bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrating patient- and caregiver-reported outcome measures into the daily care routines of specialised outpatient palliative care: a qualitative study (ELSAH) on feasibility, acceptability and appropriateness
Authors: Seipp Hannah , Haasenritter Jörg , Hach Michaela , Becker Dorothée , Schütze Dania , Engler Jennifer , Ploeger Cornelia , Bösner Stefan , Kuss Katrin
Published: May 2022

Background

The use of patient-reported outcome measures (PROM) and caregiver-reported outcome measures can raise the patient centeredness of treatment and improve the quality of palliative care. Nevertheless, the everyday implementation of self-report in patients and caregivers is complex, and should be adapted for use in specific settings. We aimed to implement a set of outcome measures that included patient and caregiver self- and proxy-reported outcome measures in specialised outpatient palliative care (SOPC). In this study, we explore how the Integrated Palliative Outcome Scale (IPOS), IPOS Views on Care (IPOS VoC) and the Short-form Zarit Caregiver Burden Interview (ZBI-7) can be feasibly, acceptably and appropriately implemented in the daily care routines of SOPC.

Methods

Five SOPC teams were trained, and used the outcome measures in daily practice. Team members were mainly nurses and physicians. To investigate their feedback, we used a multi-method qualitative design consisting of focus groups with SOPC-team members (n = 14), field notes of meetings and conversations with the SOPC teams. In an iterative process, we analysed the findings using qualitative content analysis and refined use of the outcome measures.

Results

We found that integrating patient and caregiver outcome measures into daily care routines in SOPC is feasible. To improve feasibility, acceptability and appropriateness, the resulting burden on patients and relatives should be kept to a minimum, the usefulness of the measures must be understood, they should be used considerately, and administration must be manageable. We removed ZBI-7 from the set of measures as a result of feedback on its content and wording.

Conclusions

SOPC-team members have reservations about the implementation of PROM in SOPC, but with appropriate adjustments, its application in daily care is feasible, accepted and perceived as appropriate. Previous to use, SOPC-team members should be trained in how to apply the measures, in the design of manageable processes that include integration into electronic documentation systems, and in ongoing evaluation and support. They should also be taught how useful the measures can be.

Trial registration

May 19th, 2017, German Clinical Trials Register DRKS-ID: DRKS00012421.
Problem based learning approach increases the academic satisfaction of health science students in Ethiopian universities: a comparative cross sectional study
Authors: Tadesse Selamawit Girma , Tadesse Dereje Girma , Dagnaw Eyaya Habtie
Published: May 2022

Background

Problem based learning is being highly implemented in many medical schools worldwide due to its perceived advantages including improvement of problem-solving abilities, development of communication skills, creation and development of critical thinking skill, and making of individuals to be lifelong learners & responsible for their own learning process.

Objective

The study aimed to compare academic satisfaction of Problem and Lecture based learning of regular undergraduate health science students in Ethiopian Universities, 2021.

Method

Institution based comparative cross sectional study was conducted from February 1–30, 2021. Data were collected using a pretested structured and self-administered questionnaire among 850 eligible students from two Universities. Data were entered into EPI info version 6.04 and analyzed using SPSS version 23. Binary Logistic regression model was fitted to identify factors associated with academic satisfaction considering the association to be significant p- value < 0.05.

Result

The study result revealed that the magnitude of academic satisfaction among problem based and lecture based learning students were 50.9 and 49.9% respectively. Similarly, problem based learning students were more likely to be academically satisfied than lecture based learning students in their type of curriculum with (AOR = 1.50, 95% CI = 1.02, 2.21). Experience of classroom distress (AOR = 1.93, 95% CI = 1.22, 3.06), quality of teaching (AOR = 0.54, 95% CI = 0.34, 0.86), relationship with classmates (AOR = 0.33, 95% CI = 0.13, 0.80), course content (AOR = 0.56, 95% CI = 0.33, 0.93) and accessibility of technology in the campus (AOR = 0.62, 95% CI = 0.40, 0.96) were the significant factors of academic satisfaction of problem based learning students. Year of study (AOR = 0.29, 95% CI = 0.17, 0.48), quality of teaching (AOR = 0.51, 95% CI = 0.31, 0.85), course content (AOR = 0.59, 95% CI = 0.35, 0.97) and energy & effort (AOR = 0.55, 95% CI = 0.35, 0.88) were significantly associated with academic satisfaction among lecture based learning students.

Conclusion

The study revealed that the academic satisfaction among problem based learning students was higher than lecture based learning students. Incorporating and implementing problem based learning as a formal instructional method in across the universities curriculum is recommended.
Challenges in the transition from resident to attending physician in general internal medicine: a multicenter qualitative study
Authors: Roten Christine , Baumgartner Christine , Mosimann Stefanie , Martin Yonas , Donzé Jacques , Nohl Felix , Kraehenmann Simone , Monti Matteo , Perrig Martin , Berendonk Christoph
Published: May 2022

Background

The attending physician in general internal medicine (GIM) guarantees comprehensive care for persons with complex and/or multiple diseases. Attendings from other medical specialties often report that transitioning from resident to attending is burdensome and stressful. We set out to identify the specific challenges of newly appointed attendings in GIM and identify measures that help residents better prepare to meet these challenges.

