bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the use, usefulness and ease of use of digital occupational health services: A descriptive correlational study of customer experiences
Authors: Nissinen Sari , Pesonen Sanna , Toivio Pauliina , Sormunen Erja
Published: April 2024

Objective

This study examined the customer experiences of use, perceived usefulness and ease of use of digital occupational health (OH) services.

Methods

A cross-sectional study based on an electronic survey was conducted between December 2022 and January 2023. A total of 9871 OH customers responded to the survey. The sample was restricted to respondents who used digital OH services (n = 7275). An analysis of variance was run to test the relationships between respondents’ characteristics and the rate of usefulness, and ease of use variables.

Results

The most commonly used digital services were appointment booking, access to health information recorded by professionals and prescription renewal, and the digital services provided by physicians and nurses. Respondents expressed quite high satisfaction with the digital services, but not as much with their usefulness and ease of use. Females, individuals under 50 years of age, those with higher education, working in white-collar or managerial positions and possessing proficient information and communication technology (ICT) skills gave the most positive evaluations regarding usefulness and ease of use.

Conclusions

There was a certain level of mixed experiences among respondents regarding the usefulness and ease of use of digital OH services. We can also conclude that individuals who possess the necessary ICT skills can more easily take full advantage of the available digital services. When customers are proficient in using digital services, they can confidently interact with professionals. Regardless of the user's age, gender, education or profession, it is crucial for service providers always to strive to improve the usability of digital services.
“Simply complicated”: Uncovering the processes of lifestyle behavior change among college and university students with access to a digital multiple lifestyle intervention
Authors: Åsberg Katarina , Eldh Ann Catrine , Löf Marie , Bendtsen Marcus
Published: April 2024

Background

One approach to promoting healthy lifestyle behaviors is to target students with digital interventions. One of these is the digital intervention Buddy. This study aimed to understand why college and university students’ chose to participate in a digital multiple lifestyle behavior intervention trial (Buddy), and their subsequent experiences of the behavior-change process.

Methods

College and university students taking part in a trial of the Buddy intervention were individually interviewed after completing the 4-month intervention. Participants were guided to narrate their experiences and actions that followed signing up. Altogether, 50 interviews were conducted via telephone. The verbatim transcribed texts were analyzed qualitatively.

Results

The analysis generated seven personas, which illustrated the students’ different levels of engagement with the intervention and the behavior-change process. These were: the Occupied, the Kickstarter, the Aimless, the Reflective, the Goal-oriented, the Compliant, and the Personally developed. Buddy worked best for students who had clear ideas about what they wanted to change and why, and who were aware of their needs, and those who could translate information and reflection into action and had the mental and physical energy needed to make changes.

Conclusions

The progress of behavior change depends on the interaction between the digital mode of delivery, the intervention materials of Buddy, the individual's expectations, needs, and skills, and their current life situation. This suggests that designing lifestyle interventions could benefit from more often considering the various personas’ different intentions, knowledge, and contexts. By doing so, interventions are likely to emerge that can better match different needs in the target population.
Effect of Scientific Collaboration on Interdisciplinarity in Climate Change From a Scientometric Perspective
Authors: Qiu Junping , Yu Yunlong , Chen Shiji , Zhao Teng , Wang Shanshan
Published: April 2024

Insights into the interdisciplinary response to scientific collaboration remain scarce in interdisciplinary fields. The present work focuses on the effect of scientific collaboration on disciplinary diversity in the field of climate change using multiple statistical methods. The results show that research collaboration at the author and country/region levels has significantly positive effects on variety and DIV (an integrated diversity indicator), although these effects are limited. Additionally, the associations between the values of variety, disparity, and DIV and the number of departments are significantly positive, and similar results are found regarding relationships between these indicators and the number of countries/regions at the country/region and integrated levels. However, scientific collaboration has a negative effect on the balance of references at all levels. This study can improve our understanding of how scientific collaboration affects the multidimensional aspects of interdisciplinary research, and facilitate cross-disciplinary collaboration in the future.
Exploring the Personal Identity of College Students With Intellectual and Developmental Disabilities
Authors: Smith Hill Rebecca B. , Fields Alexander M. , Castle Madeline , Perez Lucas M. , Plotner Anthony J.
Published: April 2024

