bluuebunny/crossref_metadata_2025 huggingface dataset:
External dacryocystorhinostomy: A critical overview of the current evidence
Authors: Locatello Luca Giovanni , De Zan Enrico Redolfi , Tarantini Anna , Lanzetta Paolo , Miani Cesare
Published: May 2024

Purpose

External dacryocystorhinostomy (ext-DCR) is still considered the gold standard in the treatment of distal lacrimal duct obstruction. Despite an overall high success rate, some patients do relapse after surgery and the ideal perioperative management has not been identified yet. The purpose of this study is to critically discuss the published evidence in the last five years on the medical and surgical management of external dacryocystorhinostomy. Furthermore, the drawbacks of the available literature and the perspectives in this field will be also highlighted.

Methods

Systematic review of the literature in the last 5 years by using PubMed and Google Scholar.

Results

A total of 64 articles were included. Many technical modifications and surgical refinements have been proposed but a formal comparison among the various techniques is hampered by methodological heterogeneity. The use of local anesthesia, and the perioperative adjunctive techniques to reduce the risk of restenosis are also gaining popularity but the level of evidence remains weak.

Conclusion

Ext-DCR offers satisfactory clinical outcomes even though there are many gray areas that need to be addressed in future high-quality studies.
Effects of impact damages on the performance of offshore wind power coatings after accelerated ageing
Authors: Momber Andreas W , Marquardt Tom , Irmer Michael , Kelm Daniel
Published: May 2024

Damages to multilayer organic coating systems due to impact loads can deteriorate the corrosion protection performance of the coatings under offshore exposure. The contribution is concerned with statistical investigations into the effects of load-based and coating-based factors on the protection performance of impinged coating systems for offshore wind power structures. Accelerated cyclic laboratory tests were performed on damaged multilayer coating systems, and the results were statistically analysed. Results of analysis of variance revealed that the effects on the integral corrosion protection performance of the coatings (anticorrosive effect, AE) were dominated by the factor ‘load intensity’ (impact energy). This factor could explain 34% of all effects. It also was the only significant factor. The load-based factor ‘damage area’ affected the coating delamination and was extremely significant, but it did not affect the AE. Coating-based factors, namely ‘coating system’, ‘total dry film thickness’ and ‘pull-off strength’, did not deliver effects to AE and were statistically insignificant. The factor ‘coating system’ was statistically insignificant for delamination and for AE. ‘Unknown’ effects, not considered in this study, delivered the highest contributions to the regression models (50% to 68%), indicating that additional parameters/factors of the coating systems must be considered when developing impact-resistant coatings.
Corrosion behaviour of FeCoNiCrAl high-entropy alloy in molten NaCl–KCl–MgCl2 chloride salt
Authors: Lu Huayi , Li Sen , Wang Yanli
Published: May 2024

Molten NaCl–KCl–MgCl2 is becoming a potential heat transfer fluid (HTF) and thermal energy storage (TES) material in the third generation of concentrated solar energy power (CSP) stations due to its excellent heat storage-capacity and thermal stability. However, the strong corrosion of the molten chloride salt at high temperature limits its industrial application. In this study, the corrosion behaviour of FeCoNiCrAl HEA with BCC + FCC phase structure in molten NaCl–KCl–MgCl2 (24.5–20.55–54.95 wt-%) at 650 °C under argon was investigated by a combination of weight loss and electrochemical methods. The results show that, the corrosion of FeCoNiCrAl HEA in molten chloride salt mainly manifests as the selective dissolution of Fe and Cr. With the further increase of immersion time, oxides gradually crack and slightly flake, resulting in large weight loss of FeCoNiCrAl HEA.
Event-Related Potential Changes Following 12-week Yoga Practice in T2DM Patients: A Randomized Controlled Trial
Authors: Kanthi Amit , Deepeshwar Singh , Chidananda Kaligal , Vidyashree Mahadevappa , Krishna Dwivedi
Published: May 2024

Introduction. Type 2 diabetes patients are more likely to experience cognitive decline (1.5%) and dementia (1.6%) than healthy individuals. Although cognitive impairment adversely affects Type 2 diabetes mellitus (T2DM) patients, it is the least addressed complication of T2DM patients. Objective. The present study attempts to examine the changes in cognitive performance of T2DM patients and the probable factors contributing to the changes following 12-week yoga practice. Methods. The current study is a parallel group randomized controlled trial that compared the outcomes of the participants randomized to a yoga group (YG) ( n = 25) and to a wait-list control group ( n = 29). The study assessed N200 and N450 event-related potential (ERP) components following the Stroop task, heart rate variability (HRV) and HbA1c before and after the intervention. Results. The mean amplitude of the N200 ERP component showed a significant group difference after the intervention, demonstrating an improved neural efficiency in the process of conflict monitoring and response inhibition. No differences were present for the N450 component. T2DM patients showed reduced heart rate and increased mean RR following yoga practice without any corresponding changes in other HRV parameters, demonstrating an overall improvement in cardiac activity. Along with that yoga practice also reduced HbA1c levels in T2DM patients, indicating improved glycemic control. Moreover, HbA1c levels were negatively correlated with reaction time after the intervention, indicating an impact of glycemic control on cognitive performance. Conclusion. The 12-week yoga practice improved cognitive performance by enhancing the processes of conflict monitoring and response inhibition. Further, improved cognitive performance postintervention was facilitated by improved glycemic control.
Perceptions of mental health and psychosocial problems among conflict-affected adults in North Bougainville: Results of a rapid qualitative assessment
Authors: Fine Shoshanna L. , Augustinavicius Jura L. , Barnabas Essah , Poli Marilyn K. , Tierney David , Bolton Paul
Published: May 2024

