bluuebunny/crossref_metadata_2025 huggingface dataset:
Conservative versus stent treatment for spontaneous isolated superior mesenteric artery dissection after the failure of initial 3 days’ conservative treatment: A 10-year follow-up study
Authors: Wang Lei , Xu Miao , Chen Zhaolei , Jiang Guoqing
Published: March 2024

Objectives

To compare the safety and effectiveness of conservative and stent treatment for spontaneous isolated superior mesenteric artery dissection (SISMAD) patients after the failure of initial 3 days’ conservative treatment.

Methods

All newly diagnosed SISMAD patients between 2013 and 2017 were retrospectively reviewed. After the failure of 3 days’ conservative treatment, all patients were recommended for stent treatment, but some patients refused to choose it. Their demographic, radiologic, and clinical data were compared.

Results

57 patients were not improved after initial 3 days’ conservative treatment. Among them, 19 patients were chose to receive stent placement and 38 patients were continually treated with conservative treatment. The median follow-up time was 92.0 (range 62.7–120.4) months. There were no bowel ischemia and arterial rupture. No significant difference was observed in clinical complete recovery (Conservative 31/38 vs Stent 12/19, p =.19) and hospitalization time (Conservative 8.3 ± 1.7 days vs Stent 7.2 ± 1.5 days, p =.59) between conservative and stent treatment groups. Significant statistical differences were found in radiological complete remodeling (6/38 vs 16/19, p < .01) and hospitalization expense (8662 ± 2886 China Yuan vs 32,935 ± 11,767 China Yuan, p < .01) between these two groups.

Conclusions

Although undergoing the failure of initial 3 days’ conservative treatment, continue conservative treatment still is safe and effective for SISMAD patients. Stent placement could be chosen as an alternative treatment, especially for patients potentially with bowel ischemia or arterial rupture.
Global, regional, and national burden of stroke attributable to extreme low temperatures, 1990–2019: A global analysis
Authors: Zhou Lue , Wei Yujie , Ge Yahao , Li Yapeng , Liu Kai , Gao Yuan , Song Bo , Li Yusheng , Zhang Daping , Bo Yacong , Zhang Junxi , Xu Yuming , Duan Xiaoran
Published: March 2024

Background:

Extreme ambient temperatures have been linked to increased risks of stroke morbidity and mortality. However, global estimates of the burden of stroke due to extreme low temperatures are not well-defined.

Aims:

This study aimed to determine the global burden of stroke due to extreme low temperatures and its spatiotemporal trend from 1990 to 2019.

Methods:

Based on the Global Burden of Disease Study 2019, we obtained global, regional, and national data on deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized rate of DALYs (ASDR) of stroke attributed to extreme low temperatures, further stratified by age, sex, and sociodemographic index (SDI).

Results:

Globally, in 2019, an estimated 474,000 stroke deaths with the corresponding ASMR (6.2 (95% uncertainty interval (UI): 4.6–7.9)) and ASDR (103.9 (95% UI: 77.0–134.5)) per 100,000 population, were attributable to extreme low temperatures. The most significant burden was observed in Central Asia, followed by Eastern Europe and East Asia. From 1990 to 2019, the global burden of stroke and its subtypes (ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage) attributable to extreme low temperatures exhibited a decrease in both ASMR and ASDR. Significant decreases in stroke burden occurred in the high-SDI regions, high-income Asia Pacific, and subarachnoid hemorrhage cases. Moreover, the ASMR and ASDR increased with age and were higher in males than females.

Conclusion:

The global stroke burden due to extreme low temperatures remains high despite a decreasing trend over the past three decades. The stroke burden due to extreme low temperatures was more notable for Central Asia, older people, and the male sex.
Reliability model for key components of urban rail transit train based on improved hunter-prey optimization
Authors: Zhong Jiecheng , He Deqiang , Jin Zhenzhen , Sun Haimeng , Shan Sheng
Published: March 2024

The reliability of key components of urban rail transit (URT) plays an important role in the maintenance plans of URT. It is necessary to establish the reliability model of URT trains. In the current research, the reliability model has a limited scope of application and fails to accurately depict the reliability of key components in URT trains. To solve the above problem, a multi-peak type mixture Weibull distribution model is established using several three-parameter Weibull distributions based on fault modes of components sourced from historical lifetime data. Due to the complexity of this model, parameter estimation is challenging. For this purpose, an improved hunter-prey optimization (IHPO) was proposed to improve parameter estimation accuracy. Firstly, an improved Hénon chaos map was introduced to improve the distribution of the initial population. Secondly, the Lévy flight was introduced to increase the probability of the individual spreading to the whole range at the late stage. Lastly, a nonlinear balance factor was proposed to enhance the algorithm’s global search capability. The simulation experiment was carried out with examples of the balanced pressing wheel and the wheelset. The IHPO algorithm-based parameter estimation method shows the highest R-square with values of 0.996 and 0.999, respectively, and the lowest root mean square error with values of 0.019 and 0.008, respectively. The simulation results demonstrate that the stability and optimization of the HPO are improved, and the multi-peak mixture Weibull distribution model based on the IHPO can accurately depict URT trains’ reliability.
Association of Increased Lateral Femoral Condylar Ratio With Lateral Meniscus Posterior Root Tear in Noncontact ACL Injury
Authors: Choi Nam-Hong , Yang Bong-Seok , Lee Dong-Min , Lee Choong-Ryul
Published: March 2024

Background:

In the setting of anterior cruciate ligament (ACL) injury, lateral meniscus posterior root tears (LMPRTs) are less readily diagnosed on preoperative magnetic resonance imaging (MRI). Therefore, to predict LMPRTs in ACL injuries, it is necessary to understand the risk factors associated with them.