Emerging adulthood is a period of human development ripe for personal identity exploration and a college campus can be a conducive environment for this to take place. Historically, many transition-age adults with intellectual and developmental disabilities (IDD) have been denied access to college, but with the rise in inclusive postsecondary education (IPSE) programs across the country, that is changing. This study uses a combination of semi-structured interviews and photo elicitation discussions with 11 emerging adults enrolled in a southeastern IPSE program to better understand how these individuals understand and express their personal identity as well as the contextual factors contributing to their experiences with personal identity. Using thematic analysis, we uncovered seven salient themes across the data, including a theme related to the complicated nature of the participants’ disability identity.
Reliability of Tibial Tubercle–Trochlear Groove Distance for Assessing Tibial Tubercle Lateralization: A Study Comparing Different Anatomic References
Authors: Li Kehan , Xu Chenyue , Dong Zhenyue , Ji Gang , Wang Fei
Published: April 2024

Background:

The tibial tubercle–trochlear groove (TT-TG) distance is a measurement used to quantitatively assess tibial tubercle lateralization (TTL), and it has important reference value for the treatment of patellar dislocation (PD). However, TT-TG distance accuracy has been questioned, so many new parameters have been proposed.

Purpose:

To compare which of the TT-TG, tibial tubercle–midepicondyle (TT-ME), tibial tubercle–Roman arch (TT-RA), tibial tubercle–tibial intercondylar midpoint (TT-TIM), and tibial tubercle–mid inter-epicondyle trochlea intersection (TT-MIELTI) distances better reflect TTL in patients with PD.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

A total of 96 patients who had undergone surgery for PD and 96 patients without PD (controls) were included in the study. The patients had all undergone computed tomography examination. The TT-TG, TT-ME, TT-RA, TT-TIM, TT-MIELTI distances and the TTL distance were measured independently by 2 surgeons in a blinded and randomized fashion. The t test was used to detect whether the parameters were significantly different between the 2 groups. The TTL distance was used as a reference value for lateralization of tibial tubercle. Pearson correlation coefficients were calculated to determine correlations between the defined measurements.

Results:

The intra- and interobserver reliability of the defined measurements was excellent. All parameters except for TT-TIM distance were significantly larger in the PD group than the control group ( P < .01 for all). There was a moderate correlation ( r = 0.601) between the TT-TG distance and TTL, and other parameters were less correlated with TTL.

Conclusion:

Among 5 the parameters tested, the TT-TG distance still had the highest correlation with TTL and was able to reflect TTL better in patients with PD. The role of TT-TIM distance in the assessment of PD needs further study.
Accuracy of Artificial Intelligence Models in the Prediction of Periodontitis: A Systematic Review
Authors: Polizzi A. , Quinzi V. , Lo Giudice A. , Marzo G. , Leonardi R. , Isola G.
Published: April 2024

Introduction:

Periodontitis is the main cause of tooth loss and is related to many systemic diseases. Artificial intelligence (AI) in periodontics has the potential to improve the accuracy of risk assessment and provide personalized treatment planning for patients with periodontitis. This systematic review aims to examine the actual evidence on the accuracy of various AI models in predicting periodontitis.

Methods:

Using a mix of MeSH keywords and free text words pooled by Boolean operators (‘AND’, ‘OR’), a search strategy without a time frame setting was conducted on the following databases: Web of Science, ProQuest, PubMed, Scopus, and IEEE Explore. The QUADAS-2 risk of bias assessment was then performed.

Results:

From a total of 961 identified records screened, 8 articles were included for qualitative analysis: 4 studies showed an overall low risk of bias, 2 studies an unclear risk, and the remaining 2 studies a high risk. The most employed algorithms for periodontitis prediction were artificial neural networks, followed by support vector machines, decision trees, logistic regression, and random forest. The models showed good predictive performance for periodontitis according to different evaluation metrics, but the presented methods were heterogeneous.

Conclusions:

AI algorithms may improve in the future the accuracy and reliability of periodontitis prediction. However, to date, most of the studies had a retrospective design and did not consider the most modern deep learning networks. Although the available evidence is limited by a lack of standardized data collection and protocols, the potential benefits of using AI in periodontics are significant and warrant further research and development in this area.

