were associated with increased likelihood of using condom compared with their counterparts whose partner was their spouse.

Conclusion

The Haitian government as well as institutions involved in sexual health should consider these factors when designing sexual and reproductive health interventions targeting young women. More specifically, to increase condom use and reduce risky sexual behaviors, they should combine efforts to raise awareness and induce sexual behavioral changes at two levels. In the education system, they should reinforce sexual education in primary and secondary schools while paying special attention to rural areas. In the whole society, it is important to deepen efforts toward increased awareness on family planning and condom use, through mass media and local organizations including religious ones. Priority should be given to the poorer households, young people and women, and rural areas, in order to maximize reduction in early and unintended pregnancy, and sexually transmitted infections. Interventions should include a condom price subsidy and a campaign to destigmatize condom use which is actually a “male affair”.
Multidimensional evaluation of offline and online education in dermatology teaching during the COVID-19 pandemic in a chinese teaching hospital: a cross-sectional study
Authors: Wang Ben , Zhang Mi , Zhao Zhixiang , Huang Yingxue , Li Ji , Chen Xiang , Su Juan , Yi Mei
Published: March 2023

Background

The global spread of Coronavirus disease (COVID-19) has led to the use of online teaching methods in universities, but the effect of online education on dermatology teaching remains unclear.

Methods

We designed a multi-dimensional teaching evaluation form for data collection, student teaching feedback evaluation, and assessed the scores of final theoretical and clinical skill tests, to compare the effective difference between online and offline teaching of dermatology.

Results

A total of 311 valid questionnaires of medical undergraduates were collected, 116 of which were enrolled for offline learning, and 195 for online learning. The average score of final theoretical test in the online teaching group had no significant difference compared with that in the offline teaching group (75.33 ± 7.37 vs.75.63 ± 7.51, P = 0.734). However, both scores of skin lesion recognition test and medical history collection test in the online teaching group were significantly lower than that in the offline teaching group (6.53 ± 0.86 vs. 7.10 ± 1.11, P < 0.001; 6.70 ± 1.16 vs. 7.62 ± 0.85, P < 0.001). Additionally, the scores of understanding skin lesions in the online teaching group were significantly lower than that in the offline group (P < 0.001), and the scores of overall understanding of skin diseases and evaluating their learning mode in the online teaching group also decreased (P < 0.05). Among the 195 students enrolled in the online learning group, 156 students (80.0%) recognized that the time of offline teaching should be increased.

Conclusions

Both online and offline education can be used in dermatology theory teaching, but online education is less efficient in skin lesion and practical skills learning. More online teaching software with skin diseases characteristic should be developed to improve the online teaching effect.
Perceived impacts of COVID-19 responses on routine health service delivery in Liberia and UK: cross-country lessons for resilient health systems for equitable service delivery during pandemics
Authors: Alhassan Yussif , Zaizay Zeela , Dean Laura , McCollum Rosalind , Watson Victoria , Kollie Karsor , Piotrowski Helen , Hastie Olivia , Parker Colleen , Dacombe Russell , Theobald Sally , Taegtmeyer Miriam
Published: March 2023

Background

COVID-19 has caused significant public health problems globally, with catastrophic impacts on health systems. This study explored the adaptations to health services in Liberia and Merseyside UK at the beginning of the COVID-19 pandemic (January–May 2020) and their perceived impact on routine service delivery. During this period, transmission routes and treatment pathways were as yet unknown, public fear and health care worker fear was high and death rates among vulnerable hospitalised patients were high. We aimed to identify cross-context lessons for building more resilient health systems during a pandemic response.

Methods

The study employed a cross-sectional qualitative design with a collective case study approach involving simultaneous comparison of COVID-19 response experiences in Liberia and Merseyside. Between June and September 2020, we conducted semi-structured interviews with 66 health system actors purposively selected across different levels of the health system. Participants included national and county decision-makers in Liberia, frontline health workers and regional and hospital decision-makers in Merseyside UK. Data were analysed thematically in NVivo 12 software.

Results

There were mixed impacts on routine services in both settings. Major adverse impacts included diminished availability and utilisation of critical health services for socially vulnerable populations, linked with reallocation of health service resources for COVID-19 care, and use of virtual medical consultation in Merseyside. Routine service delivery during the pandemic was hampered by a lack of clear communication, centralised planning, and limited local autonomy. Across both settings, cross-sectoral collaboration, community-based service delivery, virtual consultations, community engagement, culturally sensitive messaging, and local autonomy in response planning facilitated delivery of essential services.

Conclusion

Our findings can inform response planning to assure optimal delivery of essential routine health services during the early phases of public health emergencies. Pandemic responses should prioritise early preparedness, with investment in the health systems building blocks including staff training and PPE stocks, address both pre-existing and pandemic-related structural barriers to care, inclusive and participatory decision-making, strong community engagement, and effective and sensitive communication. Multisectoral collaboration and inclusive leadership are essential.
Characteristics of telemedicine workflows in nursing homes during the COVID-19 pandemic
Authors: Ford James H , Jolles Sally A , Heller Dee , Crnich Christopher
Published: March 2023

Background

The use of telemedicine increased dramatically in nursing homes (NHs) during the COVID-19 pandemic. However, little is known about the actual process of conducting a telemedicine encounter in NHs. The objective of this study was to identify and document the work processes associated with different types of telemedicine encounters conducted in NHs during the COVID-19 pandemic.

Methods

A mixed methods convergent study was utilized. The study was conducted in a convenience sample of two NHs that had newly adopted telemedicine during the COVID-19 pandemic. Participants included NH staff and providers involved in telemedicine encounters conducted in the study NHs. The study involved semi-structured interviews and direct observation of telemedicine encounters and post-encounter interviews with staff and providers involved in telemedicine encounters observed by research staff. The semi-structured interviews were structured using the Systems Engineering Initiative for Patient Safety (SEIPS) model to collect information about telemedicine workflows. A structured checklist was utilized to document steps performed during direct observations of telemedicine encounters. Information from interviews and observations informed the creation of a process map of the NH telemedicine encounter.

Results

A total of 17 individuals participated in semi-structured interviews. Fifteen unique telemedicine encounters were observed. A total of 18 post-encounter interviews with 7 unique providers (15 interviews in total) and three NH staff were performed. A 9-step process map of the telemedicine encounter, along with two microprocess maps related to encounter preparation and activities within the telemedicine encounter, were created. Six main processes were identified: encounter planning, family or healthcare authority notification, pre-encounter preparation, pre-encounter huddle, conducting the encounter, and post-encounter follow-up.

Conclusion

The COVID-19 pandemic changed the delivery of care in NHs and increased reliance on telemedicine services in these facilities. Workflow mapping using the SEIPS model revealed that the NH telemedicine encounter is a complex multi-step process and identified weaknesses related to scheduling, electronic health record interoperability, pre-encounter planning, and post-encounter information exchange, which represent opportunities to improve and enhance the telemedicine encounter process in NHs. Given public acceptance of telemedicine as a care delivery model, expanding the use of telemedicine beyond the COVID-19 pandemic, especially for certain NH telemedicine encounters, could improve quality of care.