Methods

We explored the perceptions of 35 residents, attendings, and department heads in GIM through focus group discussions and semi-structured interviews. We took a thematic approach to qualitatively analyze this data.

Results

Our analysis revealed four key challenges: 1) Embracing a holistic, patient centered perspective in a multidisciplinary environment; 2) Decision making under conditions of uncertainty; 3) Balancing the need for patient safety with the need to foster a learning environment for residents; and 4) Taking on a leader’s role and orchestrating an interprofessional team of health care professionals. Newly appointed attendings required extensive practical experience to adapt to their new roles. Most attendings did not receive regular, structured, professional coaching during their transition, but those who did found it very helpful.

Conclusions

Newly appointed attending physician in GIM face a number of critical challenges that are in part specific to the field of GIM. Further studies should investigate whether the availability of a mentor as well as conscious assignment of a series of increasingly complex tasks during residency by clinical supervisors will facilitate the transition from resident to attending.
Cost savings of a primary care program for individuals recently released from prison: a propensity-matched study
Authors: Harvey Tyler D. , Busch Susan H. , Lin Hsiu-Ju , Aminawung Jenerius A. , Puglisi Lisa , Shavit Shira , Wang Emily A.
Published: May 2022

Background

Criminal justice system costs in the United States have exponentially increased over the last decades, and providing health care to individuals released from incarceration is costly. To better understand how to manage costs to state budgets for those who have been incarcerated, we aimed to assess state-level costs of an enhanced primary care program, Transitions Clinic Network (TCN), for chronically-ill and older individuals recently released from prison.

Methods

We linked administrative data from Connecticut Department of Correction, Medicaid, and Department of Mental Health and Addiction Services to identify a propensity matched comparison group and estimate costs of a primary care program serving chronically-ill and older individuals released from incarceration between 2013 and 2016. We matched 94 people released from incarceration who received care at a TCN program to 94 people released from incarceration who did not receive care at TCN program on numerous characteristics. People eligible for TCN program participation were released from incarceration within the prior 6 months and had a chronic health condition or were over the age of 50. We estimated 1) costs associated with the TCN program and 2) costs accrued by Medicaid and the criminal justice system. We evaluated associations between program participation and Medicaid and criminal justice system costs over a 12-month period using bivariate analyses with nonparametric bootstrapping method.

Results

The 12-month TCN program operating cost was estimated at $54,394 ($146 per participant per month). Average monthly Medicaid costs per participant were not statistically different between the TCN ($1737 ± $3449) and comparison ($1356 ± $2530) groups. Average monthly criminal justice system costs per participant were significantly lower among TCN group ($733 ± $1130) compared with the matched group ($1276 ± $1738, p < 0.05). We estimate every dollar invested in the TCN program yielded a 12-month return of $2.55 to the state.

Conclusions

Medicaid investments in an enhanced primary care program for individuals returning from incarceration are cost neutral and positively impact state budgets by reducing criminal justice system costs.
Analyzing the effects of barriers to and facilitators of medication adherence among patients with cardiometabolic diseases: a structural equation modeling approach
Authors: Quaschning Katharina , Koerner Mirjam , Wirtz Markus Antonius
Published: May 2022

Background

Based on the theoretical model of medication adherence (WHO, 2003), the aims of the study were (1) to develop and test a theory-based multidimensional model for the predictive power of barriers to and facilitators of medication adherence and (2) to identify the mediating effects of barriers to medication adherence on drug-related patient outcomes (barrier “MedAd- “: forget; facilitator “MedAd + ”: regular intake).

Methods

Within a cross-sectional study entitled “Increasing medication adherence to improve patient safety in cardiological rehabilitation (PaSiMed)”, the model was evaluated in structural analytical terms based on data collected online ofN = 225 patients with cardiometabolic diseases. The revised “Freiburg questionnaire on medication adherence (FF-MedAd-R)" was used to measure the latent constructs (e.g., facilitator: communication; barrier: reservations).”

Results

The structural equation model proved to exhibit an appropriate data fit (RMSEA: .05; CFI: .92). For all first-order facilitators of medication adherence, a high proportion of variance (62–94%) could be explained by the second-order factor “Physician–patient relationship (PPR)”. All paths from “PPR” to the constructs depicting barriers to medication adherence showed significant negative effects. Facilitators (“MedAd + ”) and barriers (“MedAd-”) accounted for 20% and 12% of the variance, respectively, in global items of medication adherence. Whereas “Carelessness” showed a full mediation for “MedAd-”, ‘‘Reservations’’ showed a partial mediation for “MedAd + ”.