Knowledge Transfer Statement:

The use of AI in periodontics can lead to more accurate diagnosis and treatment planning, as well as improved patient education and engagement. Despite the current challenges and limitations of the available evidence, particularly the lack of standardized data collection and analysis protocols, the potential benefits of using AI in periodontics are significant and warrant further research and development in this area.
Supporting Wellness, Resilience, and Community With Forest Therapy
Authors: Abookire Susan A , Ayala Sujata G , Shadick Nancy A
Published: April 2024

Background

Physician burnout has reached epidemic proportions. Although burnout is rooted in systems, practices for physician wellbeing and community can address exhaustion, burnout, and isolation. Inspired by the Japanese practice shinrin-yoku, forest therapy/bathing (FT) is a nature immersion practice that improves wellbeing in a group setting.

Objective

This program offered guided FT experiences to frontline faculty physicians in the Department of Medicine and evaluated potential for impact on burnout, resilience, and community.

Methods

Faculty physicians were recruited via email invitations to a free Forest Therapy group experience in the Arnold Arboretum in Boston, MA. Participants completed pre-and post-course surveys and evaluated its value as a community experience. Surveys measured burnout, resilience, and qualitative feedback on the experience.

Results

Twenty-seven faculty completed the baseline survey, twenty-three faculty participated, with 19 survey respondents. At baseline, 85% reported feeling burned out at least once a month. 46% reported feeling burned out more than a few times a month. 83% of participants responded that forest therapy could help them with the feeling of being burned out from work. Post-intervention, 100% of participants rated the experience as very or extremely valuable. 96% of participants reported they were interested in more frequent forest therapy sessions. 100% of participants would recommend this practice to other faculty. 70% of respondents reported the program could help them with burnout. Despite high baseline resilience, 94% of participants reported that forest therapy could help with stressful events and setbacks. Post-intervention, participants reported feeling relaxed, at peace, and calm.

Conclusion

This pilot demonstrates feasibility and acceptability for physicians of FT. Participants would consider recommending FT to their colleagues, and agreed that FT can help with wellbeing, and expressed enthusiasm for the community experience. This program may also be successfully incorporated into programs for leadership, teambuilding, and support after adverse events.
Final outcomes from a phase 2 trial of posoleucel in allogeneic hematopoietic cell transplant recipients
Authors: Dadwal Sanjeet S. , Bansal Rajat , Schuster Michael W. , Yared Jean A. , Myers Gary Douglas , Matzko Michelle , Adnan Sama , McNeel David , Ma Julie , Gilmore Sarah A. , Vasileiou Spyridoula , Leen Ann M. , Hill Joshua A. , Young Jo-Anne H.
Published: April 2024

Allogeneic hematopoietic cell transplantation (allo-HCT) recipients are susceptible to viral infections. We conducted a phase 2 trial evaluating the safety and rate of clinically significant infections (CSIs; viremia requiring treatment or end-organ disease) after infusion of posoleucel, a partially HLA-matched, allogeneic, off-the-shelf, multivirus-specific T-cell investigational product for preventing CSIs with adenovirus, BK virus, cytomegalovirus, Epstein-Barr virus, human herpesvirus-6, or JC virus. This open-label trial enrolled allo-HCT recipients at high risk based on receiving grafts from umbilical cord blood, haploidentical, mismatched, or matched unrelated donors; post-HCT lymphocytes of <180/mm3; or use of T-cell depletion. Posoleucel dosing was initiated within 15 to 49 days of allo-HCT and subsequently every 14 days for up to 7 doses. The primary end point was the number of CSIs due to the 6 target viruses by week 14. Of the 26 patients enrolled, only 3 (12%) had a CSI by week 14, each with a single target virus. In vivo expansion of functional virus-specific T cells detected via interferon-γ enzyme-linked immunosorbent spot assay was associated with viral control. Persistence of posoleucel-derived T-cell clones for up to 14 weeks after the last infusion was confirmed by T-cell–receptor deep sequencing. Five patients (19%) had acute graft-versus-host disease grade 2 to 4. No patient experienced cytokine release syndrome. All 6 deaths were due to relapse or disease progression. allo-HCT recipients at high risk who received posoleucel had low rates of CSIs from 6 targeted viruses. Repeat posoleucel dosing was generally safe and well tolerated and associated with functional immune reconstitution. This trial was registered at www.ClinicalTrials.gov as #NCT04693637.
Hemolysis events in the phase 3 PEGASUS study of pegcetacoplan in patients with paroxysmal nocturnal hemoglobinuria
Authors: Peffault de Latour Régis , Griffin Morag , Kelly Richard J. , Szer Jeff , de Castro Carlos , Horneff Regina , Tan Lisa , Yeh Michael , Panse Jens
Published: April 2024