The Bougainville Crisis (1988–1997) was characterized by widespread human rights violations, civilian deaths, and displacement. In March 2017, a rapid qualitative assessment was conducted to better understand the major mental health and psychosocial (MHPS) problems of conflict-affected adults living in North Bougainville in order to contribute to the design of feasible interventions to address these problems and inform the development of culturally appropriate assessment instruments. We conducted 54 free-list interviews to gather information on the problems of people in local communities, and further explored five priority MHPS problems through 38 key-informant interviews. The major MHPS problems that emerged and were subsequently explored included alcohol use, drug use, arguments and fights, physical violence against women, and rape. Frequently reported indicators of these problems included anger, aggression, sadness, shame, worry, trauma, neglect, and fear. Findings highlight the highly interconnected relationship between substance use and violence in North Bougainville, as well as the set of emotional and behavioral problems that both contribute to and result from this relationship. The primacy of both drug and alcohol use in this setting is particularly notable, as is the role of these substances as individual coping mechanisms and instigators of violence. Overall, findings suggest the need for integrated strategies toward addressing MHPS issues in North Bougainville, with violence and substance use incorporated as both causes and consequences of psychological distress.
Research Progress on the Homologous Effects of Cichorium glandulosum Boiss. et Huet on Medicine and Food: A Review
Authors: Yang Jian , Lei Yi , Yan Junlin , Zhong Yewei , Abudurexiti Adalaiti , Tan Huiwen , Ye Yinsong , Zhang Rui , Tong Fenglian , Ma Xiaoli
Published: May 2024

Cichorium glandulosum Boiss. et Huet is a genus of chicory in the family of Asteraceae, and it is a “medicine food homology” herbal medicine, which has the effect of detoxifying heat, diuretic and swelling, and strengthening the stomach. This paper reviews the chemical composition, pharmacological effects, and practical applications of Cichorium glandulosum Boiss. et Huet and provides a comprehensive account of its role in human health and diet, pharmacological activities, and toxicity. Cichorium glandulosum Boiss. et Huet, “medicine food homology” herbal medicine, is often widely used in compound formulations with functions such as clearing the liver, promoting gallbladder, and enhancing immunity. Previous studies have found that multiple chemical components have been isolated and identified from Cichorium glandulosum Boiss. et Huet, mainly including 89 compounds such as flavonoids, terpenoids, phenolic acids, polysaccharides, and phenylpropanoids. Meanwhile, the extract has various biological activities, including hepatoprotective and hypoglycemic, regulating blood lipids, aiding digestion, anticancer, regulating intestinal microbiota and immune function, antioxidant, and has been proven in both in vivo and in vitro studies. As an important plant resource, the current research focuses on the traditional efficacy of Cichorium glandulosum Boiss. et Huet. The chemical composition of this genus of plants is complex and their pharmacological activities are diverse. Further in-depth studies on the molecular mechanisms and toxic side effects of its specific compounds in the organism are needed. Therefore, this review provides a reference for the development and utilization of Cichorium glandulosum Boiss. et Huet.
Shapes and frictions of synthetic data
Authors: Offenhuber Dietmar
Published: May 2024

Synthetic data are computer-generated data that mimic and substitute empirical observations without directly corresponding to real-world phenomena. Widely used in privacy protection, machine learning, and simulation, synthetic data is an emerging field only just beginning to be explored in the social sciences and critical data studies. However, recent developments, such as the use of synthetic data in the US Census and American Community Survey, make a reflection on the nature and implications of synthetic data urgent. While earlier work focused mostly on training data for machine-learning models, this paper presents a broad typology of synthetic data and discusses its frictions. The main argument presented is that the traditional representational model of data as symbolic references to corresponding physical or conceptual objects is insufficient for understanding and critically engaging with issues and implications of synthetic data. The paper discusses an alternative relational model, which defines data not through an object of reference but based on “who uses them, how and for which purposes”. The relational model is more productive for capturing the fact that synthetic data are defined through their purpose; their performance in a particular situation (such as training a machine learning model); and a context-dependent operationalization of evidence. The post-representational anything-goes epistemology of synthetic data can be productively challenged through a forensic approach that foregrounds the outliers, artifacts, and gaps in datasets as meaningful information.
Rapid review on the incentives of digital health apps for physicians and psychotherapists: A German perspective
Authors: Kreuzenbeck Cordula C. J. , Schneider Brit S. , Brenner Sophie X. , Koerber Florian
Published: May 2024

Objective

The Digital Healthcare Act introduced the prescription of digital health applications under specific circumstances in 2019 in Germany. They are funded through the social security system. In market access of prescribed digital health applications, Germany is pioneering the market. There remains a gap in understanding the views of medical professionals on the incentives of using these applications. As prescription of digital health applications starts emerging in other European countries, we sought to generate an overview of incentives and barriers that affect the caregivers in their decision of promoting and prescribing them in Germany.