Conclusions

“PPR” is an important predictor of patient medication adherence. The results underline the importance of a trustful physician–patient relationship in reducing barriers and enhancing medication adherence.
Stakeholders’ perspectives and willingness to institutionalize linkages between the formal health system and informal healthcare providers in urban slums in southeast, Nigeria
Authors: Onwujekwe Obinna , Mbachu Chinyere , Onyebueke Victor , Ogbozor Pamela , Arize Ifeyinwa , Okeke Chinyere , Ezenwaka Uche , Ensor Tim
Published: May 2022

Background

The widely available informal healthcare providers (IHPs) present opportunities to improve access to appropriate essential health services in underserved urban areas in many low- and middle-income countries (LMICs). However, they are not formally linked to the formal health system. This study was conducted to explore the perspectives of key stakeholders about institutionalizing linkages between the formal health systems and IHPs, as a strategy for improving access to appropriate healthcare services in Nigeria.

Methods

Data was collected from key stakeholders in the formal and informal health systems, whose functions cover the major slums in Enugu and Onitsha cities in southeast Nigeria. Key informant interviews (n = 43) were conducted using semi-structured interview guides among representatives from the formal and informal health sectors. Interview transcripts were read severally, and using thematic content analysis, recurrent themes were identified and used for a narrative synthesis.

Results

Although the dominant view among respondents is that formalization of linkages between IHPs and the formal health system will likely create synergy and quality improvement in health service delivery, anxieties and defensive pessimism were equally expressed. On the one hand, formal sector respondents are pessimistic about limited skills, poor quality of care, questionable recognition, and the enormous challenges of managing a pluralistic health system. Conversely, the informal sector pessimists expressed uncertainty about the outcomes of a government-led supervision and the potential negative impact on their practice. Some of the proposed strategies for institutionalizing linkages between the two health sub-systems include: sensitizing relevant policymakers and gatekeepers to the necessity of pluralistic healthcare; mapping and documenting of informal providers and respective service their areas for registration and accreditation, among others. Perceived threats to institutionalizing these linkages include: weak supervision and monitoring of informal providers by the State Ministry of Health due to lack of funds for logistics; poor data reporting and late referrals from informal providers; lack of referral feedback from formal to informal providers, among others.

Conclusions

Opportunities and constraints to institutionalize linkages between the formal health system and IHPs exist in Nigeria. However, there is a need to design an inclusive system that ensures tolerance, dignity, and mutual learning for all stakeholders in the country and in other LMICs.
Diagnoses and procedures of inpatients with female genital mutilation/cutting in Swiss University Hospitals: a cross-sectional study
Authors: Horowicz Mathilde , Cottler-Casanova Sara , Abdulcadir Jasmine
Published: May 2022

Background

Female genital mutilation/cutting (FGM/C) can result in short and long-term complications, which can impact physical, psychological and sexual health. Our objective was to obtain descriptive data about the most frequent health conditions and procedures associated with FGM/C in Swiss university hospitals inpatient women and girls with a condition/diagnosis of FGM/C. Our research focused on the gynaecology and obstetrics departments.

Methods

We conducted an exploratory descriptive study to identify the health outcomes of women and girls with a coded FGM/C diagnose who had been admitted to Swiss university hospitals between 2016 and 2018. Four of the five Swiss university hospitals provided anonymized data on primary and secondary diagnoses coded with the International Classification of Diseases (ICD) and interventions coded in their medical files.

Results

Between 2016 and 2018, 207 inpatients had a condition/diagnosis of FGM/C. The majority (96%) were admitted either to gynaecology or obstetrics divisions with few genito-urinary and psychosexual conditions coded.

Conclusions

FGM/C coding capacities in Swiss university hospitals are low, and some complications of FGM/C are probably not diagnosed. Pregnancy and delivery represent key moments to identify and offer medical care to women and girls who live with FGM/C.

Trial registration: This cross-sectional study (protocol number 2018-01851) was conducted in 2019, and approved by the Swiss ethics committee.
Parent–adolescent discussion on sexual and reproductive health issues and its associated factors among parents in Sawla town, Gofa zone, Ethiopia
Authors: Malango Nigatu Teferi , Hegena Tadele Yohannes , Assefa Netsanet Abera
Published: May 2022

Background

Parent–adolescent discussion on sexual and reproductive health (SRH) issues leads to increased awareness on reproductive health matters and reduces risky behaviors among adolescents and also contributes to negative SRH outcomes. The aim of this study was to assess parent–adolescent discussion on SRH issues and its associated factors in Sawla town, Southern Ethiopia.

Methods

A community-based cross-sectional study was conducted among parents of 10–19-year-olds in Sawla town from March to April 2020. A simple random sampling technique was employed to select 697 study subjects. Data were collected using a pretested structured questionnaire, adapted from the 2016 Ethiopia Demographic Health Survey and other published literature. The questionnaire consisted of questions about socio-demographic factors, knowledge about SRH issues, attitudes towards SRH issues, and discussions between parents and adolescents concerning SRH issues and was administered by face-to-face interviews p-value < 0.05 and 95%CI for adjusted odds ratios (AOR) were used to declare the significance of the associations.

Results

Of the total participants, 168 (25.7%) respondents had reported discussion about at least two components of SRH issues in the last 6 months prior to the study. Multiple logistic regression model revealed that attending primary education (AOR 3, 95% CI: 1.10, 7.70), secondary education (AOR 9, 95% CI: 3.87, 20.64) and diploma and above (AOR 22.33, 95% CI: 9.49, 32.56), monthly income of above 2000 Ethiopian Birr (AOR 2.40, 95% CI: 1.30, 4.55), good knowledge (AOR 2, 95% CI: 1.14, 3.50)and positive attitude (AOR 4, 95% CI: 1.57, 10) towards SRH issues were statically significant factors associated with increased parent–adolescent discussion about SRH.