Patients with paroxysmal nocturnal hemoglobinuria (PNH) experience complement-mediated intravascular hemolysis leading to anemia, fatigue, and potentially life-threatening thrombotic complications. Pegcetacoplan, a C3 inhibitor, demonstrated sustained improvements in hematologic and clinical parameters in the phase 3 PEGASUS trial in patients with PNH who remained anemic despite C5 inhibitor therapy. The present post hoc analysis describes 26 hemolysis adverse events (AEs) experienced in 19 patients during pegcetacoplan therapy in PEGASUS and baseline patient characteristics potentially associated with increased hemolysis risk. Lactate dehydrogenase (LDH) ≥2× the upper limit of normal (ULN) was observed in 19 events, including 2 with LDH ≥10× ULN. All patients experienced decreased hemoglobin during hemolysis (mean decrease, 3.0 g/dL). In 16 events (62%), a potential complement-amplifying condition underlying the event could be identified. Hemolysis AEs led to study discontinuation in 5 patients. However, of 26 hemolysis AEs, 17 (65%) were manageable without pegcetacoplan discontinuation. A greater proportion of patients with hemolysis AEs (n = 19) had key characteristics of higher disease activity at baseline compared to patients without hemolysis AEs (n = 61), namely higher-than-label eculizumab dose (53% vs 23%), detectable CH50 (total complement function; 74% vs 54%), and ≥4 transfusions in the previous 12 months (68% vs 51%). These characteristics may be useful predictors of potential future hemolysis events. This trial was registered at www.ClinicalTrials.gov as #NCT03500549.
Respiratory problems associated with liver disease in children
Authors: Ellis Jordache , Grammatikopoulos Tassos , Cook James , Deep Akash
Published: April 2024

Respiratory manifestations of chronic liver disease have a profound impact on patient clinical outcomes. Certain conditions within paediatric liver disease have an associated respiratory pathology. This overlap between liver and respiratory manifestations can result in complex challenges when managing patients and requires clinicians to be able to recognise when referral to specialists is required. While liver transplantation is at the centre of treatment, it opens up further potential for respiratory complications. It is established that these complications place patients at risk of longer stays in hospital and reduced survival. Additionally, late post-transplant complications can occur, including post-transplant lymphoproliferative disease and immunosuppression-induced interstitial lung disease. Although rare, it is important for clinicians to recognise these conditions to allow for prompt management. Finally, as liver disease progresses in children, respiratory complications can occur. Hepatopulmonary syndrome can occur in the context of portal hypertension, resulting in increased mortality and poorer quality of life for patients. Another consequence is portopulmonary hypertension, which can be associated with poor survival. Failure to recognise these complications in children may result in poorer outcomes and therefore it is vital that clinicians can establish when referral to a paediatric respiratory medicine specialist is required.
Tadalafil versus tamsulosin for distal ureteric stone expulsion; a prospective randomized comparative study
Authors: Ragheb Ahmed M. , Mohamed Ahmed G. , Mostafa Ahmed S. , Abd Elatif Ahmed , Elmarakbi Akram A. , Ibrahim Rabie M. , Elbatanouny Ahmed M.
Published: April 2024

Background

Tamsulosin, an alpha-blocker in medical expulsive therapy, selectively relaxes ureteral smooth muscle, while Tadalafil, a PDE5-Is, is recommended for treating lower urinary tract symptoms.

Methods

This study compares the effectiveness of Tadalafil and Tamsulosin as medical expulsive therapy for distal ureteric stones at the Urology Department, Beni-Suef University Hospital, Egypt, using baseline demographics, preoperative data, intraoperative data, and outcome analysis.

Results

A randomized comparative study that is prospective and was from March 2019 to March 2021. Although 280 instances were eligible, 30 were eliminated & 250 were randomized, and only 164 patients completed the study. 83 patients were in the study Tadalafil group (Group A), 54 males (65.1%) & 29 (34.9%) and 81 patients were assigned to the Tamsulosin group (Group B), 47 males (58%) &34 females made up the Tadalafil group (Group A). The study was completed by 34 females (42%). Additionally, there was a significant difference in the meantime for stone expulsion between groups A (8.8 ± 3.1 days) and B (10.8 ± 3.4 days, (p = 0.001). With fewer episodes of colic, Group A needed less analgesia than Group B.