Purpose/Hypothesis:

The purpose of this study was to investigate the association of lateral femoral condylar ratio (LFCR) with LMPRTs in ACL injuries. It was hypothesized that an increased LFCR would be associated with LMPRTs in noncontact ACL injuries.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Enrolled were consecutive patients who underwent primary acute (<6 weeks from injury) ACL reconstruction after noncontact injury and had LMPRT confirmed on preoperative MRI and arthroscopically (combined group; n = 62) as well as patients who underwent isolated acute ACL reconstruction (isolated group; n = 80) who were matched to the combined group by age, height, and body mass index (BMI). All patients underwent surgery between January 1999 and November 2021. LFCR and posterior tibial slope (PTS) were measured and compared between the isolated and combined groups. The area under the receiver operating characteristic curve (AUC) was calculated to determine the cutoff for detecting increased risk of LMPRTs.

Results:

The demographic characteristics of the 2 groups did not differ significantly, nor did the PTS. The LFCR was a significant factor (odds ratio [OR], 1.23; P = .001) associated with LMPRT. Patient age, height, BMI, and PTS were not associated with LMPRT. The AUC (0.66; 95% CI, 0.57-0.75) for LFCR had a sensitivity of 39% and specificity of 90% to predict LMPRT. The calculated cutoff associated with an increased risk for LMPRT when compared with the isolated group was 67.0% (OR, 4.98; 95% CI, 2.10-11.79).

Conclusion:

Increased LFCR was associated with the presence of LMPRTs in patients with acute ACL injuries. The LFCR may provide surgeons with additional information regarding the risk of having a concomitant LMPRT when planning ACL reconstructions.
The leading role of expert safety knowledge in supporting the mission of caring for patients during man-made and natural disasters: state of emergency medicine in Ethiopia, Myanmar, and Ukraine
Authors: Miles Ralph C. , Avelino-Silva Vivian I. , Odoke Wilfred , van den Hombergh Jan , Fonseca Fernanda F. , GebreMichael Mengistu , Lopatina Yaroslava , Oo Win , Benzaken Adele Schwartz
Published: March 2024

Preparedness to endure extreme situations such as natural disasters or military conflicts is not commonplace in healthcare training programs. Moreover, multidisciplinary teams in health services rarely (if ever) include experts in security. However, when emergency situations occur, prevailing healthcare demands do not cease to exist, and unexpected demands often surge due to the shortage of other services and supplies or as a consequence of the emergency condition itself.

With services in 45 countries, AIDS Healthcare Foundation (AHF) has operated in several conflict zones, facing broad and challenging security demands. Since 2017 AHF has implemented the Global Department of Safety and Security (GDSS), a dedicated intelligence and safety program that had a key role in the security monitoring, preparedness, and defense responses, assisting staff members and clients during recent conflicts.

In this manuscript, we describe the experience of AHF’s GDSS in three recent military conflicts in Ethiopia, Myanmar, and Ukraine, and provide insights into steps that can be taken to assure staff safety and support the mission of caring for patients throughout catastrophic events.
GWABLUP: genome-wide association assisted best linear unbiased prediction of genetic values
Authors: Meuwissen Theo , Eikje Leiv Sigbjorn , Gjuvsland Arne B.
Published: March 2024

Background

Since the very beginning of genomic selection, researchers investigated methods that improved upon SNP-BLUP (single nucleotide polymorphism best linear unbiased prediction). SNP-BLUP gives equal weight to all SNPs, whereas it is expected that many SNPs are not near causal variants and thus do not have substantial effects. A recent approach to remedy this is to use genome-wide association study (GWAS) findings and increase the weights of GWAS-top-SNPs in genomic predictions. Here, we employ a genome-wide approach to integrate GWAS results into genomic prediction, called GWABLUP.

Results

GWABLUP consists of the following steps: (1) performing a GWAS in the training data which results in likelihood ratios; (2) smoothing the likelihood ratios over the SNPs; (3) combining the smoothed likelihood ratio with the prior probability of SNPs having non-zero effects, which yields the posterior probability of the SNPs; (4) calculating a weighted genomic relationship matrix using the posterior probabilities as weights; and (5) performing genomic prediction using the weighted genomic relationship matrix. Using high-density genotypes and milk, fat, protein and somatic cell count phenotypes on dairy cows, GWABLUP was compared to GBLUP, GBLUP (topSNPs) with extra weights for GWAS top-SNPs, and BayesGC, i.e. a Bayesian variable selection model. The GWAS resulted in six, five, four, and three genome-wide significant peaks for milk, fat and protein yield and somatic cell count, respectively. GWABLUP genomic predictions were 10, 6, 7 and 1% more reliable than those of GBLUP for milk, fat and protein yield and somatic cell count, respectively. It was also more reliable than GBLUP (topSNPs) for all four traits, and more reliable than BayesGC for three of the traits. Although GWABLUP showed a tendency towards inflation bias for three of the traits, this was not statistically significant. In a multitrait analysis, GWABLUP yielded the highest accuracy for two of the traits. However, for SCC, which was relatively unrelated to the yield traits, including yield trait GWAS-results reduced the reliability compared to a single trait analysis.