Methods

A Rapid Review of the Web of Science database for the years 2017–2023 was performed using sensitive search strings. Two reviewers conducted a three-phase selection via title, abstract and full-text independently from each other. The quality of studies was assessed systematically by both reviewers. Both quantitative and qualitative studies with primary data were included, and study quality was assessed using a standardised form.

Results

Out of 1643 initial results, 12 studies with information from 9302 physicians and psychotherapists were identified. Eight quantitative and four qualitative studies were included in the analysis. Key findings suggest that while between 40% and 60% of caregivers see relevant incentives mainly based on patients’ benefits, 20–40% see relevant barriers. For the physicians’ daily work, there were slightly more barriers than incentives identified in the quantitative synthesis. The qualitative studies revealed no relevant incentives that were not attributed to patients.

Conclusion

While digital health solutions offer promising avenues for enhancing patient care, their acceptance among healthcare professionals hinges on addressing prevailing concerns. Continuous research and dialogues with the medical community are pivotal to harness the full potential of digital health applications in healthcare.
Patient perspectives on informed consent for medical AI: A web-based experiment
Authors: Park Hai Jin
Published: May 2024

Objective

Despite the increasing use of AI applications as a clinical decision support tool in healthcare, patients are often unaware of their use in the physician's decision-making process. This study aims to determine whether doctors should disclose the use of AI tools in diagnosis and what kind of information should be provided.

Methods

A survey experiment with 1000 respondents in South Korea was conducted to estimate the patients’ perceived importance of information regarding the use of an AI tool in diagnosis in deciding whether to receive the treatment.

Results

The study found that the use of an AI tool increases the perceived importance of information related to its use, compared with when a physician consults with a human radiologist. Information regarding the AI tool when AI is used was perceived by participants either as more important than or similar to the regularly disclosed information regarding short-term effects when AI is not used. Further analysis revealed that gender, age, and income have a statistically significant effect on the perceived importance of every piece of AI information.

Conclusions

This study supports the disclosure of AI use in diagnosis during the informed consent process. However, the disclosure should be tailored to the individual patient's needs, as patient preferences for information regarding AI use vary across gender, age and income levels. It is recommended that ethical guidelines be developed for informed consent when using AI in diagnoses that go beyond mere legal requirements.
Acceptability, usability, and credibility of a mindfulness-based digital therapeutic for pediatric concussion: A mixed-method study
Authors: Sicard Veronik , O’Kane Kiarah , Brown Olivier , Butterfield Lauren , Kardish Rachel , Choi Esther , Healey Katherine , Silverberg Noah , Smith Andra M , Goldfield Gary , Saab Bechara J , Gray Clare , Goulet Kristian , Anderson Peter , Mackie Craig , Roth Sonja , Osmond Martin , Zemek Roger , Cairncross Molly , Ledoux Andrée-Anne
Published: May 2024

Background

The ability to cope with concussion symptoms and manage stress is an important determinant of risk for prolonged symptoms.

Objective

This open-label mixed-methods pilot study assessed the acceptability and credibility of a mindfulness-based intervention delivered through a digital therapeutic (DTx; therapeutic smartphone app) for pediatric concussion.

Methods

Participants aged 12 to 18 years were recruited from an emergency department within 48 hours of a concussion (acute cohort) or from a tertiary care clinic at least 1-month post-concussion (persisting symptoms cohort). Participants completed a novel 4-week mindfulness-based intervention, for 10 to 15 minutes/day, at a minimum of 4 days/week. At 2 weeks, participants completed a credibility and expectancy questionnaire. At 4 weeks, participants completed questionnaires assessing satisfaction, usability and working alliance, as well as a semi-structured phone interview.

Results

Ten participants completed the study outcomes (7 acute; 3 persisting symptoms). The intervention was perceived as credible (median/max possible = 6.50/9.00 [6.83,8.75]) and DTx was usable (median/max possible = 70.00/100.00 [55.00,82.50]). Participants rated their satisfaction with the DTx (median/max possible = 27.00/32.00 [24.50,29.50]) and the working alliance with the digital mindfulness guides (median/max possible = 3.92/5.00 [3.38–4.33]) as high. Four themes were identified from the qualitative data: (a) positive attributes; (b) negative attributes; (c) ideas for modifications; and (d) technical issues.

