bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy analysis of C5V chemotherapy combined with transcatheter subcutaneous radiofrequency ablation in the treatment of children with advanced (Stage III/IV) hepatoblastoma
Authors: Qi Yan-wei , Liu Wei-dong , Gao Lei , Gong Ying-xin
Published: August 2022

Objectives: To evaluate the clinical efficacy of C5V chemotherapy combined with transcatheter subcutaneous radiofrequency ablation in the treatment of children with advanced (stage III/IV) hepatoblastoma.

Methods: Eighty children with advanced (Stage III/IV) hepatoblastoma were admitted in Hebei Children’s Hospital from May 2019 to September 2021 randomly divided into two groups: control group and experimental group, with 40 cases in each group. Children in the control group received C5V chemotherapy, while those in the experimental group received C5V chemotherapy combined with transcatheter subcutaneous radiofrequency ablation. After treatment, the treatment effect, adverse drug reactions, AFP, ALT, AST, HBG and other indicators of the two groups were compared and analyzed. And the difference in survival rate and recurrence rate between the two groups was compared and analyzed.

Results: The total efficacy of the experimental group was 67.5%, which was significantly better than 45% of the control group (p=0.04). The incidence of adverse drug reactions in the experimental group was 50%, while that in the control group was 35% (p=0.15). After treatment, AFP, ALT and AST in the experimental group were significantly lower than those in the control group, while the HBG was slightly higher than that of the control group (p=0.03). Moreover, the overall survival rate of the experimental group was significantly higher than that of the control group, and the recurrence rate was significantly lower than that of the control group.

Conclusion: C5V chemotherapy combined with transcathetal subcutaneous radio fascial ablation is a safe and effective regimen for children with advanced (stage III/IV) hepatoblastoma, boasting definite efficacy and no increase in adverse reactions.

doi: https://doi.org/10.12669/pjms.38.7.5899

How to cite this:Qi Y, Liu W, Gao L, Gong Y. Efficacy analysis of C5V chemotherapy combined with transcatheter subcutaneous radiofrequency ablation in the treatment of children with advanced (Stage III/IV) hepatoblastoma. Pak J Med Sci. 2022;38(7):---------.  doi: https://doi.org/10.12669/pjms.38.7.5899

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Older adults and family caregivers’ experience of digital health technology in frailty care: A systematic review and meta-ethnography protocol
Authors: Darley Andrew , Dix Rachael , Rocher Elena , Stokes Diarmuid , Carroll Áine
Published: August 2022

Background: Digital health technology has been identified as a valuable tool to support older adults with frailty needs in their home setting. Despite the numerous technologies and evaluations of these innovations, a synthesis of the older person and family caregivers’ experience using technology for support self-management has not been conducted to date.

Methods and analysis: A systematic review and meta-ethnography will be conducted in accordance with the PRISMA and eMERGe reporting guidelines. Four peer-reviewed empirical evidence databases will be searched (Medline (Ovid), CINAHL, EMBASE, PsycINFO) using a defined search strategy. Studies containing qualitative data on the experiences of older people or family caregivers of using digital health technology to support frailty care will be included. Covidence software will be used to screen studies and extract data. The Critical Appraisal Skills Programme (CASP) checklist for qualitative research will be used by two independent reviewers to appraise all included papers. A meta-ethnography will be undertaken in accordance with the seven-phase method described by Noblit and Hare: (1) Getting started, (2) Deciding what is relevant to the initial interest, (3) Reading the studies, (4) Determining how the studies are related, (5) Translating the studies into one another, (6) Synthesizing translations and (7) Expressing the synthesis.

Discussion: To the best of our knowledge, this will be the first systematic review to integrate and synthesize the findings of qualitative studies of older citizens’ experience of digital health technology. The findings of this meta-ethnography will endeavour to inform future research, policy and clinical practice. In particular, the results will help to inform the design of future digital health technology to meet the needs of older adults.

PROSPERO registration number: CRD42022314608.
Finding Feasible Systems for Subjective Constraints Using Recycled Observations
Authors: Zhou Yuwei , Andradóttir Sigrún , Kim Seong-Hee , Park Chuljin
Published: August 2022

We consider the problem of finding a set of feasible or near-feasible systems among a finite number of simulated systems in the presence of stochastic constraints. When the constraints are subjective, a decision maker may want to test multiple threshold values for the constraints. Or the decision maker may simply want to determine how a set of feasible systems changes as constraints become more strict with the objective of pruning systems or finding the system with the best performance. When only the constraint thresholds change for the same set of underlying systems, it is natural to reuse observations collected from the feasibility check with a different threshold value. We present an indifference-zone procedure that recycles observations and provide an overall probability of correct decision for all threshold values. Our numerical experiments show that the proposed procedure performs well in reducing the required number of observations while providing a statistical guarantee on the probability of correct decision.