Conclusions

GWABLUP uses GWAS results to differentially weigh all the SNPs in a weighted GBLUP genomic prediction analysis. GWABLUP yielded up to 10% and 13% more reliable genomic predictions than GBLUP for single and multitrait analyses, respectively. Extension of GWABLUP to single-step analyses is straightforward.
Few-shot genes selection: subset of PAM50 genes for breast cancer subtypes classification
Authors: Okimoto Leandro Y. S. , Mendonca-Neto Rayol , Nakamura Fabíola G. , Nakamura Eduardo F. , Fenyö David , Silva Claudio T.
Published: March 2024

Background

In recent years, researchers have made significant strides in understanding the heterogeneity of breast cancer and its various subtypes. However, the wealth of genomic and proteomic data available today necessitates efficient frameworks, instruments, and computational tools for meaningful analysis. Despite its success as a prognostic tool, the PAM50 gene signature’s reliance on many genes presents challenges in terms of cost and complexity. Consequently, there is a need for more efficient methods to classify breast cancer subtypes using a reduced gene set accurately.

Results

This study explores the potential of achieving precise breast cancer subtype categorization using a reduced gene set derived from the PAM50 gene signature. By employing a “Few-Shot Genes Selection” method, we randomly select smaller subsets from PAM50 and evaluate their performance using metrics and a linear model, specifically the Support Vector Machine (SVM) classifier. In addition, we aim to assess whether a more compact gene set can maintain performance while simplifying the classification process. Our findings demonstrate that certain reduced gene subsets can perform comparable or superior to the full PAM50 gene signature.

Conclusions

The identified gene subsets, with 36 genes, have the potential to contribute to the development of more cost-effective and streamlined diagnostic tools in breast cancer research and clinical settings.
Improving productivity and soil fertility in Medicago sativa and Hordeum marinum through intercropping under saline conditions
Authors: Guerchi Amal , Mnafgui Wiem , Jabri Cheima , Merghni Meriem , Sifaoui Kalthoum , Mahjoub Asma , Ludidi Ndiko , Badri Mounawer
Published: March 2024

Background and aims

Intercropping is an agriculture system used to enhance the efficiency of resource utilization and maximize crop yield grown under environmental stress such as salinity. Nevertheless, the impact of intercropping forage legumes with annual cereals on soil salinity remains unexplored. This research aimed to propose an intercropping system with alfalfa (Medicago sativa)/sea barley (Hordeum marinum) to explore its potential effects on plant productivity, nutrient uptake, and soil salinity.

Methods

The experiment involved three harvests of alfalfa and Hordeum marinum conducted under three cropping systems (sole, mixed, parallel) and subjected to salinity treatments (0 and 150 mM NaCl). Agronomical traits, nutrient uptake, and soil properties were analyzed.

Results

revealed that the variation in the measured traits in both species was influenced by the cultivation mode, treatment, and the interaction between cultivation mode and treatment. The cultivation had the most significant impact. Moreover, the mixed culture (MC) significantly enhanced the H. marinum and M. sativa productivity increasing biomass yield and development growth under salinity compared to other systems, especially at the second harvest. Furthermore, both intercropping systems alleviated the nutrient uptake under salt stress, as noted by the highest levels of K+/Na+ and Ca2+/Mg2+ ratios compared to monoculture. However, the intercropping mode reduced the pH and the electroconductivity (CEC) of the salt soil and increased the percentage of organic matter and the total carbon mostly with the MC system.

Conclusions

Intercropped alfalfa and sea barely could mitigate the soil salinity, improve their yield productivity, and enhance nutrient uptake. Based on these findings, we suggest implementing the mixed-culture system for both target crops in arid and semi-arid regions, which further promotes sustainable agricultural practices.
Butyrylcholinesterase activity in patients with postoperative delirium after cardiothoracic surgery or percutaneous valve replacement- an observational interdisciplinary cohort study
Authors: Schlake Konstantin , Teller Johannes , Hinken Lukas , Laser Hans , Lichtinghagen Ralf , Schäfer Andreas , Fegbeutel Christine , Weissenborn Karin , Jung Carolin , Worthmann Hans , Gabriel Maria Magdalena
Published: March 2024

Background and objectives

Postoperative delirium is a frequent and severe complication after cardiac surgery. Activity of butyrylcholinesterase (BChE) has been discussed controversially regarding a possible role in its development. This study aimed to investigate the relevance of BChE activity as a biomarker for postoperative delirium after cardiac surgery or percutaneous valve replacement.

Methods

A total of 237 patients who received elective cardiothoracic surgery or percutaneous valve replacement at a tertiary care centre were admitted preoperatively. These patients were tested with the Montreal Cognitive Assessment investigating cognitive deficits, and assessed for postoperative delirium twice daily for three days via the 3D-CAM or the CAM-ICU, depending on their level of consciousness. BChE activity was measured at three defined time points before and after surgery.