Conclusion

The occurrence of parent–adolescent SRH discussion is low in Sawla town. Educational status, average monthly income, knowledge and attitude on SRH issues were major factors affecting parent–adolescent discussion on SRH issues. Continuous capacity building on SRH issues for parents to increase the level of parental knowledge and attitude about SRH issues and sustainable advocacy should be provided about the importance of parent to the adolescent discussion. Moreover, it is important to support and scale up the adult learning program to decrease the level of illiteracy.
Secondary school students’ and peer educators’ perceptions of adolescent education in rural Tanzania: a qualitative study
Authors: Ito Keiko , Madeni Frida E. , Shimpuku Yoko
Published: May 2022

Background

In many African countries, cultural norms and values hinder conversations about sexuality among adolescents and their parents. Currently, there are no sex education classes in the curriculum at schools in Tanzania. Even when sex education is provided, the content is often abstinence-oriented, and there is a lack of in-depth instruction and exploration on the topic. To help overcome this, peer education is encouraged. After implementing peer-based adolescent education via a non-profit organization, this study aims to (1) identify students’ and peer educators’ perceptions of adolescent education and (2) identify the changes that occur as a result of adolescent education with peer educators.

Methods

This was a qualitative descriptive study using focus group discussions (FGDs). Secondary school students, including peer educators as well as students who received adolescent education, were asked about their perception of peer-based adolescent education. The FGDs were conducted in Swahili with the support of local collaborators. Data were transcribed and translated into English and Japanese. Content analysis was conducted to merge the categories and subcategories.

Results

A total of 92 students (57 girls and 35 boys) were included from three urban and three rural secondary schools where peer education was being implemented. Six FGDs were conducted for girls and four for boys, for a total of 10 FGDs. The students had both positive and negative perceptions of peer-based adolescent education. Both the peer educators and the other students felt that they gained more confidence through the process, based on the conversations they had and the trusting relationship that formed as a result. The peer educators were also successful in eliciting behavioral changes, and the students shared their sex-related knowledge with other peers as well.

Conclusion

The peer education process helped students gain confidence in teaching their peers and elicit behavioral changes. Adult supervision for peer educators is suggested.
Optimization of immune receptor-related hypersensitive cell death response assay using agrobacterium-mediated transient expression in tobacco plants
Authors: Huh Sung Un
Published: May 2022

Background

The study of the regulatory mechanisms of evolutionarily conserved Nucleotide-binding leucine-rich repeat (NLR) resistance (R) proteins in animals and plants is of increasing importance due to understanding basic immunity and the value of various crop engineering applications of NLR immune receptors. The importance of temperature is also emerging when applying NLR to crops responding to global climate change. In particular, studies of pathogen effector recognition and autoimmune activity of NLRs in plants can quickly and easily determine their function in tobacco using agro-mediated transient assay. However, there are conditions that should not be overlooked in these cell death-related assays in tobacco.

Results

Environmental conditions play an important role in the immune response of plants. The system used in this study was to establish conditions for optimal hypertensive response (HR) cell death analysis by using the paired NLR RPS4/RRS1 autoimmune and AvrRps4 effector recognition system. The most suitable greenhouse temperature for growing plants was fixed at 22 °C. In this study, RPS4/RRS1-mediated autoimmune activity, RPS4 TIR domain-dependent cell death, and RPS4/RRS1-mediated HR cell death upon AvrRps4 perception significantly inhibited under conditions of 65% humidity. The HR is strongly activated when the humidity is below 10%. Besides, the leaf position of tobacco is important for HR cell death. Position #4 of the leaf from the top in 4–5 weeks old tobacco plants showed the most effective HR cell death.

Conclusions

As whole genome sequencing (WGS) or resistance gene enrichment sequencing (RenSeq) of various crops continues, different types of NLRs and their functions will be studied. At this time, if we optimize the conditions for evaluating NLR-mediated HR cell death, it will help to more accurately identify the function of NLRs. In addition, it will be possible to contribute to crop development in response to global climate change through NLR engineering.
The diagnostic value of serum miR-21 in patients with ovarian cancer: a systematic review and meta-analysis
Authors: Qiu Lili , Weng Guangping
Published: May 2022

Objective

There have been a variety of published studies on the expression of serum miR-21 in patients with ovarian cancer associated with the diagnostic value of ovarian cancer, but the conclusions are not clearly elucidated. This study aims to evaluate the value of serum miR-21 expression in the diagnosis of patients with ovarian cancer by meta-analysis.

Methods

Databases, such as PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and China WanFang, were searched for relevant studies upon the correlation between the expression of serum miR-21 and the diagnostic value of ovarian cancer from inception to March 7, 2022. Statistical analysis was performed using Stata 15.0 software. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were calculated. The meta-regression analysis and subgroup analysis were used to explore the sources of heterogeneity. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) system was used to evaluate the quality of the included literature.