Summary of Contribution: We consider the problem of determining the feasibility of a finite number of systems in the presence of subjective constraints on performance measures that can be estimated only by stochastic simulation. Specifically, our work focuses on the situation where the decision maker is willing to relax some constraint thresholds if necessary to achieve feasibility. Also, we discuss how our proposed procedures can help select the best system in the presence of multiple objectives. This is the first work that considers subjective constraints in the field of ranking and selection in simulation and it provides a practically useful decision-making tool with more flexibility on feasibility determination.

History: Accepted by Bruno Tuffin, Area Editor for Simulation.

Supplemental Material: The online supplement is available at https://doi.org/10.1287/ijoc.2022.1227 .
Bystanders Join in Cyberbullying on Social Networking Sites: The Deindividuation and Moral Disengagement Perspectives
Authors: Chan Tommy K. H. , Cheung Christy M. K. , Benbasat Izak , Xiao Bo , Lee Zach W. Y.
Published: August 2022

Bystanders Join in Cyberbullying on Social Networking Sites: The Deindividuation and Moral Disengagement Perspectives

Cyberbullying on social networking sites escalates when bystanders join in the bullying. Bystanders’ joining-in behaviors reinforce the abuse, expose victims to a larger audience, and encourage further abuse by signaling their approval of the aggressive behavior. This study developed an integrative model that explains bystanders’ joining-in cyberbullying behaviors on SNSs to offer actionable insights into reducing such harmful behaviors. We tested the model using 1,179 responses using a scenario survey study. Our findings suggest that IT artifacts (including digital profile, search and privacy, relational ties, and network transparency) activated two key mechanisms that lead to cyberbullying joining-in behaviors: (i) the deindividuation experiences that attenuate self-identity and put salience on group/social identity, and (ii) the moral disengagement practices that permit the exercise of cognitive maneuvers to justify group-interested choices that do not align with social standard. The findings explain why people who do not know each other gang up to bully a target on social media. Platform owners who wish to discourage bystanders from joining in undesirable activities may consider regulating how users could share and access digital resources in a social network and should acknowledge the influence of social identity in igniting, driving, and prolonging harmful online group behaviors.
Living well with heart failure: evaluation of an education and support programme for patients and caregivers
Authors: Butcher Dan , Walthall Helen , Wee Bee
Published: August 2022

Background/Aims

Living with advanced heart failure places a considerable burden on patients and their caregivers. Improving the education and support given to patients and caregivers, with the input of palliative care services, could support them to live well with heart failure. This study evaluated an 8-week programme of education and support delivered in a day hospice for patients diagnosed with heart failure and their informal caregivers.

Methods

An 8-week programme was delivered five times between January 2018 and March 2019, with a total of 39 participants (24 patients and 15 caregivers). Two focus groups were conducted at the end of each programme (one with patients and one with caregivers). Groups were recorded and transcribed verbatim, and inductive thematic analysis was performed.

Results

Most patient participants were male (92%) and aged >70 years, while most caregiver participants were female (93%) and aged >50 years. The main themes from the patient participants' focus groups regarding the programme were the importance of knowledge; support and communication; having a gateway to resources; and the concept of living with heart failure. The main themes from the caregiver participant focus groups were becoming stronger; altered outcomes for the future; and connection through knowledge. All participants gave positive feedback about the programme, with increased knowledge about heart failure and access to peer support being highlighted as particularly valuable.

Conclusions

This hospice-based model of support and education, involving patients and their caregivers, has considerable potential as a means of helping these individuals to live well with heart failure. Greater integration between cardiac services and palliative care is needed to support this growing patient group.
The impact of clinical simulation on the development of advanced practice skills
Authors: Reynolds Julie , Mortimore Gerri , Swift Karen , Cocking Caroline , Hughes Gareth
Published: August 2022

This article considers the findings of a qualitative research study into the impact of simulation on the development of advanced clinical practitioners' skills and knowledge. Study aim: To explore simulated learning through the eyes of trainee and trained advanced clinical practitioners (ACPs) and consider its potential in supporting their development. Method: This qualitative research study explored the experiences of trained and trainee ACP volunteers undertaking a structured simulated event provided by a local acute hospital trust simulation team. A questionnaire (n=10) and a focus group (n=4) acted as the data gathering tools. Results: Although simulation can be daunting for the participants, the overwhelming outcome was positive. Participants stated that they gained confidence and suggested that simulation offered a safe place to practise the challenging scenarios that occur in the clinical environment. Additionally, they emphasised that simulation provided a place to network and receive constructive feedback that was non-judgemental, and which helped them to develop clinical knowledge and appreciate their limitations. Conclusion: Simulation is a valuable addition to the education and development of ACPs. It should be considered for inclusion within the educational curriculum as a supplement to theoretical knowledge and to the structured clinical supervision provided within the clinical environment.
Students' experience of the challenges of using assertive communication
Authors: Keates Claire
Published: August 2022