Results

Postoperative delirium occurred in 39.7% of patients (n = 94). Univariate analysis showed an association of pre- and postoperative BChE activity with its occurrence (p = 0.037, p = 0.001). There was no association of postoperative delirium and the decline in BChE activity (pre- to postoperative, p = 0.327). Multivariable analysis including either preoperative or postoperative BChE activity as well as age, MoCA, type 2 diabetes mellitus, coronary heart disease, type of surgery and intraoperative administration of red-cell concentrates was performed. Neither preoperative nor postoperative BChE activity was independently associated with the occurrence of postoperative delirium (p = 0.086, p = 0.484). Preoperative BChE activity was lower in older patients (B = -12.38 (95% CI: -21.94 to -2.83), p = 0.011), and in those with a history of stroke (B = -516.173 (95% CI: -893.927 to -138.420), p = 0.008) or alcohol abuse (B = -451.47 (95% CI: -868.38 to -34.55), p = 0.034). Lower postoperative BChE activity was independently associated with longer procedures (B = -461.90 (95% CI: -166.34 to -757.46), p = 0.002), use of cardiopulmonary bypass (B = -262.04 (95% CI: -485.68 to -38.39), p = 0.022), the number of administered red cell-concentrates (B = -40.99 (95% CI: -67.86 to -14.12), p = 0.003) and older age (B = -9.35 (95% CI: -16.04 to -2.66), p = 0.006).

Conclusion

BChE activity is not independently associated with the occurrence of postoperative delirium. Preoperative BChE values are related to patients’ morbidity and vulnerability, while postoperative activities reflect the severity, length and complications of surgery.
LABS score– a prognostic tool for FOLFOX4-treated advanced hepatocellular carcinoma and real-world efficacy: a single-center retrospective study
Authors: Wonglhow Jirapat , Sunpaweravong Patrapim , Sathitruangsak Chirawadee , Dechaphunkul Arunee
Published: March 2024

Background

No widely used prognostic tool exists to demonstrate the benefit of oxaliplatin plus 5-fluorouracil/leucovorin (FOLFOX4) in patients with advanced hepatocellular carcinoma (HCC). We aimed to establish a prognostic score and demonstrate the real-world efficacy of FOLFOX4 chemotherapy in Thai patients.

Methods

Between August 2017 and December 2021, we identified 58 FOLFOX4-treated patients with HCC. Overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) were assessed. The prognostic score was constructed by stepwise Cox proportional hazards regression analysis to select variables for the best model with the lowest Akaike information criterion from all potential variables.

Results

Forty-four patients (76%) received FOLFOX4 as first-line therapy. The ORR in the entire cohort was 8.6%, and the disease control rate was 29.3%. The PFS and OS were 3.7 and 4.8 months, respectively. Four clinically relevant variables were included in the new prognostic score to predict 6-month OS: L, the presence of lung metastasis; A, alcoholic cirrhosis; B, elevated total bilirubin level; and S, sorafenib-naïve status. Using the LABS score, patients were classified into low-, intermediate-, and high-risk groups, demonstrating OS values of 9.3, 4.2, and 2.1 months, respectively (p < 0.0001). The C-index and area under the receiver-operating characteristic curve of the score were 0.71 and 0.73, respectively.

Conclusions

The proposed LABS score could discriminate patients who would derive benefit from FOLFOX4 chemotherapy. FOLFOX4 chemotherapy is an option for patients who cannot receive immunotherapy and targeted therapy, particularly those with a low-risk score. However, further validation of this model via larger cohorts is warranted.
Acute retinal pigment epitheliitis during treatment of hyperprolactinaemia
Authors: Kowalik-Jagodzińska Małgorzata , Czajor Karolina , Turno-Kręcicka Anna
Published: March 2024

Background

Acute retinal pigment epitheliitis (ARPE) is a rare, idiopathic and self-limiting disease. The article aims to present ARPE in a patient using D2 dopamine receptor agonists for the treatment of hyperprolactinemia.

Case presentation

A 28-year-old female during hyperprolactinaemia treatment suffered from a dyschromatopsia and a central visual field defect in the left eye. She noticed a deterioration of vision and discontinued the cabergoline administration. The woman had not been diagnosed with other chronic conditions and exhibited no symptoms of infection. Upon admission, the patient was subjected to a test for COVID-19, which was negative.

The ophthalmological examination revealed a decrease in visual acuity to distance in the left eye, which amounted to 18/20 on the Snellen chart. A central scotoma was noted on the Amsler chart and a loss of pigment epithelium was visible on the fundus of the left eye. Fluorescein angiography showed a discrete window defect in the left one, with no signs of leakage. Optical coherence tomography (OCT) scans of the maculae revealed a characteristic change in the photoreceptor layer and retinal pigment epithelium (RPE) in the fovea in the left eye. The electrophysiological tests revealed decreased function of cells in macular region.

A magnetic resonance imaging (MRI) of the head and orbits demonstrated an asymmetric pituitary gland without chiasm compression and discrete signal enhancement from the left optic nerve.

The patient underwent observation during hospitalisation. She reported improved colour vision and a decreased scotoma in the centre of her visual field.

In regular outpatient follow-ups, successive improvements in visual acuity, as well as a decreased RPE damage and outer photoreceptor layer loss during an OCT test were observed.

Conclusions

A case of ARPE is reported in a patient taking medications for hyperprolactinemia. The role of dopamine receptor antagonists in the photoreceptor function and causation of ARPE needs further evaluation.
Association between elevated serum matrix metalloproteinase-2 and tumor necrosis factor-α, and clinical symptoms in male patients with treatment-resistant and chronic medicated schizophrenia
Authors: Yang Haidong , Peng Ruijie , Yang Man , Zhang Jing , Shi Zhihui , Zhang Xiaobin
Published: March 2024

Background

Inflammation has an important role in the pathogenesis of schizophrenia. The aim of this study was to investigate the levels of tumor necrosis factor (TNF) and matrix metalloproteinase-2 (MMP-2) in male patients with treatment-resistant schizophrenia (TRS) and chronic medicated schizophrenia (CMS), and the relationship with psychopathology.