Results

A total of 6 articles were included in the meta-analysis. The results showed that the pooled sensitivity, specificity, PLR, NLR, and DOR were 0.81 (95%CI: 0.73–0.88), 0.82 (95%CI: 0.75–0.87), 4.51 (95%CI: 3.22–6.31), 0.23 (95%CI: 0.16–0.33), and 19.87 (95% CI: 11.27–35.03), respectively. The area under the summary receiver operating characteristic curve was 0.89 (95%CI: 0.85–0.91). No significant publication bias was found (P > 0.05).

Conclusion

Serum miR-21 has a good diagnostic value for ovarian cancer, which can be an ideal diagnostic biomarker for ovarian cancer. However, we should gingerly use miR-21 as a diagnostic reference standard, due to the limited number of included studies and heterogeneity.
Development and evaluation of a package to improve hypertension control in Nigeria [DEPIHCON]: a cluster-randomized controlled trial
Authors: Ajayi IkeOluwapo O. , Oyewole Oyediran E. , Ogah Okechukwu S. , Akinyemi Joshua O. , Salawu Mobolaji M. , Bamgboye Eniola A. , Obembe Taiwo , Olawuwo Morenikeji , Sani Mahmoud Umar
Published: May 2022

Background

Nigeria’s healthcare system capacity to stem the increasing trend in hypertension is limited in coverage, scope and manpower. Use of trained community-based care providers demonstrated to be an effective complement in improving access to, and supporting healthcare delivery has not been adequately examined for hypertension care in Nigeria. This study is proposed to evaluate the effectiveness of using trained community-oriented resource persons (CORPs) to improve hypertension control in Nigeria.

Methods

An intervention study will be conducted in three states using a mixed method design. First is a baseline survey using a semi-structured pre-tested questionnaire to collect information on demographics, clinical data, knowledge, occurrence and risk factors of hypertension among 1704 adults ≥18 years. Focus group discussions (FGD) and key informant interviews (KII) will be conducted to explore a community’s experience of hypertension, challenges with hypertension management and support required to improve control in 10 selected communities in each state. The second is a cluster-randomized controlled trial to evaluate effect of a package on reduction of blood pressure (BP) and prevention of cardiovascular (CVD) risk factors among 200 hypertensive patients to be followed up in intervention and control arms over a 6-month period in each state. The package will include trained CORPs conducting community-based screening of BP and referral, diagnosis confirmation and initial treatment in the health facility, followed by monthly home-based follow-up care and provision of health education on hypertension control and healthy lifestyle enhanced by phone voice message reminders. In the control arm, the usual care (diagnosis, treatment and follow-up care in hospital of a patient’s choice) will continue. Third, an endline survey will be conducted in both intervention and control communities to evaluate changes in mean BP, control, knowledge and proportion of other CVD risk factors. In addition, FGD and KII will be used to assess participants’ perceived quality and acceptability of the interventions as delivered by CORPs.

Discussion

This research is expected to create awareness, improve knowledge, perception, behaviours, attitude and practices that will reduce hypertension in Nigeria. Advocacy for buy-in and scale up of using CORPs in hypertension care by the government is key if found to be effective.

Trial registration

PACTR Registry PACTR202107530985857. Registered on 26 July 2021.
Coproduction and enhancement of electricity and biobutanol using adsorption carrier solid-state fermentation
Authors: Feng Xinyu , Wang Lan , Chen Hongzhang
Published: May 2022

Background

Electric energy is not collected and utilized in biobutanol fermentation. The reason is that the yields of electron shuttles and nanowires are not enough to gather and transfer all electrons to the electrode in liquid fermentation. However, the solid matrix of the adsorption carrier may be conducive to the collection and transfer of electrons because of its good adsorption and conductivity. Therefore, this first-attempt study coupled microbial fuel cell (MFC) with adsorption carrier solid-state fermentation (ACSF). In addition, the effect and mechanism of adsorption carrier solid-state fermentation on power generation were explored.

Results

The power generation performance and fermentation performance were improved by ACSF. The power density by polyurethane and carbon felt carrier solid-state fermentation (PC) was 12 times that by no carrier fermentation (NC). The biobutanol yield of absorbent cotton and carbon felt carrier solid-state fermentation (ACC) was increased by 36.86%. Moreover, the mechanism was explored via metabolic flux analysis, cyclic voltammetry and scanning electron microscopy. The results of metabolic flux analysis showed that more electrons were produced and more carbon flowed to biobutanol production. The cyclic voltammetry results revealed that more riboflavin was produced to enhance extracellular electron transport (EET) by ACSF. The scanning electron microscopy image showed that the adsorption capacity and aggregation degree of bacteria were increased on the electrode and nanowires were observed by ACSF.

Conclusions

A new fermentation mode was established by coupling MFC with ACSF to improve substrate utilization, which will provide crucial insights into the fermentation industry. In addition, the ACSF is an effective method to enhance power generation performance and fermentation performance.