Conclusion

Results show modifications to the DTx, instructions and mindfulness intervention, and potential ways to increase adherence by leveraging positive attributes. A randomized control trial will assess the effectiveness of the DTx MBI to decrease the risk of persisting symptoms and reduce the symptom burden following pediatric concussion.
Willingness to pay for health apps, its sociodemographic correlates, and reasons for being unwilling to pay
Authors: Liu Hao , Xie Zhenzhen , Or Calvin
Published: May 2024

Background

Knowledge about whether, how much, and why individuals are willing to pay for health apps is limited.

Objectives

This study aimed to examine (1) the proportion of individuals willing to pay for health apps, (2) their willingness to pay (WTP; i.e. the maximum price the individual is willing to pay) for health apps, (3) the sociodemographic correlates determining whether individuals are willing to pay for these apps, (4) the sociodemographic correlates of their WTP, and (5) reasons for being unwilling to pay.

Methods

Six hundred adults were invited to participate in a questionnaire survey examining their sociodemographic characteristics, WTP for health apps, and reasons for being unwilling to pay. Sociodemographic characteristics and WTP for health apps were analyzed using descriptive statistics. Logistic regression was applied to examine the sociodemographic variables correlated with whether individuals were willing to pay for health apps. Among those who were willing to pay, log-linear regression was conducted to examine the sociodemographic correlates of their WTP. The reasons for unwillingness to pay were descriptively analyzed.

Results

A total of 577 individuals completed the questionnaire. Of them, 58.9% were willing to pay for health apps. Their median WTP was HK$50 (HK$1 ≈ US$0.13). Participants with a bachelor's degree or higher and those who had previously installed health apps were more inclined to pay for health apps. WTP was positively associated with the maximum price previously paid for a health app. The most frequently cited reasons for being unwilling to pay were the belief that the government should provide free health apps, distrust in health apps, and a lack of awareness of health apps and their benefits.

Conclusions

This study provides insights that can inform strategies to enhance the marketability, affordability, and accessibility of health apps.
Scale Development and Validation for Green Supply Chain Practices Impact on the Organized Retail Performance Evaluation in India: The ORGRSCALE
Authors: L Shah Amitkumar , Parmar Hitesh
Published: May 2024

Green supply systems are helping several of the world's largest retailers boost profits. Green practices make firms more ecologically friendly. No research has considered all of the green supply chain management (GSCM) methods needed to develop a green supply chain in India's retail business. This investigation seeks to examine GSCM techniques and their effects on Indian organized retail. The ORGSCALE helps define GSCM in organized retail. The study generated items through literature reading and focus group talks. A total of 554 responses out of 1,800 survey responses were usable. The study indicated that GSCM methods affect organizational performance and environmental, economic and profitability. In Indian organized retail businesses, there is a lack of research on a reliable and valid scale to measure the performance impact of GSCM strategies. This study provides a measure to assess how GSCM practices affect Indian organized retail performance.
Molecular, clinical, and therapeutic determinants of outcome in NPM1-mutated AML
Authors: Othman Jad , Potter Nicola , Ivey Adam , Tazi Yanis , Papaemmanuil Elli , Jovanovic Jelena , Freeman Sylvie D. , Gilkes Amanda , Gale Rosemary , Rapoz-D’Silva Tanya , Runglall Manohursingh , Kleeman Michelle , Dhami Pawan , Thomas Ian , Johnson Sean , Canham Joanna , Cavenagh Jamie , Kottaridis Panagiotis , Arnold Claire , Ommen Hans Beier , Overgaard Ulrik Malthe , Dennis Mike , Burnett Alan , Wilhelm-Benartzi Charlotte , Huntly Brian , Russell Nigel H. , Dillon Richard
Published: May 2024

Although NPM1-mutated acute myeloid leukemia (AML) carries a generally favorable prognosis, many patients still relapse and die. Previous studies identified several molecular and clinical features associated with poor outcomes; however, only FLT3-internal tandem duplication (ITD) mutation and adverse karyotype are currently used for risk stratification because of inconsistent results and uncertainty about how other factors should influence treatment, particularly given the strong prognostic effect of postinduction measurable residual disease (MRD). Here, we analyzed a large group of patients with NPM1 mutations (NPM1mut) AML enrolled in prospective trials (National Cancer Research Institute [NCRI] AML17 and AML19, n = 1357) to delineate the impact of baseline molecular and clinical features, postinduction MRD status, and treatment intensity on the outcome. FLT3-ITD (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.01-1.63), DNMT3A (HR, 1.65; 95% CI, 1.32-2.05), WT1 (HR, 1.74; 95% CI, 1.27-2.38), and non-ABD NPM1mut (HR, 1.64; 95% CI, 1.22-2.21) were independently associated with poorer overall survival (OS). These factors were also strongly associated with MRD positivity. For patients who achieved MRD negativity, these mutations (except FLT3-ITD) were associated with an increased cumulative incidence of relapse (CIR) and poorer OS. However, apart from the few patients with adverse cytogenetics, we could not identify any group of MRD-negative patients with a CIR >40% or with benefit from allograft in first remission. Intensified chemotherapy with the FLAG-Ida (fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin) regimen was associated with improved outcomes in all subgroups, with greater benefits observed in the high-risk molecular subgroups.
Viscoelastic modelling and analysis of two-dimensional woven CNT-based multiscale fibre reinforced composite material system
Authors: Swain Ashirbad , Palani Vignesh , Francis Sigil , Thomas Benedict , Roy Tarapada
Published: May 2024