Methods

The study enrolled 31 TRS and 49 cm male patients, and 53 healthy controls. Serum MMP-2 and TNF-α levels were measured by the Luminex liquid suspension chip detection method. Positive and Negative Syndrome Scale (PANSS) scores were used to evaluate symptom severity and Repeatable Battery for the Assessment of Neuropsychological Status was used to assess cognitive function.

Results

Serum TNF-α and MMP-2 levels differed significantly between TRS, CMS and healthy control patients (F = 4.289, P = 0.016; F = 4.682, P = 0.011, respectively). Bonferroni correction demonstrated that serum TNF-α levels were significantly elevated in CMS patients (P = 0.022) and MMP-2 levels were significantly higher in TRS patients (P = 0.014) compared to healthy controls. In TRS patients, TNF-α was negatively correlated with age (r=-0.435, P = 0.015) and age of onset (r=-0.409, P = 0.022). In CMS patients, MMP-2 and TNF-α were negatively correlated with PANSS negative and total scores, and TNF-α was negatively correlated with PANSS general psychopathology scores (all P < 0.05). MMP-2 levels were positively correlated with TNF-α levels (P < 0.05), but not with cognitive function (P > 0.05).

Conclusion

The results indicate the involvement of inflammation in the etiology of TRS and CMS. Further studies are warranted.
Temporal-spatial distribution characteristics and associated socioeconomic factors of visiting frequency for rural patients with hypertension in Fujian Province, Southeast China
Authors: Fu Rong , Huang Zhi , Lin Yulan , Tang Xuwei , Zheng Zhenquan , Hu Zhijian
Published: March 2024

Background

Regular follow-up and medication can effectively reduce the risk of adverse outcomes for patients with hypertension. This study aimed to explore the temporal-spatial distribution characteristics and associated socioeconomic factors of visiting frequency for rural patients with hypertension in Fujian province from 2011 to 2016.

Methods

The medical records of patients with hypertension were abstracted from the database of New Rural Cooperative Medical Scheme. Geographically and temporally weighted regression model was used to analyze the associations between percentage of patients whose visiting frequency ≥ 4 times within a year and seven socioeconomic factors at the county level.

Results

The visiting rate of rural patients with hypertension was 0.79%, 1.27%, 1.87%, 2.29%, 2.78%, 3.43% over the six-year study period, respectively. The percentage of patients whose visiting frequency ≥ 4 times within a year gradually increased over time and the percentage ranged from 61 to 80% in a half of the counties by 2016. In general, there was positive association between Gross Domestic Product per capita and the percentage of patients whose visiting frequency ≥ 4 times within a year. The percentage of female patients, percentage of patients who aged ≥ 60 years, percentage of low-income patients, carbon emission intensity, percentage of savings and number of health technicians per 10,000 persons were negatively correlated with the percentage of patients whose visiting frequency ≥ 4 times within a year in most of counties of Fujian Province. In the sensitivity analysis, the percentage of outpatients whose visiting frequency ≥ 4 times within a year was higher than that of all patients. There was positive association between percentage of outpatients who aged ≥ 60 years and the percentage of outpatients whose visiting frequency ≥ 4 times.

Conclusions

The visiting rate and the visiting frequency within a year for rural patients with hypertension in Fujian province need to be improved. Female and elderly patients should be the focus of health management. Effectively implementing the family doctor services, providing several kinds of free antihypertensive drugs, improving energy utilization efficiency and reasonably allocating the health resources may be the effective strategies to improve the follow-up compliance of patients.
Health system barriers to the first dose of measles immunization in Ethiopia: a qualitative study
Authors: Addis Meron , Mekonnen Wubegzier , Estifanos Abiy Seifu
Published: March 2024

Background

Ethiopia has made considerable progress toward measles elimination. Despite ongoing efforts, the country remains among those with the highest number of children missing their initial dose of measles vaccine, and the disease continues to be a public health emergency. The barriers within the health system that hinder the first dose of measles immunization have not been thoroughly investigated. This study aims to identify these barriers within the Ethiopian context.

Methods

Qualitative research, using purposive expert sampling to select key informants from health organizations in Addis Ababa, Ethiopia was employed. We conducted in-depth face-to-face interviews using a semi-structured interview guide. A thematic analysis based on the World Health Organization’s health systems building blocks framework was conducted.

Results

The study uncovered substantial health system barriers to the uptake of the first dose of the measles vaccine in Ethiopia. These barriers include; restricted availability of immunization services, vaccine stockouts, shortage of cold chain technologies, data inaccuracy resulting from deliberate data falsification or accidental manipulation of data, as well as data incompleteness.

Conclusion

Our research highlighted significant health system barriers to MCV1 immunization, contributing to unmet EPI targets in Ethiopia. Our results suggest that to accelerate the country towards measles elimination, there is an urgent need to improve the health systems components such as service delivery, information systems, as well as access to vaccine and cold chain technologies.
Mortality from non-communicable diseases and associated risk factors in Zambia; analysis of the sample vital registration with verbal autopsy 2015/2016
Authors: Musonda Emmanuel , Mumba Peter , Malungo Jacob R.S.
Published: March 2024

Background

Non-communicable diseases (NCDs) are the world’s growing cause of preventable illness, disability, morbidity, and mortality which account for 71% of deaths. The aim of this study was to determine the factors associated with mortality from NCDs among persons aged 15 years and above in Zambia.