Graphical Abstract
Effect of low back pain on clinical-functional factors and its associated potential risk of chronicity in adolescent dancers of classical ballet: cross-sectional study
Authors: de Souza Brenda Luciano , de Souza Patricia Colombo , Ribeiro Ana Paula
Published: May 2022

Background

Low back pain (LBP) is a common symptom in classical ballet dancers, which can limit their daily activities and dance training routines. The purpose of the study was to verify the association and comparison of clinical-functional outcomes (spine flexibility and foot posture) between different levels of intensity low back pain in adolescents of classical ballet and the potential risk of chronicity using the STarT back tool.

Methods

Cross-sectional study. Participants: 78 adolescent girls who practice classical ballet were evaluated and divided into groups according to level of low back pain: mild (n = 21), moderate (n = 17), and high (n = 20), and a control group (n = 20). Main outcome measures: Pain, flexibility of the spine (thoracic and lumbosacral), risk of chronicity for low back pain, and foot posture were assessed using the visual analogue scale, clinical tests, STarT back screening tool (SBST) questionnaire, and foot posture index (FPI), respectively.

Results

Dancers with high-intensity low back pain showed a potential risk of chronicity by the SBST. The spine pain intensity was not different considering thoracic and lumbosacral flexibility in the sagittal plane, but was different with greater supine FPI when compared to control dancers. Mild low back pain was associated with greater supine FPI. The SBST score was associated with higher exposure time–frequency and time of dancing.

Conclusion

Adolescents of classical ballet with high-intensity low back pain showed a potential risk of chronicity by the SBST. The level of intensity low back pain did not influence the clinical-functional aspects of spine flexibility in the sagittal plane, but the level of intensity moderate pain promoted changes in foot posture (more supinated). The potential risk of chronicity using the SBST was also associated with higher exposure time–frequency and time of dancing, in adolescents of classical ballet.
Investigating the safety and efficacy of hematopoietic and mesenchymal stem cell transplantation for treatment of T1DM: a systematic review and meta-analysis
Authors: Madani Sedigheh , Amanzadi Mahdiyeh , Aghayan Hamid Reza , Setudeh Aria , Rezaei Negar , Rouhifard Mahtab , Larijani Bagher
Published: May 2022

Background

Stem cell transplantation (SCT) has paved the way for treatment of autoimmune diseases. SCT has been investigated in type 1 diabetes mellitus (T1DM) as an autoimmune-based disorder, but previous studies have not presented a comprehensive view of its effect on treatment of T1DM.

Methodology

After registration of the present systematic review and meta-analysis in the PROSPERO, a search was done according to the Cochrane guidelines for evaluation of clinical trials to find eligible clinical trials that investigated the effect of SCT on T1DM (based on ADA® diagnostic criteria) from PubMed, Web of science, Scopus, etc, as well as registries of clinical trials from January 1, 2000, to September 31, 2019. A search strategy was designed using MeSH and EM-tree terms. Primary outcome included the changes in the insulin total daily dose (TDD) (U/kg) level, and secondary outcomes included the changes in the HbA1c, c-peptide, and adjusted HbA1c levels. TheQCochrane test andI2statistic were performed to assess the heterogeneity and its severity in primary clinical trials. The Cochrane ROB was used to determine risk of bias, and Cochrane Handbook for Systematic Reviews of Interventions was used in the full text papers. The meta-analysis was accomplished in the STATA software, and the results were shown on their forest plots. Confounders were evaluated by the meta-regression test.

Results

A total of 9452 studies were electronically screened, and 35 papers were included for data extraction. The results of this review study showed that 173 (26.5%) diabetic patients experienced insulin-free period (from 1 to 80 months), and 445 (68%) showed reduction in TDD of insulin after the SCT. Combination of hematopoietic stem cell (HSC) with mesenchymal stem cell (MSC) transplantation were significantly associated with improvement of the TDD (SMD: − 0.586, 95% CI: − 1.204/− 0.509,I2: 0%), HbA1c (SMD: − 0.736, 95% CI: − 1.107/− 0.365,I2: 0%), adjusted HbA1c (SMD: − 2.041, 95% CI: − 2.648/− 1.434,I2: 38.4%), and c-peptide (SMD: 1.917, 95% CI: 0.192/3.641,I2: 92.5%) on month 3 of follow-up, while its association had a growing trend from 3 to 12 months after the transplantation. Considering severe adverse events, HSC transplantation accompanied with conditioning could not be suggested as a safe treatment.

Conclusion

Most of the clinical trials of SCT in T1DM were single arm. Although meta-analysis illustrated the SCT is associated with T1DM improvement, well-designed randomized clinical trials are needed to clarify its efficacy.