Assertive communication is a skill that many nurses, particularly nursing students, find challenging. This article describes the findings of phenomenological study that set out to explore third-year student nurses' experiences of using assertive communication in the clinical setting. A narrative enquiry approach reviewed six reflective written accounts of their experiences. In addition, seven students took part in an in-depth semi-structured group discussion of their clinical experiences. Data were analysed using a hybrid interpretive phenomenological analysis and discourse analysis framework. Three key themes emerged: a sense of responsibility/duty and a sense of failure when this is not upheld, the importance of mentors in promoting self-confidence and self-esteem, and a sense of belonging on placement. The students responded well to positive role models and were able to identify negative role models. Accurate, constructive feedback and support was important to help students reflect appropriately.
A student coaching in practice (SCiP) approach: the impact on adult field pre-registration nursing students
Authors: Norman Kay
Published: August 2022

Background:

A ‘student coaching in practice’ (SCiP) approach, based on the OSCAR and GROW model of coaching, was implemented across three UK NHS trusts in the West Midlands, involving seven placement areas that consisted of both acute and community hospital settings.

Aim:

To explore the impact of a SCiP approach on preparing students for their next stage of learning and perceived confidence.

Method:

Seventy nursing students across Years 1, 2 and 3 of their BSc (Hons) programme took part in the study through completing an evaluative survey consisting of both quantitative and qualitative responses. Ethical approval was obtained by the host university.

Findings:

Participants across each year group found SCiP beneficial in developing learning and skills in practice, helped them prepare for the next stage of learning or registration, and increased perceived confidence. Students in year 1 and year 3 of their nursing programme gave the most positive responses. Implementing SCiP resulted in the expansion of placement capacity.
Leave of absence under the Mental Health Act 1983
Authors: Griffith Richard
Published: August 2022

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers a recent decision of the Upper Tribunal that limits the use of leave of absence provisions when testing a detained patient's rehabilitation
Working in partnership to implement change in wound dressings use
Authors: Mangan Maggie , Shoreman Sara
Published: August 2022

Background:

Wound care provision relies on safety, effectiveness, patient acceptance and accessibility of selected wound management products, supported by a sound education programme. Challenges with changing patient needs and service provision before and during the COVID-19 pandemic have resulted in new training and service delivery programmes to manage increased prevalence of wounds with dwindling resources.

Method:

South Warwickshire University NHS Foundation Trust incorporated a wound care audit identifying local challenges, available resources and areas for improvement, which led to changes in practice around training and the supply of dressings. This article sets out the rationale for change and steps taken to implement new practice, keeping the patient at the heart of care while following clinical governance.

Results:

The new practice resulted in a rigorous training programme to cover total wound management from assessment to standardised treatment that could encourage self-care where possible and improve patient outcomes. Wise use of all resources to manage stock levels released more qualified staff to focus on complex cases. Non-prescription ordering of dressings reduced stock wastage and the Trust recorded cost savings of more than 25% on the previous year.

Conclusion:

Sound wound care practice aligned to the National Wound Care Strategy, training in partnership with industry and the use of an efficient dressings delivery system achieved positive patient outcomes and significant financial savings for the Trust.
Impact of prolonged PPE use on Canadian health professionals
Authors: LeBlanc Kimberley , Woo Kevin , Wiesenfeld Lorne , Bresnai-Harris Julia , Heerschap Corey , Butt Britney , Chaplain Valérie , Wiesenfeld Samantha
Published: August 2022

Aim:

To explore the impact that prolonged use of personal protective equipment (PPE) has on the skin integrity of Canadian health professionals.

Method:

A descriptive, pan-Canadian, cross-sectional, online survey was carried out to explore the type and prevalence of PPE-related skin injury among Canadian health professionals. Convenience sampling was used to disseminate the online survey link to health professionals.

Results:

There were responses from 757 health professionals. Masks worn included surgical masks (90%), a combination of surgical or N95/KN95 masks (7.7%) and an N95/KN95 mask alone (2.7%). Responses showed 84.6% of providers always wear a mask while at work with 38.5% wearing the same mask all shift; 90% of participants wore protective eye wear. Complications included soreness or pressure injuries behind the ears (70%), new or worsening acne (52%), a runny nose or sneezing (45%), itching (39%), and dry skin (37%). Hand issues included dry skin (53%), red skin (30%), itching (26%), broken skin (20%), rash (16%), and dermatitis (11%) – 51% of respondents did not moisturise their hands. Complications related to gown use included itching (6%), moisture-associated skin damage (5.5%), feeling claustrophobic (4.5%), and new or worsening acne (3%). Increased perspiration due to PPE was experienced in 87.5% of respondents. Some 43% of respondents noted their mental health became worse due to wearing PPE for prolonged periods.