Carbon nanotube (CNT) has fostered research as a promising nanomaterial for a variety of applications due to its exceptional mechanical, optical, and electrical characteristics. The present article proposes a novel and comprehensive micromechanical framework to assess the viscoelastic properties of a multiscale CNT-reinforced two-dimensional (2D) woven hybrid composite. It also focuses on demonstrating the utilisation of the proposed micromechanics in the dynamic analysis of shell structure. First, the detailed constructional attributes of the proposed trans-scale composite material system are described in detail. Then, according to the nature of the constructional feature, mathematical modelling of each constituent phase or building block’s material properties is established to evaluate the homogenised viscoelastic properties of the proposed composite material system. To highlight the novelty of this study, the viscoelastic characteristics of the modified matrix are developed using the micromechanics method of Mori–Tanaka (MT) in combination with the weak viscoelastic interphase (WI) theory. In the entire micromechanical framework, the CNTs are considered to be randomly oriented. The strength of the material (SOM) approach is used to establish mathematical frameworks for the viscoelastic characteristics of yarns, whereas the unit cell method (UCM) is used to determine the viscoelastic properties of the representative unit cell (RUC). Different numerical results have been obtained by varying the CNT composition, interface conditions, agglomeration, carbon fibre volume percentage, excitation frequency, and temperature. The influences of geometrical parameters like yarn thickness, width, and the gap length to yarn width ratio on the viscoelasticity of such composite material systems are also explored. The current study also addresses the issue of resultant anisotropic viscoelastic properties due to the use of dissimilar yarn thickness. The results of this micromechanical analysis provide valuable insights into the viscoelastic properties of the proposed composite material system and suggest its potential applications in vibration damping. To demonstrate the application of developed novel micromechanics in vibration analysis, as one of the main contributions, comprehensive numerical experiments are conducted on a shell panel. The results show a significant reduction in vibration amplitudes compared to traditional composite materials in the frequency response and transient response analyses. To focus on the aspect of micromechanical behaviour on dynamic response and for the purpose of brevity, only linear strain displacement relationships are considered for dynamic analysis. These insights could inform future research and development in the field of composite materials.
DengueSeq: a pan-serotype whole genome amplicon sequencing protocol for dengue virus
Authors: Vogels Chantal B. F. , Hill Verity , Breban Mallery I. , Chaguza Chrispin , Paul Lauren M. , Sodeinde Afeez , Taylor-Salmon Emma , Ott Isabel M. , Petrone Mary E. , Dijk Dennis , Jonges Marcel , Welkers Matthijs R. A. , Locksmith Timothy , Dong Yibo , Tarigopula Namratha , Tekin Omer , Schmedes Sarah , Bunch Sylvia , Cano Natalia , Jaber Rayah , Panzera Charles , Stryker Ian , Vergara Julieta , Zimler Rebecca , Kopp Edgar , Heberlein Lea , Herzog Kaylee S. , Fauver Joseph R. , Morrison Andrea M. , Michael Scott F. , Grubaugh Nathan D.
Published: May 2024

Background

The increasing burden of dengue virus on public health due to more explosive and frequent outbreaks highlights the need for improved surveillance and control. Genomic surveillance of dengue virus not only provides important insights into the emergence and spread of genetically diverse serotypes and genotypes, but it is also critical to monitor the effectiveness of newly implemented control strategies. Here, we present DengueSeq, an amplicon sequencing protocol, which enables whole-genome sequencing of all four dengue virus serotypes.

Results

We developed primer schemes for the four dengue virus serotypes, which can be combined into a pan-serotype approach. We validated both approaches using genetically diverse virus stocks and clinical specimens that contained a range of virus copies. High genome coverage (>95%) was achieved for all genotypes, except DENV2 (genotype VI) and DENV 4 (genotype IV) sylvatics, with similar performance of the serotype-specific and pan-serotype approaches. The limit of detection to reach 70% coverage was 10-100 RNA copies/μL for all four serotypes, which is similar to other commonly used primer schemes. DengueSeq facilitates the sequencing of samples without known serotypes, allows the detection of multiple serotypes in the same sample, and can be used with a variety of library prep kits and sequencing instruments.

Conclusions

DengueSeq was systematically evaluated with virus stocks and clinical specimens spanning the genetic diversity within each of the four dengue virus serotypes. The primer schemes can be plugged into existing amplicon sequencing workflows to facilitate the global need for expanded dengue virus genomic surveillance.
Investigating factors associated to HBV/HIV co-infected patients in antiretroviral treatment clinic, in Northeast Ethiopia
Authors: Wasihun Yitbarek , Asnake Desalegn , Kebede Natnael
Published: May 2024

Background

Existing research in Ethiopia has primarily focused on the individual epidemiology of HIV and HBV, often overlooking the intricate dynamics of co-infection. This study aims to address this gap by comprehensively exploring the prevalence of HBV and HIV co-infection and the associated factors influencing co-infection rates within the specific context of ART clinics. The existing study provides limited insights into the unique challenges posed by this dual infection in the Ethiopian population receiving ART.