Recommendation

Based on the results of this meta-analysis, the MSC and its combination with HSC could be considered as “Safe Cell” for SCT in T1DM. Furthermore, to evaluate the SCT efficacy, calculation of insulin TDD (U/kg/day), AUC of c-peptide, and adjusted HbA1c are highly recommended.
Numerical investigation of fractional-order Kersten–Krasil’shchik coupled KdV–mKdV system with Atangana–Baleanu derivative
Authors: Iqbal Naveed , Botmart Thongchai , Mohammed Wael W. , Ali Akbar
Published: May 2022

In this article, we present a fractional Kersten–Krasil’shchik coupled KdV-mKdV nonlinear model associated with newly introduced Atangana–Baleanu derivative of fractional order which uses Mittag-Leffler function as a nonsingular and nonlocal kernel. We investigate the nonlinear behavior of multi-component plasma. For this effective approach, named homotopy perturbation, transformation approach is suggested. This scheme of nonlinear model generally occurs as a characterization of waves in traffic flow, multi-component plasmas, electrodynamics, electromagnetism, shallow water waves, elastic media, etc. The main objective of this study is to provide a new class of methods, which requires not using small variables for finding estimated solution of fractional coupled frameworks and unrealistic factors and eliminate linearization. Analytical simulation represents that the suggested method is effective, accurate, and straightforward to use to a wide range of physical frameworks. This analysis indicates that analytical simulation obtained by the homotopy perturbation transform method is very efficient and precise for evaluation of the nonlinear behavior of the scheme. This result also suggests that the homotopy perturbation transform method is much simpler and easier, more convenient and effective than other available mathematical techniques.
The superficial zone of articular cartilage
Authors: Saito Taku
Published: May 2022

The superficial zone of articular cartilage contributes to smooth joint motion through the production of proteoglycan 4 (PRG4), also known as lubricin. Recent studies indicate novel effects of PRG4 as a signaling molecule, other than a simple extracellular matrix protein. Additionally, the accumulating evidence displays that various molecules and signaling pathways are involved in regulating the superficial zone and PRG4 expression. In addition, Prg4-expressing cells include a progenitor population of articular chondrocytes. Several non-clinical and clinical studies have shown that PRG4 and related molecules are promising candidates for disease-modifying drugs for treating osteoarthritis. Since PRG4 is also expressed in the synovium, tendons, and ligaments, further studies of PRG4-related pathways and PRG4-positive cells may elucidate the mechanisms underlying joint homeostasis.
Diagnostic value of shear wave ultrasound elastography of tibial nerve in patients with diabetic peripheral neuropathy
Authors: Ibrahim Heba R.
Published: May 2022

Background

Diabetic peripheral neuropathy (DPN) is a major complication of Diabetes mellitus. So this study aimed at investigation of the value of tibial nerve stiffness measured by shear wave ultrasound elastography (SWE) for detection of DPN. This case–control study involved 50 patients with DPN, 50 patients with diabetes mellitus but without DPN, and 50 healthy controls. Clinical examination, nerve conduction study of both tibial nerves, high resolution ultrasound and SWE to assess cross sectional area "CSA" of tibial nerves, and tibial nerves mean stiffness, respectively. ROC curve analysis was also performed.

Results

Mean tibial nerve stiffness by SWE was higher in patients with DPN compared to other groups (P value < 0.001). The CSA of the tibial nerve in the DPN group was significantly larger than that in the other groups (P value = 0.01). The cutoff value by ROC curve analysis for tibial nerve stiffness to differentiate patients with DPN and control group was 70.6 kPa (P value < 0.001, 95.4% sensitivity, 94.7% specificity, AUC = 0.963), while 86.5 kPa was the optimal cutoff point to differentiate patients with DPN and other groups with a 94.6% sensitivity, 93.8% specificity, AUC of 0.975 and P value < 0.001. Higher diagnostic accuracy was found when combination of SWE and high resolution US (high resolution US + shear wave; 0.987, P value < 0.001).

Conclusions

Tibial nerve stiffness was increased in patients with DPN. SWE can be used as an effective complementary method in diagnosis of DPN with high sensitivity and accuracy.
A new DAS sensor prototype for multicomponent seismic data
Authors: Takekawa Junichi , Mikada Hitoshi , Xu Shibo , Uno Masahiro , Kamei Shiori , Kishida Kinzo , Azuma Daiji , Aoyanagi Masafumi , Tanaka Naoto , Ichikawa Hiroki
Published: May 2022

We present a novel type of multicomponent sensor prototype that uses distributed acoustic sensing (DAS) technology. A prototype of the new sensor has three individual parts consisting of optical fiber wound around a polyvinyl chloride frame. We deployed the sensor prototype at a test site and recorded seismic waves generated by a wooden hammer. A geophone array was also set for comparison purposes. The data observed with the new DAS sensor prototype show good agreement with the conventional geophone. The particle motion of waveforms obtained by the DAS sensor prototype shows ellipsoidal motion, the propagating velocity of which coincides with the velocity of the Rayleigh waves estimated by the dispersion curve based on the geophone data. We introduced a simple string model to explain the dynamic behavior of the sensor. The analysis results of the string model can explain features of recorded seismic data. These results indicate that the DAS sensor prototype records seismic waves via lateral vibration of the string. The present study shows a new possibility of the multicomponent sensor with the DAS technology.
Reviews
Authors: Green William
Published: May 2022

Bandit Algorithms, by Tor Lattimore and Csaba Szepesvári, ISBN 978-1-108-48682-8, 2020, Cambridge University Press, 536 p. Advanced Digital Signal Processing of Seismic Data, by Wail A. Mousa, ISBN 978-1-107-03965-0, 2020, Cambridge University Press, 338 p.
Ramsey scheme applied to string theoretical processes
Authors: Wani Salman Sajad , Shabir Arshid , Faizal Mir , Rubab Seemin
Published: May 2022