Conclusions

Tadalafil is a safer and more effective treatment for 5–9 mm lower ureteric end stones, offering a higher stone expulsion rate, earlier passage, lower analgesic requirements, and fewer colic episodes.
Constructing eRNA-mediated gene regulatory networks to explore the genetic basis of muscle and fat-relevant traits in pigs
Authors: Wang Chao , Chen Choulin , Lei Bowen , Qin Shenghua , Zhang Yuanyuan , Li Kui , Zhang Song , Liu Yuwen
Published: April 2024

Background

Enhancer RNAs (eRNAs) play a crucial role in transcriptional regulation. While significant progress has been made in understanding epigenetic regulation mediated by eRNAs, research on the construction of eRNA-mediated gene regulatory networks (eGRN) and the identification of critical network components that influence complex traits is lacking.

Results

Here, employing the pig as a model, we conducted a comprehensive study using H3K27ac histone ChIP-seq and RNA-seq data to construct eRNA expression profiles from multiple tissues of two distinct pig breeds, namely Enshi Black (ES) and Duroc. In addition to revealing the regulatory landscape of eRNAs at the tissue level, we developed an innovative network construction and refinement method by integrating RNA-seq, ChIP-seq, genome-wide association study (GWAS) signals and enhancer-modulating effects of single nucleotide polymorphisms (SNPs) measured by self-transcribing active regulatory region sequencing (STARR-seq) experiments. Using this approach, we unraveled eGRN that significantly influence the growth and development of muscle and fat tissues, and identified several novel genes that affect adipocyte differentiation in a cell line model.

Conclusions

Our work not only provides novel insights into the genetic basis of economic pig traits, but also offers a generalizable approach to elucidate the eRNA-mediated transcriptional regulation underlying a wide spectrum of complex traits for diverse organisms.
Assembly and comparative analysis of the complete multichromosomal mitochondrial genome of Cymbidium ensifolium, an orchid of high economic and ornamental value
Authors: Shen Baoming , Shen Airong , Liu Lina , Tan Yun , Li Sainan , Tan Zhuming
Published: April 2024

Background

Orchidaceae is one of the largest groups of angiosperms, and most species have high economic value and scientific research value due to their ornamental and medicinal properties. In China, Chinese Cymbidium is a popular ornamental orchid with high economic value and a long history. However, to date, no detailed information on the mitochondrial genome of any species of Chinese Cymbidium has been published.

Results

Here, we present the complete assembly and annotation of the mitochondrial genome of Cymbidium ensifolium (L.) Sw. The mitogenome of C. ensifolium was 560,647 bp in length and consisted of 19 circular subgenomes ranging in size from 21,995 bp to 48,212 bp. The genome encoded 35 protein-coding genes, 36 tRNAs, 3 rRNAs, and 3405 ORFs. Repeat sequence analysis and prediction of RNA editing sites revealed a total of 915 dispersed repeats, 162 simple repeats, 45 tandem repeats, and 530 RNA editing sites. Analysis of codon usage showed a preference for codons ending in A/T. Interorganellar DNA transfer was identified in 13 of the 19 chromosomes, with plastid-derived DNA fragments representing 6.81% of the C. ensifolium mitochondrial genome. The homologous fragments of the mitochondrial genome and nuclear genome were also analysed. Comparative analysis showed that the GC content was conserved, but the size, structure, and gene content of the mitogenomes varied greatly among plants with multichromosomal mitogenome structure. Phylogenetic analysis based on the mitogenomes reflected the evolutionary and taxonomic statuses of C. ensifolium. Interestingly, compared with the mitogenomes of Cymbidium lancifolium Hook. and Cymbidium macrorhizon Lindl., the mitogenome of C. ensifolium lost 8 ribosomal protein-coding genes.

Conclusion

In this study, we assembled and annotated the mitogenome of C. ensifolium and compared it with the mitogenomes of other Liliidae and plants with multichromosomal mitogenome structures. Our findings enrich the mitochondrial genome database of orchid plants and reveal the rapid structural evolution of Cymbidium mitochondrial genomes, highlighting the potential for mitochondrial genes to help decipher plant evolutionary history.
Utilize multi-metabolic parameters as determinants for prediction of skeletal muscle mass quality in elderly type2 diabetic Chinese patients
Authors: Chen Huiling , Lou Jingjing , Dong Meiyuan , Liu Xintao , Yan Shijie , Wen Song , Zhou Ligang , Liu Xingdang , Yuan Xinlu
Published: April 2024

Background

Sarcopenia, an age-related disorder characterized by loss of skeletal muscle mass and function, is recently recognized as a complication in elderly patients with type 2 diabetes mellitus (T2DM). Skeletal muscles play a crucial role in glycemic metabolism, utilizing around 80% of blood glucose. Accordingly, we aimed to explore the relationship between glucose metabolism and muscle mass in T2DM.