Conclusion:

These findings should be used in the development of guidelines to prevent and manage PPE-related skin injuries among health professionals. Education for professionals should focus on skin protection, prevention of PPE-related skin complications and support for mental health issues.
Dry surface biofilms: what you need to know
Authors: Ledwoch K , Vickery K , Maillard J-Y
Published: August 2022

Environmental dry surface biofilms are a new type of biofilm found on dry surfaces, that are not visible to the human eye. Dry surface biofilms harbour multidrug-resistant organisms, are resistant to cleaning and disinfection and cannot be detected by wet or dry swabbing, so may play an important role in the persistence of pathogens in the healthcare environment.
Low-intensity illumination for lensless digital holographic microscopy with minimized sample interaction
Authors: Mirecki Bartosz , Rogalski Mikołaj , Arcab Piotr , Rogujski Piotr , Stanaszek Luiza , Józwik Michał , Trusiak Maciej
Published: August 2022

Exposure to laser light alters cell culture examination via optical microscopic imaging techniques based on label-free coherent digital holography. To mitigate this detrimental feature, researchers tend to use a broader spectrum and lower intensity of illumination, which can decrease the quality of holographic imaging due to lower resolution and higher noise. We study the lensless digital holographic microscopy (LDHM) ability to operate in the low photon budget (LPB) regime to enable imaging of unimpaired live cells with minimized sample interaction. Low-cost off-the-shelf components are used, promoting the usability of such a straightforward approach. We show that recording data in the LPB regime (down to 7 µW of illumination power) does not limit the contrast or resolution of the hologram phase and amplitude reconstruction compared to regular illumination. The LPB generates hardware camera shot noise, however, to be effectively minimized via numerical denoising. The ability to obtain high-quality, high-resolution optical complex field reconstruction was confirmed using the USAF 1951 amplitude sample, phase resolution test target, and finally, live glial restricted progenitor cells (as a challenging strongly absorbing and scattering biomedical sample). The proposed approach based on severely limiting the photon budget in lensless holographic microscopy method can open new avenues in high-throughout (optimal resolution, large field-of-view, and high signal-to-noise-ratio single-hologram reconstruction) cell culture imaging with minimized sample interaction.
Fast measurement of the thickness and group refractive index distribution of solid plates by line-field dispersive interferometry
Authors: Zhang Jinxu , Xiong Shilin , Zhang Ruixue , Zhou Siyu , Jia Xingyu , Shi Liheng , Liu Bin , Mi Qinggai , Wu Guanhao
Published: August 2022

Real-time measurement of the thickness and group refractive index is crucial for semiconductor devices. In this paper, we proposed a fast synchronous method for measuring the thickness and group refractive index distribution of solid plates based on line-field dispersive interferometry. The proposed method measured the line-field distribution in an illuminated region through a single step. A low-cost spectrometer calibration method using an eight-channel dense wavelength division multiplexer was developed for verification. The line-field distribution of a three-step silicon wafer was successfully measured within 3.3 ms. The combined uncertainties for the geometrical thickness and group refractive index were <50 nm and 4 × 10−4, respectively.
Absolute frequency readout derived from ULE cavity for next generation geodesy missions: erratum
Authors: Rees Emily Rose , Wade Andrew R. , Sutton Andrew J. , Spero Robert E. , Shaddock Daniel A. , McKenzie Kirk
Published: August 2022

We found a calculation error affecting the scaling of results presented in Figure 7 of our article "Absolute frequency readout derived from ULE cavity for next generation geodesy missions" [Opt. Express 29 26014 (2021)10.1364/OE.434483] . The corrected Figure 7 is published here.
Habitat loss exacerbates pathogen spread: An Agent-based model of avian influenza infection in migratory waterfowl
Authors: Yin Shenglai , Xu Yanjie , Xu Mingshuai , de Jong Mart C. M. , Huisman Mees R. S. , Contina Andrea , Prins Herbert H. T. , Huang Zheng Y. X. , de Boer Willem F.
Published: August 2022

Habitat availability determines the distribution of migratory waterfowl along their flyway, which further influences the transmission and spatial spread of avian influenza viruses (AIVs). The extensive habitat loss in the East Asian-Australasian Flyway (EAAF) may have potentially altered the virus spread and transmission, but those consequences are rarely studied. We constructed 6 fall migration networks that differed in their level of habitat loss, wherein an increase in habitat loss resulted in smaller networks with fewer sites and links. We integrated an agent-based model and a susceptible-infected-recovered model to simulate waterfowl migration and AIV transmission. We found that extensive habitat loss in the EAAF can 1) relocate the outbreaks northwards, responding to the distribution changes of wintering waterfowl geese, 2) increase the outbreak risk in remaining sites due to larger goose congregations, and 3) facilitate AIV transmission in the migratory population. In addition, our modeling output was in line with the predictions from the concept of “migratory escape”, i.e., the migration allows the geese to “escape” from the location where infection risk is high, affecting the pattern of infection prevalence in the waterfowl population. Our modeling shed light on the potential consequences of habitat loss in spreading and transmitting AIV at the flyway scale and suggested the driving mechanisms behind these effects, indicating the importance of conservation in changing spatial and temporal patterns of AIV outbreaks.
The increasing incidence of visceral leishmaniasis relapse in South Sudan: A retrospective analysis of field patient data from 2001–2018
Authors: Naylor-Leyland Gabriel , Collin Simon M. , Gatluak Francis , den Boer Margriet , Alves Fabiana , Mullahzada Abdul Wasay , Ritmeijer Koert
Published: August 2022

Background

Visceral Leishmaniasis (VL) is endemic in South Sudan, manifesting periodically in major outbreaks. Provision of treatment during endemic periods and as an emergency response is impeded by instability and conflict. Médecins Sans Frontières (MSF) has provided health care in South Sudan since the late 1980’s, including treatment for 67,000 VL patients. In recent years, MSF monitoring data have indicated increasing numbers of VL relapse cases. A retrospective analysis of these data was performed in order to provide insight into the possible causes of this increase.