In this paper, we analyze the evolution of physical quantities due to the interaction of strings with background fields. We will obtain the characteristic function for such a string theoretical process. This will be done by generalizing the Ramsey scheme to world-sheet, and using it to obtain the information about the evolution of quantity in a string theoretical process, without making two-point measurements. We will also use the characteristic function to obtain the average of the difference between the initial and final values of such a quantity. Finally, using the characteristic function, we calculate the Fisher information for the difference of such a quantity.
Nie pożądaj Rzeczy… – o pojęciu „das Ding” w Etyce psychoanalizy i Kanta Sadem Lacana
Authors: Michalik Grzegorz
Published: May 2022

Celem niniejszego artykułu jest próba opisu pojęcia Rzeczy w nauczaniu Lacana. Inaczej, niż inne terminy, które wydają się towarzyszyć Lacanowi przez większość jego nauczania „Rzecz” zdaje się być pojęciową efemerydą, która jak szybko się pojawiła, tak nagle zniknęła. Chcemy jednak wskazać, że ulotność tego pojęcia jest jedynie pozorna. Rzecz nie tylko była istotna dla wypracowania przez Lacana podstaw „etyki psychoanalizy”, lecz stanowiła de facto pierwszą jego próbę zmierzenia się z problemem Realnego, czego konsekwencje obecne były także w późniejszym nauczaniu. W artykule prześledzimy freudowskie źródła tego pojęcia oraz wskażemy na jego znaczenie dla Lacanowskiej etyki w kontekście tak Seminarium o etyce, jak i tekstu Kanta Sadem.
Transportation in the Sharing Economy
Authors: Gansterer Margaretha , Hartl Richard F. , Tzur Michal
Published: May 2022

Traditionally, individuals and firms have bought and owned resources. For instance, owning a car was a status symbol for people. In recent years, this focus has changed. Young people just want to have some convenient means of transportation available. Sharing cars, bikes, or rides is also acceptable and has the advantage of increased sustainability compared with everyone owning such a device. A similar development can also be observed in industry. Already for decades, smaller farmers in rural areas have shared some expensive harvesting machines, via cooperatives. In recent years, cost pressures have incentivized all firms to use their equipment more efficiently and to avoid idle capacities. This has led, among other things, to the exchange of transportation requests between smaller carriers, when one of them faces an overload situation and another has idle resources. Similarly, some production firms share storage space and logistics service providers operate this storage jointly with greater efficiency than each firm could do separately. All these tendencies have led to the development of a new paradigm, the “Sharing Economy.” In transportation, these resources are the vehicles used to deliver goods or move passengers. Given an increasing pressure to act economically and ecologically sustainable, efficient mechanisms that help to benefit from idle capacities are on the rise. They are typically organized through digital platforms that facilitate the efficient exchange of goods or services and help cope with data privacy issues. Both transportation companies and heavy users of transportation services need to learn how to play in a world of shared idle capacities. “Transportation in the Sharing Economy” was the theme of the 2019 Transportation Science and Logistics Workshop held in Vienna, and it is therefore also the focus of this associated special issue. The papers included cover several forms of shared resources in transportation, where the first part deals with freight, whereas in the second part, the focus lies on passenger transportation. Each study highlights the benefits of sharing resources. We received 40 submissions, of which 10 papers were accepted for this special issue after the reviewing process.
Coincidence of Events Causing Paradoxical Hypotension in a Patient with an Intra-Aortic Balloon Pump
Authors: Noori Muhammad Atif Masood , Fichadiya Hardik , Saeed Hasham , Jawed Qirat , Jesani Shruti , Latif Asnia , Joshi Meherwan
Published: May 2022

The left ventricular outflow tract is a region of the left ventricle that lies between the anterior leaflet of the mitral valve and the ventricular septum. Dynamic left ventricular outflow tract obstruction (LVOTO) has classically been observed in patients with hypertrophic obstructive cardiomyopathy (HOCM) where it occurs secondary to asymmetric septal hypertrophy and systolic anterior motion (SAM) of the mitral valve. However, there are some instances that lead to hypercontractility of the myocardium, and with a combination of other physiological conditions, result in SAM of a mitral valve leaflet, leading to LVOTO in the absence of phenotype.
 We present such a case of an acute inferolateral wall myocardial infarction that was complicated by cardiogenic shock, requiring an intra-aortic balloon pump (IABP) and inotropic support which paradoxically provoked LVOTO. A reduction in IABP counterpulsation from 1:1 to 1:3 and the addition of intravenous fluids and a beta blocker resulted in significant improvement in blood pressure with rapid tapering of pressors. Inotropes and IABP, although helpful in cardiogenic shock, have the potential to induce or worsen the LVOTO, which can lead to a vicious cycle of worsening hypotension and increasing adrenergic drive that further deteriorates myocardial viability. Timely diagnosis with an echocardiogram and the withdrawal of inotropic and IABP support has the potential to improve haemodynamics and, thereby, outcome.