Methods

We employed the AWGS 2019 criteria for diagnosing low muscle mass and 1999 World Health Organization (WHO) diabetes diagnostic standards. This study included data of 191 individuals aged 60 and above with T2DM of Shanghai Pudong Hospital from November 2021 to November 2022. Fasting C-peptide (FPCP), fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (PPG) and postprandial 2-hour C-peptide (PPCP), glycated hemoglobin A1c (HbA1c), glycated albumin (GA), serum lipids spectrum, renal and hepatic function, hemoglobin, and hormone were measured. Based on the findings of univariate analysis, logistic regression and receiver operating characteristic (ROC) curves were established.

Results

Participants with low muscle mass had significantly lower alanine and aspartate aminotransferase, and both FPCP and PPCP levels (P < 0.05). Compared with those without low muscle mass, low muscle mass group had significantly higher FPG, HbA1c, GA levels (P < 0.05). Body fat (BF, OR = 1.181) was an independent risk factor for low muscle mass. PPCP (OR = 0.497), BMI (OR = 0.548), and female (OR = 0.050) were identified as protective factors for low skeletal muscle. The AUC of BMI was the highest, followed by the PPCP, gender and BF (0.810, 0.675, 0.647, and 0.639, respectively), and the AUC of the combination of the above four parameters reached 0.895.

Conclusions

In this cross-sectional study, BMI, Female, and PPCP associated with T2DM were protective factors for low muscle mass. BF was associated with T2DM and risk factor for low muscle mass.
Factors affecting hand hygiene practice during the COVID-19 pandemic in the Zimbabwean population: a qualitative study
Authors: Midzi Nicholas , Mutsaka-Makuvaza Masceline Jenipher , Charimari Lincoln Sunganai , Mangwiro Priscilla , Manengureni Tonderai , Mugadza Gladys
Published: April 2024

Background

Practicing hand hygiene is recommended as one of the key preventive measures for reducing the transmission of COVID-19 and other infectious agents. However, it is often not practiced frequently enough or correctly by the public. We aimed to identify barriers to and facilitators of hand hygiene in the Zimbabwean population during the COVID-19 pandemic.

Methods

A qualitative study was conducted with a purposive sample of health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected from ten districts across the country from September to October 2022. Semistructured interviews were conducted with 3 key informant interviews per site. In addition, one homogenous focus group discussion was also conducted per site using a focus group discussion guide. The data were recorded on audiotapes, transcribed verbatim, and translated into English. All the analyses were performed manually using thematic analysis.

Results

Two themes were identified as facilitators of hand hygiene. These include individual factors (knowledge of hand hygiene practices and how they are performed) and access-related factors (access to hand washing infrastructure, soap, and sanitizers). Among the barriers to hand hygiene, four themes were identified: individual factors (knowledge gaps in proper hand washing, lack of conviction about hand hygiene, and habitual behaviour), access-related factors (lack of access to hand washing infrastructure, soap, and sanitizers), safety concerns (concern about the side effects of sanitizers), and sociocultural and religious factors (social customs, cultural beliefs, values, and religious practices).

Conclusion

During public health emergencies, there is a need for people to access uninterrupted, on-premises water supplies to promote compliance with hand hygiene. The provision of clean water and hand washing facilities is critical for vulnerable communities to afford them the opportunity to improve quality of life and facilitate resilience in the event of future pandemics. Community engagement is important for identifying vulnerability factors to provide appropriate mitigatory measures.
Caesarean delivery on maternal request: the perspective of the postpartum women
Authors: Muhandule Célia J. L. Sitoe , Benetti Cristine M. S. , Fogulin Laura B. , Bento Silvana F. , Amaral Eliana
Published: April 2024

Background

Caesarean delivery on maternal request (CDMR) is an increasing delivery option among women. As such, we aimed to understand the reasons that led pregnant women to request a caesarean delivery.

Methods

A phenomenological study was conducted with semi-structured interviews, in a convenience sample, for women who had undergone a CDMR between March and June 2023, in a public reference university hospital in Campinas, Brazil. The interviews were recorded, transcribed and subjected to thematic analysis, supported by Nvivo®, and Reshape®.