Methodology/Principal findings

Programme monitoring data from the MSF hospital in Lankien, Jonglei State, South Sudan, for the period 2001–2018 were analysed to detect trends in VL relapse as a proportion of all VL cases presenting to MSF treatment centres. Routinely collected patient-level data from relapse and primary VL cases treated at all MSF sites in South Sudan over the same period were analysed to describe patient characteristics and treatments received. VL relapse as a proportion of all VL cases increased by 6.5% per annum (95% CI 0.3% to 13.0%, p = 0.04), from 5.2% during 2001–2003 to 14.4% during 2016–2018. Primary VL and VL relapse patients had similar age, sex and anthropometric characteristics, the latter indicating high indices of undernutrition which were relatively constant over time. Clinical factors (Hb, spleen size, and VL severity score) also did not vary substantially over time. SSG/PM was the main treatment regimen from 2001–2018, used in 68.7% of primary and 70.9% of relapse VL cases; AmBisome was introduced in 2013, received by 22.5% of primary VL and 32.6% of VL relapse cases from 2013–2018.

Conclusion

Increasing incidence of VL relapse in South Sudan does not appear to be explained by changes in patient characteristics or other factors. Our data are concerning and may indicate an emergence of treatment-resistant parasite strains, decreasing the effectiveness of treatment regimens. This warrants further investigation as a causal factor. New chemical entities that will enable safe and highly effective short-course oral treatments for VL are urgently needed.
Screening of drug candidates against Endothelin-1 to treat hypertension using computational based approaches: Molecular docking and dynamics simulation
Authors: Fatima Israr , Ihsan Hamza , Masoud Muhammad Shareef , Kalsoom Saeeda , Aslam Sidra , Rehman Abdur , Ashfaq Usman Ali , Qasim Muhammad
Published: August 2022

Hypertension (HTN) is a major risk factor for cardiovascular and renal diseases, cerebrovascular accidents (CVA) and a prime underlying cause of worldwide morbidity and mortality. Hypertension is a complex condition and a strong interplay of multiple genetic, epigenetic and environmental factors is involved in its etiology. Previous studies showed an association of overexpression of genes with hypertension. Satisfactory control of Blood Pressure (BP) levels is not achieved in a major portion of hypertensive patients who take antihypertensive drugs. Since existing antihypertensive drugs have many severe or irreversible side effects and give rise to further complications like frequent micturition and headaches, dizziness, dry irritating cough, hypoglycemia, GI hemorrhage, impaired left ventricular function, hyperkalemia, Anemia, angioedema and azotemia. There is a need to identify new antihypertensive agents that can inhibit the expression of these overexpressed genes contributing to hypertension. The study was designed to identify drug-able targets against overexpressed genes involved in hypertension to intervene the disease. The structure of the protein encoded by an overexpressed gene Endothelin-1 was retrieved from Protein Database (PDB). A library of five thousand phytochemicals was docked against Endothelin-1. The top four hits against Endothelin-1 protein were selected based on S score and Root Mean Square Deviation (RMSD). S score is a molecular docking score which is used to determine the preferred orientation, binding mode, site of the ligand and binding affinity. RMSD refines value for drug target identification. Absorption, distribution, metabolism, excretion, and toxicity profiling (ADMET) was done. The study provides novel insights into HTN etiology and improves our understanding of BP pathophysiology. These findings help to understand the impact of gene expression on BP regulation. This study might be helpful to develop an antihypertensive drug with a better therapeutic profile and least side effects.
Validation of temporal parameters within the skating sub-techniques when roller skiing on a treadmill, using inertial measurement units
Authors: Meyer Frédéric , Seeberg Trine M. , Kocbach Jan , Danielsen Jørgen , Sandbakk Øyvind , Austeng Andreas
Published: August 2022

The aim of this study was to develop and validate a method using inertial measurements units (IMUs) to determine inner-cycle parameters (e.g., cycle, poles and skis contact, and swing time) and the main sub-techniques (i.e., G2, G3 and G4) in cross-country roller ski skating on a treadmill. The developed method is based on the detection of poles and skis initial and final contacts with the ground during the cyclic movements. Thirteen well-trained athletes skied at different combinations of speed (6–24 km∙h-1) and incline (2–14%) on a treadmill using the three different sub-techniques. They were equipped with IMUs attached to their wrists and skis. Their movements were tracked using reflective markers and a multiple camera infrared system. The IMU-based method was able to detect more than 99% of the temporal events. It calculated the inner-cycle temporal parameters with a precision ranging from 19 to 66 ms, corresponding to 3.0% to 7.8% of the corresponding inner-cycle duration. The obtained precision would likely allow differentiation of skiers on different performance levels and detection of technique changes due to fatigue. Overall, this laboratory validation provides interesting possibilities also for outdoor applications.
Real world effectiveness of digital mental health services during the COVID-19 pandemic
Authors: Prescott Maximo R. , Sagui-Henson Sara J. , Welcome Chamberlain Camille E. , Castro Sweet Cynthia , Altman Myra
Published: August 2022