Methodology

The study used data from Sample Vital Registration with Verbal Autopsy (SAVVY) 2015/16 (Zambia). A total of 3529 Verbal Autopsy were completed in the study, with only 2599 of death where among people aged 15 years and above. Three-level data analysis was applied; univariate analysis, bivariate analysis, and multivariate analysis (binary logistic regression).

Findings

The overall number of deaths from NCDs was 28.81%. Stratified analysis by gender showed that deaths from NCDs were higher among women (32.60%) as compared to men (26.25%). Among all persons, dying from NCDs was associated with tobacco use, age, and education. Tobacco use was negatively associated with mortality from NCDs (adjusted odds ratio [aOR] = 0.68; 95% confidence interval [CI]: 0.48–0.98). Age was positively associated with the odds of dying from NCDs among persons aged 45–59 years (aOR = 3.87, 95% CI: 2.13–7.01), 60–74 years (aOR = 12.05, 95% CI: 6.44–22.55), and 75 + years (aOR = 15.16, 95% CI: 7.93–28.97). The likelihood of dying from NCDs was higher among persons with secondary education as compared to those with no education (aOR = 1.93, 95% CI: 1.11–3.33).

Conclusion

The findings from this study suggest that public health interventions targeting NCDs need to consider behavioural factors, especially tobacco use which exposes people to second-hand smoke. We also recommend large-scale national-level studies to further examine the contribution of each factor leading to mortality from NCDs.
Effects of triple therapy on disease burden in patients of GOLD groups C and D: results from the observational COPD cohort COSYCONET
Authors: Zader Jennifer A. , Jörres Rudolf A. , Mayer Imke , Alter Peter , Bals Robert , Watz Henrik , Mertsch Pontus , Rabe Klaus F. , Herth Felix , Trudzinski Franziska C. , Welte Tobias , Kauczor Hans-Ulrich , Behr Jürgen , Walter Julia , Vogelmeier Claus F. , Kahnert Kathrin
Published: March 2024

Background

Randomized controlled trials described beneficial effects of inhaled triple therapy (LABA/LAMA/ICS) in patients with chronic obstructive pulmonary disease (COPD) and high risk of exacerbations. We studied whether such effects were also detectable under continuous treatment in a retrospective observational setting.

Methods

Data from baseline and 18-month follow-up of the COPD cohort COSYCONET were used, including patients categorized as GOLD groups C/D at both visits (n = 258). Therapy groups were defined as triple therapy at both visits (triple always, TA) versus its complement (triple not always, TNA). Comparisons were performed via multiple regression analysis, propensity score matching and inverse probability weighting to adjust for differences between groups. For this purpose, variables were divided into predictors of therapy and outcomes.

Results

In total, 258 patients were eligible (TA: n = 162, TNA: n = 96). Without adjustments, TA patients showed significant (p < 0.05) impairments regarding lung function, quality of life and symptom burden. After adjustments, most differences in outcomes were no more significant. Total direct health care costs were reduced but still elevated, with inpatient costs much reduced, while costs of total and respiratory medication only slightly changed.

Conclusion

Without statistical adjustment, patients with triple therapy showed multiple impairments as well as elevated treatment costs. After adjusting for differences between treatment groups, differences were reduced. These findings are compatible with beneficial effects of triple therapy under continuous, long-term treatment, but also demonstrate the limitations encountered in the comparison of controlled intervention studies with observational studies in patients with severe COPD using different types of devices and compounds.
Coping strategies mediate the relationship between fear of cancer recurrence and quality of life in postoperative patients with prostate cancer: a multicentre survey
Authors: Yu Chen , Jingzhen Zhu , Luqiang Zhou , Xiaojuan Yuan , Ji Zheng
Published: March 2024

Purpose

The aim of the present study was to investigate the relationships between fear of cancer recurrence and quality of life in patients with prostate cancer. A model based on Lazarus’ and Folkman’s theory tested the specific hypothesis: fear of cancer recurrence has a direct and indirect effect on quality of life mediated by coping strategies.

Methods

A questionnaire survey was conducted on 305 patients with prostate cancer who underwent radical surgery, including demographic information, FoP-Q-SF (Fear of Progression Questionnaire), MCMQ (The Medical Coping Modes Questionnaire), QLQ-C30 (Questionnaire for Quality of Life Assessment in patients with cancer, version 3.0), and a mediator model was tested using the PROCESS macro for SPSS.

Results

The total FoP-Q-SF score of 305 postoperative prostate cancer patients was 34.3 ± 5.856, with approximately 41.6% of the patients scoring higher than 34. There were significant indirect effects of fear of cancer recurrence on global health status through face [a1b1; 0.0394, Boot CIs 0.0025, 0.0819] and yield [a3b3; -0.1075, Boots CIs − 0.1657, -0.0557] but not for evasive [a2b2; 0.0235; Boots CIs − 0.057, 0.0508].

Conclusions

Coping strategies are the most important mediating factors between fear of cancer recurrence and QOL among patients with prostate cancer. Our results support the proposed conceptual model, based on Lazarus’ and Folkman’s theory. Medical personnel need to develop corresponding intervention measures based on the different coping methods of patients, promote disease recovery, and improve postoperative quality of life.
The relationship between emotional intelligence, spiritual intelligence, and student achievement: a systematic review and meta-analysis
Authors: Zhou Zhenfei , Tavan Hamed , Kavarizadeh Forouzan , Sarokhani Mandana , Sayehmiri Kourosh
Published: March 2024

Introduction

Emotional and spiritual intelligence are crucial factors in enhancing individuals’ knowledge and academic achievement. This study aims to examine the correlation between spiritual intelligence, emotional intelligence, and student achievement through a systematic review and meta-analysis.