Methods

An institutional-based cross-sectional study was conducted among people living with HIV aged 18 years and above attending ART clinics in northeast Ethiopia from April to May 2022. A sample size of 350(97% response rate) participants was selected by using a systematic random sampling method. Data were collected using a pre-tested interviewer-administered structured questionnaire. Data was entered into Epi Data version software and was exported to SPSS version 25 for further analysis. Descriptive statistics using Frequency, proportion, and summary measures were done. Binary logistic regressions were done to identify independent variables associated with HBV infection among HIV patients. A P-value less than 0.05 and adjusted odds ratio with a 95% confidence interval non-inclusive of one was considered statistically significant.

Results

The prevalence of Hepatitis B Surface Antigen (HBsAg) was identified constituting 7.14% of the study population. Females [AOR] 0.14; 95% Confidence Interval [CI] [0.041–0.478]). Participants with an educational status of only reading and writing (AOR 8.7; 95% CI [1.143–66.5]). Single individuals (AOR 2.04; 95% CI [1.346–28.6]) were associated factors. Moreover, participants with a viral load exceeding 1000 copies/ml were 6.5 times more likely to be infected with HBV compared to those with undetectable viral loads (AOR 6.53, 95% CI [1.87–22.72]). Additionally, individuals with a CD4 count ranging from 351 to 500 cells/ml were 1.2 times more likely to be infected with HBV compared to those with a CD4 count of 500 cells/ml or above (AOR 10.4, 95% CI [1.28-85]).

Conclusion

The prevalence of HBV infection was found to be intermediate in HIV-infected patients in the study area. Being male, marital status of single and divorced, educational level was only read and written, current viral load of > 1000 copies/ml &<1000 copies/ml, and current CD4 < 250 cells/ml were found statistically associated factors for HBV infection. Thus, we recommend the provision of routine screening for HBsAg and appropriate treatment with accurate information on risk factors for HBV to improve quality of life and reduce morbidity.
Study protocol of the GRoningen early-PD Ambroxol treatment (GREAT) trial: a randomized, double-blind, placebo-controlled, single center trial with ambroxol in Parkinson patients with a GBA mutation
Authors: Siemeling O. , Slingerland S. , van der Zee S. , van Laar T.
Published: May 2024

Background

To date, no disease modifying therapies are available for Parkinson’s disease (PD). Since PD is the second most prevalent neurodegenerative disorder, there is a high demand for such therapies. Both environmental and genetic risk factors play an important role in the etiology and progression of PD. The most common genetic risk factor for PD is a mutation in the GBA1(GBA)-gene, encoding the lysosomal enzyme glucocerebrosidase (GCase). The mucolytic ambroxol is a repurposed drug, which has shown the property to upregulate GCase activity in-vitro and in-vivo. Ambroxol therefore has the potency to become a disease modifying therapy in PD, which was the reason to design this randomized controlled trial with ambroxol in PD patients.

Methods

This trial is a single-center, double-blind, randomized, placebo-controlled study, including 80 PD patients with a GBA mutation, receiving either ambroxol 1800 mg/day or placebo for 48 weeks. The primary outcome measure is the Unified Parkinson’s Disease Rating Scale motor subscore (part III) of the Movement Disorder Society (MDS-UPDRSIII) in the practically defined off-state at 60 weeks (after a 12-week washout period). Secondary outcomes include a 3,4-dihydroxy-6-18F-fluoro-I-phenylalanine ([18F]FDOPA) PET-scan of the brain, Magnetic Resonance Imaging (with resting state f-MRI and Diffusion Tensor Imaging), GCase activity, both intra- and extracellularly, sphingolipid profiles in plasma, Montreal Cognitive Assessment (MoCA), quality of life (QoL) measured by the Parkinson’s Disease Questionnaire (PDQ-39) and the Non-Motor Symptom Scale (NMSS) questionnaire.

Discussion

Ambroxol up to 1200 mg/day has shown effects on human cerebrospinal fluid endpoints, which supports at least passage of the blood-brain-barrier. The dose titration in this trial up to 1800 mg/day will reveal if this dose level is safe and also effective in modifying the course of the disease.

Trial registration

NCT05830396. Registration date: March 20, 2023.
Community screening for dementia among older adults in China: a machine learning-based strategy
Authors: Zhang Yan , Xu Jian , Zhang Chi , Zhang Xu , Yuan Xueli , Ni Wenqing , Zhang Hongmin , Zheng Yijin , Zhao Zhiguang
Published: May 2024

Background

Dementia is a leading cause of disability in people older than 65 years worldwide. However, diagnosing dementia in its earliest symptomatic stages remains challenging. This study combined specific questions from the AD8 scale with comprehensive health-related characteristics, and used machine learning (ML) to construct diagnostic models of cognitive impairment (CI).