Background

The COVID-19 pandemic created an unprecedented need for mental health services that can be remotely delivered. Digital mental health services that offer personalized care recommendations hold promise to efficiently expand service, but evidence of the effectiveness of digitally delivered mental health care in real-world settings remains limited.

Methods

A retrospective cohort of adults (N = 1,852) receiving care through a digital mental health platform with elevated depressive symptoms during the COVID-19 pandemic was analyzed to estimate changes in subjective well-being and clinical improvement in depressive symptoms (using the World Health Organization-Five [WHO-5] Well-Being Index), as well as compare the relative effectiveness and cost of different care utilization patterns.

Results

The average improvement in WHO-5 score was 10.1 points (CI: 9.3–10.9, p<0.001) at follow-up, which constituted a medium effect size (d = 0.73). The odds of clinical improvement in depressive symptoms were significantly greater among those who utilized telecoaching (aOR = 2.45, 95%CI: 1.91–3.15, p < .001), teletherapy (aOR = 2.01, 95%CI: 1.57–2.57, p < .001), and both services (aOR = 2.28, 95%CI: 1.67–3.11, p < .001) compared to those who only utilized assessments, adjusting for baseline WHO-5 score, age, sex, and number of days between baseline and follow-up assessments. The average estimated cost of care for telecoaching was $124 per individual, which was significantly less than teletherapy ($413) or both services ($559).

Conclusion

Digitally delivered care with a therapist and/or coach was effective in improving subjective well-being and clinical improvement in depressive symptoms. Although clinical outcomes were similar across utilization patterns, the cost of care was lowest among those utilizing telecoaching.
An in vitro methodology for experimental simulation on the natural hip joint
Authors: Jimenez-Cruz David , Dubey Mudit , Board Tim , Williams Sophie
Published: August 2022

Different hip pathologies can cause geometric variation of the acetabulum and femoral head. These variations have been considered as an underlying mechanism that affects the tribology of the natural hip joint and changes the stress distribution on the articular surface, potentially leading to joint degradation. To improve understanding of the damage mechanisms and abnormal mechanics of the hip joint, a reliable in-vitro methodology that represents the in vivo mechanical environment is needed where the position of the joint, the congruency of the bones and the loading and motion conditions are clinically relevant and can be modified in a controlled environment. An in vitro simulation methodology was developed and used to assess the effect of loading on a natural hip joint. Porcine hips were dissected and mounted in a single station hip simulator and tested under different loading scenarios. The loading and motion cycle consisted of a simplified gait cycle and three peak axial loading conditions were assessed (Normal, Overload and Overload Plus). Joints were lubricated with Ringer’s solution and tests were conducted for 4 hours. Photographs were taken and compared to characterise cartilage surface and labral tissue pre, during and post simulation. The results showed no evidence of damage to samples tested under normal loading conditions, whereas the samples tested under overload and overload plus conditions exhibited different severities of tears and detachment of the labrum at the antero-superior region. The location and severity of damage was consistent for samples tested under the same conditions; supporting the use of this methodology to investigate further effects of altered loading and motion on natural tissue.
Gender norms and women’s empowerment as barriers to facility birth: A population-based cross-sectional study in 26 Nigerian states using the World Values Survey
Authors: Litorp Helena , Kågesten Anna , Båge Karin , Uthman Olalekan , Nordenstedt Helena , Fagbemi Mariam , Puranen Bi , Ekström Anna-Mia
Published: August 2022

Background

Central and western Africa struggle with the world’s lowest regional proportion of facility birth at 57%. The aim of the current study was to compare beliefs related to maternal health care services, science/technology, gender norms, and empowerment in states with high vs. low proportions of facility birth in Nigeria.

Methods

Face-to-face interviews were performed as part of a nationally representative survey in Nigeria using a new module to measure values and beliefs related to gender and sexual and reproductive health and rights collected as part the 2018 World Values Survey. We compared beliefs related to maternal health care services, science/technology, gender norms, and empowerment between Nigerian states with facility birth proportions > 50% vs. < 25% as presented in the 2018 Nigerian Demographic Health Survey report. Pearson’s chi-squared test, the independent t-test, and univariable and multivariable logistic and linear regression were used for analyses. Results were also stratified by gender.