Materials and methods

A search was conducted in the PubMed, Scopus, Web of Science, SID, and Google Scholar databases from 2007 to December 2022. The effect sizes (EF) included the mean and standard deviation of emotional intelligence, spiritual intelligence, and student achievement and correlation coefficients among spiritual intelligence, emotional intelligence, and student achievement. Random effects models were used to pool the results, and the Q test and I2 index were employed to assess heterogeneity. Correlation coefficients were transformed into standard data (Z) using log transformation.

Results

The overall mean score of educational achievement in university and school students was 15.91 (95% CI: 15.26–16.78). The mean scores of spiritual and emotional intelligence were 138.27 (95% CI: 129.19-147.35) and 128.94 (95% CI: 117.08–140.80), respectively. The correlation coefficients between spiritual intelligence, emotional intelligence, and student achievement were r = 0.36 (95% CI: 0.18–0.51) and r = 0.50 (95% CI: 0.28–0.67), respectively.

Conclusions

Emotional and spiritual intelligence are independent predictive factors in educational achievement for university and school students. Therefore, improvements in emotional and spiritual intelligence can promote students’ academic achievement.
Poor personal protective equipment practices were associated with heat-related symptoms among Asian healthcare workers: a large-scale multi-national questionnaire survey
Authors: Yang Hsiao-Yu , Chou Hsiu-Ling , Leow Clarence Hong Wei , Kao Ching-Chiu , Daniel D. , Jaladara Vena , Khoe Levina Chandra , Latha P K , Mahendradhata Yodi , Nguyen Phuong Minh , Sirijatuphat Rujipas , Soemarko Dewi Sumaryani , Venugopal Vidhya , Zhang Kai , Lee Jason Kai Wei
Published: March 2024

Background

It is pertinent to understand the perceptions of healthcare workers (HCWs) with their associated personal protective equipment (PPE) usage and heat strain symptoms experienced to effectively combat the negative effects of heat stress during treatment and care activities.

Methods

We evaluated the associated heat stress perceived by HCWs across Asia and validated a questionnaire on perceptions of heat stress, associated PPE usage, and heat strain symptoms experienced. The questionnaire was administered to 3,082 HCWs in six Asian regions. Factor analyses, including Cronbach’s alpha, assessed the questionnaire’s validity and reliability. Structural equation modelling analysed the effects of knowledge, attitudes and practices, and heat strain symptoms.

Results

The questionnaire was found to be reliable in assessing HCWs’ knowledge, and attitudes and practices towards heat stress and PPE usage (both Cronbach’s alpha = 0.9), but not heat strain symptoms (Cronbach’s alpha = 0.6). Despite knowledge of heat stress, HCWs had negative attitudes and practices regarding PPE usage (β1 = 0.6, p < 0.001). Knowledge (path coefficient = 0.2, p < 0.001), and negative attitudes and practices (path coefficient = 0.2, p < 0.001) of HCWs towards heat stress and PPE usage adversely affected symptoms experienced.

Conclusions

The questionnaire was not reliable in assessing symptoms. HCWs should, nevertheless, still self-assess their symptoms for early detection of heat strain. To effectively attenuate heat strain, understanding HCWs’ attitudes and practices towards PPE usage should guide policymakers in implementing targeted heat management strategies.
Global migration and factors influencing retention of Asian internationally educated nurses: a systematic review
Authors: Ung Danny Shin Kai , Goh Yong Shian , Poon Ryan Yuan Sheng , Lin Yongxing Patrick , Seah Betsy , Lopez Violeta , Mikkonen Kristina , Yong Keng Kwang , Liaw Sok Ying
Published: March 2024

Background

Given nurses’ increasing international mobility, Asian internationally educated nurses (IENs) represent a critical human resource highly sought after within the global healthcare workforce. Developed countries have grown excessively reliant on them, leading to heightened competition among these countries. Hence, this review aims to uncover factors underlying the retention of Asian IENs in host countries to facilitate the development of more effective staff retention strategies.

Methods

A mixed-methods systematic review was conducted using the Joanna Briggs Institute methodology for mixed-method systematic review. A search was undertaken across the following electronic databases for studies published in English during 2013–2022: CINAHL, Embase, PubMed, Scopus, Web of Science and PsycINFO. Two of the researchers critically appraised included articles independently using the Joanna Briggs Critical Appraisal Tools and Mixed Methods Appraisal Tool (version 2018). A data-based convergent integrated approach was adopted for data synthesis.

Results

Of the 27 included articles (19 qualitative and eight quantitative), five each were conducted in Asia (Japan, Taiwan, Singapore and Malaysia), Australia and Europe (Italy, Norway and the United Kingdom); four each in the United States and the Middle East (Saudi Arabia and Kuwait); two in Canada; and one each in New Zealand and South Africa. Five themes emerged from the data synthesis: (1) desire for better career prospects, (2) occupational downward mobility, (3) inequality in career advancement, (4) acculturation and (5) support system.