Methods

The study was based on the Shenzhen Healthy Ageing Research (SHARE) project, and we recruited 823 participants aged 65 years and older, who completed a comprehensive health assessment and cognitive function assessments. Permutation importance was used to select features. Five ML models using BalanceCascade were applied to predict CI: a support vector machine (SVM), multilayer perceptron (MLP), AdaBoost, gradient boosting decision tree (GBDT), and logistic regression (LR). An AD8 score ≥ 2 was used to define CI as a baseline. SHapley Additive exPlanations (SHAP) values were used to interpret the results of ML models.

Results

The first and sixth items of AD8, platelets, waist circumference, body mass index, carcinoembryonic antigens, age, serum uric acid, white blood cells, abnormal electrocardiogram, heart rate, and sex were selected as predictive features. Compared to the baseline (AUC = 0.65), the MLP showed the highest performance (AUC: 0.83 ± 0.04), followed by AdaBoost (AUC: 0.80 ± 0.04), SVM (AUC: 0.78 ± 0.04), GBDT (0.76 ± 0.04). Furthermore, the accuracy, sensitivity and specificity of four ML models were higher than the baseline. SHAP summary plots based on MLP showed the most influential feature on model decision for positive CI prediction was female sex, followed by older age and lower waist circumference.

Conclusions

The diagnostic models of CI applying ML, especially the MLP, were substantially more effective than the traditional AD8 scale with a score of ≥ 2 points. Our findings may provide new ideas for community dementia screening and to promote such screening while minimizing medical and health resources.
School-aged children’s movement behaviours and subjective health complaints in Japan: a cross-sectional study during COVID-19 pandemic-related school closures and after school reopenings
Authors: Kasai Akane , Shikano Akiko , Tanaka Ryo , Yoshinaga Mari , Noi Shingo
Published: May 2024

Background

Social restrictions associated with the COVID-19 pandemic have altered children’s movement behaviours and impacted their mental health. However, the influence of social restrictions on subjective health complaints remains inadequately understood. This study compared adherence to 24-hour movement behaviour guidelines and the prevalence of subjective health complaints during school closure and one year after reopening. We also examined how combinations of adherence to movement behaviour recommendations relate to subjective health complaints.

Methods

A repeated cross-sectional survey was conducted at two points. The first survey in May 2020 included 1535 (766 boys and 769 girls) participants during school closures, while the second survey from May to July 2021 involved 1125 (583 boys and 542 girls) participants one year after school reopening. The questionnaire covered socio-demographics, physical activity, screen time, sleep, and subjective health complaints. Differences between periods were analysed using chi-square tests. Logistic regression models assessed the association between adherence to guidelines and subjective health complaints.

Results

During school closure, children were more likely to meet ‘only sleep’ recommendations and have irritability and lethargy symptoms. Irrespective of sex, those adhering to two or all three recommendations (excluding physical activity and screen time) had a lower risk of symptoms related to physical and mental pain, fatigue, irritability, and lethargy as compared to those who met none of the recommendations.

Conclusions

Children should meet at least one physical activity or screen time recommendation in addition to sleep recommendations for subjective health. Strategies considering the priority of each movement behaviour are crucial, even during abnormal situations, such as pandemic-related social restrictions. This study offers insightful findings concerning children’s mental health issues during unprecedented and massive disasters or crises.
Self-reported competence among advanced practice nursing students in Denmark, Finland and Norway: a cross-sectional multicentre study
Authors: Martinsen Randi , Ahlin-Søvde Sigrid , Grov Ellen Karine , Andersson Ewa K. , Gardulf Ann
Published: May 2024

Background

The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice nursing, is of great importance to ensure effective, safe and high-quality care.

Aim

The aim of this study was to investigate self-reported competence using the Nurse Professional Competence Scale Short-Form for the first time among master’s students of advanced practice nursing in the Nordic countries and to relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursing experience.

Methods

A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark, Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas was used with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 for analysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparative statistics were used to analyse the data.

Results

The highest mean score was found for the competence area ‘Value-based nursing care’. Students living with home-dwelling children (≤ 18 years) reported significantly higher competence in ‘Nursing care’, while students ≥33 years reported significantly higher competence in ‘Nursing care’ and ‘Value-based nursing care’. No significant differences were found between students working and those not working alongside their studies, between students with and without further nursing-related education, or between students with long and short experience as nurses.

Conclusions

The findings from this study might help to further develop curricula in advanced practice nursing master’s programmes to ensure high-quality nursing and sustainable health care in the future. Future high-quality master’s programmes might benefit from systematic collaboration between Nordic higher education institutions as also Sweden is planning master’s programme. Higher age, having children at home and working while studying should not be considered causes for concern.
Enablers and barriers to primary health care access for Indigenous adolescents: a systematic review and meta-aggregation of studies across Australia, Canada, New Zealand, and USA
Authors: Harfield Stephen , Purcell Tara , Schioldann Eliza , Ward James , Pearson Odette , Azzopardi Peter
Published: May 2024

Background

Indigenous adolescents access primary health care services at lower rates, despite their greater health needs and experience of disadvantage. This systematic review identifies the enablers and barriers to primary health care access for Indigenous adolescents to inform service and policy improvements.