Results

Among the 1,273 participants interviewed, 653 resided in states with high and 360 resided in states with low proportions of facility birth. There were no significant differences between the groups in perceived safety of facility birth (96% vs. 94%) and confidence in antenatal care (91% vs 94%). However, in states with low proportions of facility birth, participants had higher confidence in traditional birth attendants (61% vs. 39%, adjusted odds ratio [aOR] 2.1, [1.5–2.8]), men were more often perceived as the ones deciding whether a woman should give birth at a clinic (56% vs. 29%, aOR 2.4 [1.8–3.3]), and participants experienced less freedom over their own lives (56% vs. 72%, aOR 0.56 [0.41–0.76]). Most differences in responses between men and women were not statistically significant.

Conclusions

In order to increase facility births in Nigeria and other similar contexts, transforming gender norms and increasing women’s empowerment is key.
Diagnosis of temporomandibular disorders using artificial intelligence technologies: A systematic review and meta-analysis
Authors: Jha Nayansi , Lee Kwang-sig , Kim Yoon-Ji
Published: August 2022

Background

Artificial intelligence (AI) algorithms have been applied to diagnose temporomandibular disorders (TMDs). However, studies have used different patient selection criteria, disease subtypes, input data, and outcome measures. Resultantly, the performance of the AI models varies.

Objective

This study aimed to systematically summarize the current literature on the application of AI technologies for diagnosis of different TMD subtypes, evaluate the quality of these studies, and assess the diagnostic accuracy of existing AI models.

Materials and methods

The study protocol was carried out based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA). The PubMed, Embase, and Web of Science databases were searched to find relevant articles from database inception to June 2022. Studies that used AI algorithms to diagnose at least one subtype of TMD and those that assessed the performance of AI algorithms were included. We excluded studies on orofacial pain that were not directly related to the TMD, such as studies on atypical facial pain and neuropathic pain, editorials, book chapters, and excerpts without detailed empirical data. The risk of bias was assessed using the QUADAS-2 tool. We used Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) to provide certainty of evidence.

Results

A total of 17 articles for automated diagnosis of masticatory muscle disorders, TMJ osteoarthrosis, internal derangement, and disc perforation were included; they were retrospective studies, case-control studies, cohort studies, and a pilot study. Seven studies were subjected to a meta-analysis for diagnostic accuracy. According to the GRADE, the certainty of evidence was very low. The performance of the AI models had accuracy and specificity ranging from 84% to 99.9% and 73% to 100%, respectively. The pooled accuracy was 0.91 (95% CI 0.76–0.99), I2 = 97% (95% CI 0.96–0.98), p < 0.001.

Conclusions

Various AI algorithms developed for diagnosing TMDs may provide additional clinical expertise to increase diagnostic accuracy. However, it should be noted that a high risk of bias was present in the included studies. Also, certainty of evidence was very low. Future research of higher quality is strongly recommended.
Nicotine has no significant cytoprotective activity against SARS-CoV-2 infection
Authors: Zheng Fang , Lian Elena , Ramirez Gaby , McAlister Carley , Zhou Shuo , Zhang Wen , Liu Chunming , Perera Rushika , Zhan Chang-Guo
Published: August 2022

When coronavirus disease 2019 (COVID-19) became a pandemic, one of most important questions was whether people who smoke are at more risk of COVID-19 infection. A number of clinical data have been reported in the literature so far, but controversy exists in the collection and interpretation of the data. Particularly, there is a controversial hypothesis that nicotine might be able to prevent SARS-CoV-2 infection. In the present study, motivated by the reported controversial clinical data and the controversial hypothesis, we carried out cytotoxicity assays in Vero E6 cells to examine the potential cytoprotective activity of nicotine against SARS-CoV-2 infection and demonstrated for the first time that nicotine had no significant cytoprotective activity against SARS-CoV-2 infection in these cells.
Understanding teamwork in rapidly deployed interprofessional teams in intensive and acute care: A systematic review of reviews
Authors: Schilling Stefan , Armaou Maria , Morrison Zoe , Carding Paul , Bricknell Martin , Connelly Vincent
Published: August 2022

The rapid increase of acute and intensive care capacities in hospitals needed during the response to COVID-19 created an urgent demand for skilled healthcare staff across the globe. To upscale capacity, many hospitals chose to increase their teams in these departments with rapidly re-deployed inter-professional healthcare personnel, many of whom had no prior experience of working in a high-risk environment and were neither prepared nor trained for work on such wards. This systematic review of reviews examines the current evidence base for successful teamwork in rapidly deployed interprofessional teams in intensive and acute care settings, by assessing systematic reviews of empirical studies to inform future deployments and support of rapidly formed clinical teams. This study identified 18 systematic reviews for further analysis. Utilising an integrative narrative synthesis process supported by thematic coding and graphical network analysis, 13 themes were found to dominate the literature on teams and teamwork in inter-professional and inter-disciplinary teams. This approach was chosen to make the selection process more transparent and enable the thematic clusters in the reviewed papers to be presented visually and codifying four factors that structure the literature on inter-professional teams (i.e., team-internal procedures and dynamics, communicative processes, organisational and team extrinsic influences on teams, and lastly patient and staff outcomes). Practically, the findings suggest that managers and team leaders in fluid and ad-hoc inter-professional healthcare teams in an intensive care environment need to pay attention to reducing pre-existing occupational identities and power-dynamics by emphasizing skill mix, establishing combined workspaces and break areas, clarifying roles and responsibilities, facilitating formal information exchange and developing informal opportunities for communication. The results may guide the further analysis of factors that affect the performance of inter-professional teams in emergency and crisis deployment.
Proteomic analysis of the effect of high-fat-diet and voluntary physical activity on mouse liver
Authors: So Byunghun , Ji Li Li , Imdad Saba , Kang Chounghun
Published: August 2022