Results

We interviewed eighteen women between 21 and 43 years of age. The reasons for C-section as their choice were: 1) fear of labour pain, 2) fear for safety due to maternal or fetal risks, 3) traumatic previous birth experiences of the patient, family or friends 4) sense of control, and 5) lack of knowledge about the risks and benefits of C-section.

Conclusions

The perception of C-section as the painless and safest way to give birth, the movement of giving voice and respecting the autonomy of pregnant women, as well as the national regulation, contribute to the increased rates of surgical abdominal delivery under request. Cultural change concerning childbirth and better counseling could support a more adequate informed decision-making about delivery mode.
A nomogram based on the quantitative and qualitative features of CT imaging for the prediction of the invasiveness of ground glass nodules in lung adenocarcinoma
Authors: Yang Yantao , Xu Jing , Wang Wei , Ma Mingsheng , Huang Qiubo , Zhou Chen , Zhao Jie , Duan Yaowu , Luo Jia , Jiang Jiezhi , Ye Lianhua
Published: April 2024

Purpose

Based on the quantitative and qualitative features of CT imaging, a model for predicting the invasiveness of ground-glass nodules (GGNs) was constructed, which could provide a reference value for preoperative planning of GGN patients.

Materials and methods

Altogether, 702 patients with GGNs (including 748 GGNs) were included in this study. The GGNs operated between September 2020 and July 2022 were classified into the training group (n = 555), and those operated between August 2022 and November 2022 were classified into the validation group (n = 193). Clinical data and the quantitative and qualitative features of CT imaging were harvested from these patients. In the training group, the quantitative and qualitative characteristics in CT imaging of GGNs were analyzed by using performing univariate and multivariate logistic regression analyses, followed by constructing a nomogram prediction model. The differentiation, calibration, and clinical practicability in both the training and validation groups were assessed by the nomogram models.

Results

In the training group, multivariate logistic regression analysis disclosed that the maximum diameter (OR = 4.707, 95%CI: 2.06–10.758), consolidation/tumor ratio (CTR) (OR = 1.027, 95%CI: 1.011–1.043), maximum CT value (OR = 1.025, 95%CI: 1.004–1.047), mean CT value (OR = 1.035, 95%CI: 1.008–1.063; P = 0.012), spiculation sign (OR = 2.055, 95%CI: 1.148–3.679), and vascular convergence sign (OR = 2.508, 95%CI: 1.345–4.676) were independent risk parameters for invasive adenocarcinoma. Based on these findings, we established a nomogram model for predicting the invasiveness of GGN, and the AUC was 0.910 (95%CI: 0.885–0.934) and 0.902 (95%CI: 0.859–0.944) in the training group and the validation group, respectively. The internal validation of the Bootstrap method showed an AUC value of 0.905, indicating a good differentiation of the model. Hosmer–Lemeshow goodness of fit test for the training and validation groups indicated that the model had a good fitting effect (P > 0.05). Furthermore, the calibration curve and decision analysis curve of the training and validation groups reflected that the model had a good calibration degree and clinical practicability.

Conclusion

Combined with the quantitative and qualitative features of CT imaging, a nomogram prediction model can be created to forecast the invasiveness of GGNs. This model has good prediction efficacy for the invasiveness of GGNs and can provide help for the clinical management and decision-making of GGNs.
Effectiveness of substance use disorder treatment as an alternative to imprisonment
Authors: Virtanen Suvi , Aaltonen Mikko , Latvala Antti , Forsman Mats , Lichtenstein Paul , Chang Zheng
Published: April 2024

Introduction

Drug courts are criminal justice programs to divert people with substance use disorders from incarceration into treatment. Drug courts have become increasingly popular in the US and other countries. However, their effectiveness in reducing important public health outcomes such as recidivism and substance-related health harms remains ambiguous and contested. We used nationwide register data from Sweden to evaluate the effectiveness of contract treatment sanction, the Swedish version of drug court, in reducing substance misuse, adverse somatic and mental health outcomes, and recidivism.

Methods

In this prospective cohort study, two quasi-experimental designs were used: difference-in-differences and the within-individual design. In the latter, we compared the risk of outcomes during time on contract treatment to, 1) parole after imprisonment and, 2) probation.