Methods

We systematically searched databases for publications reporting enablers or barriers to primary health care access for Indigenous adolescents from the perspective of adolescents, their parents and health care providers, and included studies focused on Indigenous adolescents aged 10–24 years from Australia, Canada, New Zealand, and United States of America. Results were analyzed against the WHO Global standards for quality health-care services for adolescents. An additional ninth standard was added which focused on cultural safety.

Results

A total of 41 studies were included. More barriers were identified than enablers, and against the WHO Global standards most enablers and barriers related to supply factors – providers’ competencies, appropriate package of services, and cultural safety. Providers who built trust, respect, and relationships; appropriate package of service; and culturally safe environments and care were enablers to care reported by adolescents, and health care providers and parents. Embarrassment, shame, or fear; a lack of culturally appropriate services; and privacy and confidentiality were common barriers identified by both adolescent and health care providers and parents. Cultural safety was identified as a key issue among Indigenous adolescents. Enablers and barriers related to cultural safety included culturally appropriate services, culturally safe environment and care, traditional and cultural practices, cultural protocols, Indigenous health care providers, cultural training for health care providers, and colonization, intergenerational trauma, and racism. Nine recommendations were identified which aim to address the enablers and barriers associated with primary health care access for Indigenous adolescents.

Conclusion

This review provides important evidence to inform how services, organizations and governments can create accessible primary health care services that specifically meet the needs of Indigenous adolescents. We identify nine recommendations for improving the accessibility of primary health care services for Indigenous adolescents.
Improving routine use of clinical pathway decision support through integration of an EHR with a clinical library resource designed to provide evidence-based guidance within oncology workflows
Authors: Ichiuji Mary , Asakura Laura , Cain Carol , Aye Nancy , Kolevska Tatjana , Chen David , Brasfield Farah Mohebpour , Kotak Dinesh
Published: May 2024

Background

The rapid evolution, complexity, and specialization of oncology treatment makes it challenging for physicians to provide care based on the latest and best evidence. We hypothesized that physicians would use evidence-based trusted care pathways if they were easy to use and integrated into clinical workflow at the point of care.

Methods

Within a large integrated care delivery system, we assembled clinical experts to define and update drug treatment pathways, encoded them as flowcharts in an online library integrated with the electronic medical record, communicated expectations that clinicians would use these pathways for every eligible patient, and combined data from multiple sources to understand usage over time.

Results

We were able to achieve > 75% utilization of eligible protocols ordered through these pathways within two years, with > 90% of individual oncologists having consulted the pathway at least once, despite no requirements or external incentives associated with pathway usage. Feedback from users contributed to improvements and updates to the guidance.

Conclusions

By making our clinical decision support easily accessible and actionable, we find that we have made considerable progress toward our goal of having physicians consult the latest evidence in their treatment decisions.
Plasmodium falciparum alters the trophoblastic barrier and stroma villi organization of human placental villi explants
Authors: López-Guzmán Carolina , García Ana María , Ramirez Juan Diego , Aliaga Trinidad Torres , Fernández-Moya Alejandro , Kemmerling Ulrike , Vásquez Ana María
Published: May 2024

Background

The sequestration of Plasmodium falciparum infected erythrocytes in the placenta, and the resulting inflammatory response affects maternal and child health. Despite existing information, little is known about the direct impact of P. falciparum on the placental barrier formed by trophoblast and villous stroma. This study aimed to assess placental tissue damage caused by P. falciparum in human placental explants (HPEs).

Methods

HPEs from chorionic villi obtained of human term placentas (n = 9) from normal pregnancies were exposed to P. falciparum-infected erythrocytes (IE) for 24 h. HPEs were embedded in paraffin blocks and used to study tissue damage through histopathological and histochemical analysis and apoptosis using TUNEL staining. Culture supernatants were collected to measure cytokine and angiogenic factors and to determine LDH activity as a marker of cytotoxicity. A subset of archived human term placenta paraffin-embedded blocks from pregnant women with malaria were used to confirm ex vivo findings.

Results

Plasmodium falciparum-IE significantly damages the trophoblast layer and the villous stroma of the chorionic villi. The increased LDH activity and pathological findings such as syncytial knots, fibrin deposits, infarction, trophoblast detachment, and collagen disorganization supported these findings. The specific damage to the trophoblast and the thickening of the subjacent basal lamina were more pronounced in the ex vivo infection. In contrast, apoptosis was higher in the in vivo infection. This disparity could be attributed to the duration of exposure to the infection, which significantly varied between individuals naturally exposed over time and the 24-h exposure in the ex vivo HPE model.

Conclusion

Exposure to P. falciparum-IE induces a detachment of the syncytiotrophoblast, disorganization of the stroma villi, and an increase in apoptosis, alterations that may be associated with adverse results such as intrauterine growth restriction and low birth weight.