Nonalcoholic fatty liver disease (NALFD), characterized by an abnormal accumulation of triglycerides in hepatocytes, is closely linked to insulin resistance, metabolic syndrome, and changes in lipogenesis in the liver. The accumulation of hepatic lipids can lead to a range of pathologies from mild steatosis to severe cirrhosis. Endurance exercise is known to ameliorate the adverse health effects of NAFLD. Therefore, we aimed to investigate the effect of voluntary wheel running (VWR) on the metabolic changes in the livers of high-fat diet (HFD)-induced NAFLD mice and used LC-MS/MS (Liquid chromatography–mass spectrometry) to determine whether the tested intervention affected the protein expression profiles of the mouse livers. Male C57BL/6 mice were randomly divided into three groups: control (CON), high-fat diet sedentary group (HFD), high-fat diet VWR group (HFX). HFX group performed voluntary wheel running into individually cages, given a high-fat diet for 12 weeks. Food consumption, body weight, and running distance were measured every week. Using 2D (2-dimensional)-gel electrophoresis, we detected and quantitatively analyzed the protein expression with >2.0-fold change in the livers of HFD-fed mice, HFD-fed exercise (HFX) mice, and chow-fed mice. Body weight was significantly increased in HFD compared to CON (P < 0.05). The 2D-gel electrophoresis analysis indicated that there was a difference between CON and HFD groups, showing 31 increased and 27 decreased spots in the total 302 paired spots in the HFD group compared to CON. The analysis showed 43 increased and 17 decreased spots in the total 258 spots in the HFX group compared to CON. Moreover, 12 weeks of VWR showed an increase of 35 and a decrease of 8 spots in a total of 264 paired spots between HFD and HFX. LC-MS/MS of HFD group revealed that proteins involved in ketogenesis, lipid metabolism, and the metabolism of drugs and xenobiotics were upregulated, whereas detoxifying proteins, mitochondrial precursors, transport proteins, proteasomes, and proteins involved in amino acid metabolism were downregulated. On the other hand, VWR counteracted the protein expression profile of HFD-fed mice by upregulating molecular chaperones, gluconeogenesis-, detoxification-, proteasome-, and energy metabolism-related proteins. This study provided a molecular understanding of the HFD- and exercise-induced protein marker expression and presented the beneficial effects of exercise during pathophysiological conditions.
Assessment of COVID-19 vaccination-related medical waste management practices in Bangladesh
Authors: Rayhan Md Rayhanul Islam , Liza Jannatul Mawya , Rahman Md. Mostafizur
Published: August 2022

The COVID-19 pandemic forces people to be vaccinated as early as possible. The COVID-19 vaccination program certainly raised the medical waste volume all over the world, including in Bangladesh. Numerous recent reports showed a fragile medical waste management system in Bangladesh; during the pandemic, the situation became worse. In addition, the nation-wide ongoing COVID-19 vaccination processes have been posing an extra burden to the existing biomedical waste management in the country. Failing to proper management of this waste might be a threat to human and environmental health. Therefore, the study investigated the current COVID-19 vaccine waste management practices in Bangladesh and made a comparison to the proposed standard operating procedures of international organizations and vaccine waste management practices of two other countries (USA and India). The study was carried out through a mixed methodological approach such as qualitative and quantitative, including a questionnaire survey in 15 Upazila of 4 Districts (Dhaka, Narayanganj, Manikganj, and Gazipur) of Bangladesh. The article focused on a nation-wide legitimate COVID-19 vaccination waste estimation, strength, weakness, opportunity, and threat (SWOT) analysis and drivers, pressure, state, impact, and response (DPSIR) framework analysis to identify the present state of medical waste management in the study area. The study found an excellent segregation system (100%) but very poor waste handling (35.5%) along with very poor syringes and sharps disposal method (open burning without buried 46.6%) and poor vials disposal method (without disinfection/open dump 52%) of vaccine waste. It is estimated that about 58 and 257.85 tonnes of syringes (with needles and packaging) and vaccine vials (Sinopharm 2 doses) waste have been generated since the mass-vaccination program started. Upon SWOT analysis, good separation techniques, poor waste management (ex-situ), enough space for management, and environmental and human health concerns were mostly identified as a strength, weakness, opportunity, and threat, respectively. Finally, a DPSIR framework was prepared for vaccine waste generation and its consequences in the studied area. This study will be useful to prepare a suitable vaccination waste management system in Bangladesh.