Conclusion

This systematic review investigated the factors influencing AMN retention and identified several promising retention strategies: granting them permanent residency, ensuring transparency in credentialing assessment, providing equal opportunities for career advancement, instituting induction programmes for newly employed Asian IENs, enabling families to be with them and building workplace social support. Retention strategies that embrace the Asian IENs’ perspectives and experiences are envisioned to ensure a sustainable nursing workforce.
Inhibition of cc chemokine receptor 10 ameliorates osteoarthritis via inhibition of the phosphoinositide-3-kinase/Akt/mammalian target of rapamycin pathway
Authors: Luo Yan , Zhou Feng , Wang Xiaojing , Yang Runwei , Li Yi , Wu Xiaochun , Ye Bin
Published: March 2024

Background

Osteoarthritis (OA) is a joint disease characterized by inflammation and progressive cartilage degradation. Chondrocyte apoptosis is the most common pathological feature of OA. Interleukin-1β (IL-1β), a major inflammatory cytokine that promotes cartilage degradation in OA, often stimulates primary human chondrocytes in vitro to establish an in vitro OA model. Moreover, IL-1β is involved in OA pathogenesis by stimulating the phosphoinositide-3-kinase (PI3K)/Akt and mitogen-activated protein kinases pathways. The G-protein-coupled receptor, cc chemokine receptor 10 (CCR10), plays a vital role in the occurrence and development of various malignant tumors. However, the mechanism underlying the role of CCR10 in the pathogenesis of OA remains unclear. We aimed to evaluate the protective effect of CCR10 on IL-1β-stimulated CHON-001 cells and elucidate the underlying mechanism.

Methods

The CHON-001 cells were transfected with a control small interfering RNA (siRNA) or CCR10-siRNA for 24 h, and stimulated with 10 ng/mL IL-1β for 12 h to construct an OA model in vitro. The levels of CCR10, cleaved-caspase-3, MMP-3, MMP-13, Collagen II, Aggrecan, p-PI3K, PI3K, p-Akt, Akt, phosphorylated-mammalian target of rapamycin (p-mTOR), and mTOR were detected using quantitative reverse transcription polymerase chain reaction and western blotting. Viability, cytotoxicity, and apoptosis of CHON-001 cells were assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, lactate dehydrogenase assay (LDH), and flow cytometry analysis, respectively. Inflammatory cytokines (TNF-α, IL-6, and IL-8) were assessed using enzyme-linked immunosorbent assay.

Results

Level of CCR10 was substantially higher in the IL-1β-stimulated CHON-001 cells than that in the control group, whereas CCR10 was down-regulated in the CCR10-siRNA transfected CHON-001 cells compared to that in the control-siRNA group. Notably, CCR10 inhibition alleviated IL-1β-induced inflammatory injury in the CHON-001 cells, as verified by enhanced cell viability, inhibited LDH release, reduced apoptotic cells, and cleaved-caspase-3 expression. Meanwhile, IL-1β induced the release of tumor necrosis factor alpha, IL-6, and IL-8, increase of MMP-3 and MMP-13, and decrease of Collagen II and Aggrecan in the CHON-001 cells, which were reversed by CCR10-siRNA. However, these effects were reversed upon PI3K agonist 740Y-P treatment. Further, IL-1β-induced PI3K/Akt/mTOR signaling pathway activation was inhibited by CCR10-siRNA, which was increased by 740Y-P treatment.

Conclusion

Inhibition of CCR10 alleviates IL-1β-induced chondrocytes injury via PI3K/Akt/mTOR pathway inhibition, suggesting that CCR10 might be a promising target for novel OA therapeutic strategies.
Correlation of serum and local CXCL13 levels with disease severity in patients with non-traumatic osteonecrosis of femoral head
Authors: Zhao Yong-Heng , Zhu Wen-Xiu , Ye Qing-He , Zhang Peng , Wei Biao-Fang
Published: March 2024

Objective

The primary aim of the present study was to explore the potential correlation of serum / local CXCL13 expressions and disease severity in non-traumatic osteonecrosis of the femoral head (NT-ONFH).

Methods

In total, NT-ONFH patients (n = 130) together with healthy controls (HCs, n = 130) were included in this investigation. Radiographic progression was evaluated based on the imaging criteria outlined in the ARCO classification system. To assess the diagnostic value of serum CXCL13 in relation to radiographic progression, Receiver operating characteristic (ROC) curve analysis was conducted. Serum CXCL13 levels were quantified utilizing ELISA in all participants. Furthermore, local protein/mRNA expressions of CXCL13 were examined employing immunohistochemistry, western blot, as well as RT-PCR techniques. Clinical severity was appraised using the visual analogue scale (VAS), Harris Hip Score (HHS), and Western Ontario as well as McMaster Universities Osteoarthritis Index (WOMAC).

Results

The findings revealed a significant reduction in serum CXCL13 levels among NT-ONFH patients in contrast with HCs. Moreover, both mRNA and protein expressions of CXCL13 were markedly decreased in the necrotic area (NA) than the non-necrotic area (NNA) as well as the healthy femoral head tissues. Additionally, serum CXCL13 levels were substantially lower among patients classified as ARCO stage 4 than those at ARCO stage 3. The concentrations of CXCL13 in stage 3 patients were notably diminished relative to those at ARCO stage 2. Notably, serum CXCL13 levels demonstrated a negative association with ARCO grade. Furthermore, these levels were also inversely linked to VAS scores as well as WOMAC scores while displaying a positive association with HHS scores. The findings of ROC curve suggested that reduced serum CXCL13 levels could be an underlying indicator for ARCO stage.

Conclusions

The reduced levels of either serum CXCL13 or local CXCL13 were intricately linked to disease severity for patients with NT-ONFH.