Results

The cohort included 11,893 individuals (13% women) who underwent contract treatment. Contract treatment was associated with a reduction of 7 percentage points (95% CI: -.088, -.055) in substance misuse, 5 percentage points (-.064, -.034) in adverse mental health events, 9 percentage points (-.113, -.076) in adverse somatic health events, and 3 fewer charges (-3.16, -2.85) for crime in difference-in-differences analyses. Within-individual associations suggested that the same individual had longer times-to-event for all outcomes during contract treatment than on parole or on probation.

Conclusions

Contract treatment is an effective intervention from both public health and criminal justice perspective. Our findings suggest that it is a superior alternative to incarceration in its target group. Further, we find that an implementation approach that is less punitive and more inclusive than what is typical in the US can be successful.
Association between the COVID-19 pandemic and childhood development aged 30 to 36 months in South Korea, based on the National health screening program for infants and children database
Authors: Lee Kyung-Shin , Choi Youn Young , Kim You Sun , Kim Yeonjae , Kim Myoung-Hee , Lee Nami
Published: April 2024

Background

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the neurodevelopment of children. However, the precise effects of the virus and the social consequences of the pandemic on pediatric neurodevelopment are not yet fully understood. We aimed to compare the neurodevelopment of children between before and during the COVID-19 pandemic, as well as examine the impact of socioeconomic status (SES) and regional differences on the development.

Methods

The study used the Korean Developmental Screening Test to compare the difference in the risk of neurodevelopmental delay between before and during the COVID-19 pandemic. Multivariable logistic regression analysis was conducted to identify the relationship between experiencing the COVID-19 pandemic and the risk of neurodevelopmental delay. Stratified analyses were performed to determine whether the developmental delays caused by the pandemic’s impact varied depending on SES or regional inequality.

Results

This study found an association between the experience of COVID-19 and a higher risk of neurodevelopmental delay in communication (adjusted OR [aOR]: 1.21, 95% confidence interval [CI]: 1.19, 1.22;P-value: < 0.0001) and social interaction (aOR: 1.15, 95% CI: 1.13, 1.17;P-value: < 0.0001) domains among children of 30–36 months’ ages. Notably, the observed association in the Medicaid group of children indicates a higher risk of neurodevelopmental delay compared to those in the non-Medicaid group.

Conclusions

These findings highlight the need to be concerned about the neurodevelopment of children who experienced the COVID-19 pandemic. The study also calls for increased training and support for Medicaid children, parents, teachers, and healthcare practitioners. Additionally, policy programs focused on groups vulnerable to developmental delays are required.
“Bone in the penis” or fasciitis ossificans of the penis – a first time description of a pseudo-tumor at an extraordinary site
Authors: Lenart Sebastian , Koperek Oskar , Scharrer Anke , Comperat Eva
Published: April 2024

Background

Fasciitis ossificans is a rare subtype of nodular fasciitis, a benign soft tissue tumor with reactive characteristics. Due to its rapid growth, it is often misdiagnosed as a malignant tumor. While fasciitis ossificans commonly originates from the subcutaneous tissue and can appear throughout the body, it may also arise from extraordinary sites.

Case presentation

We report the first-ever documented case of fasciitis ossificans arising from the penis in a male patient who presented with a tumor on the glans penis. The tumor was surgically resected due to suspicion of penile cancer. Initial histopathological analysis led to a misdiagnosis of squamous cell carcinoma. However, pathological consultation ultimately confirmed the diagnosis of fasciitis ossificans of the penis originating from the glans penis by demonstrating ossification.

Conclusion

This case underscores the importance of considering fasciitis ossificans in the differential diagnosis of soft tissue tumors, even in unusual locations such as penile soft tissue.
Oral epithelial dysplasia detection and grading in oral leukoplakia using deep learning
Authors: Peng Jiakuan , Xu Ziang , Dan Hongxia , Li Jing , Wang Jiongke , Luo Xiaobo , Xu Hao , Zeng Xin , Chen Qianming
Published: April 2024

Background

The grading of oral epithelial dysplasia is often time-consuming for oral pathologists and the results are poorly reproducible between observers. In this study, we aimed to establish an objective, accurate and useful detection and grading system for oral epithelial dysplasia in the whole-slides of oral leukoplakia.

Methods

Four convolutional neural networks were compared using the image patches from 56 whole-slide of oral leukoplakia labeled by pathologists as the gold standard. Sequentially, feature detection models were trained, validated and tested with 1,000 image patches using the optimal network. Lastly, a comprehensive system named E-MOD-plus was established by combining feature detection models and a multiclass logistic model.

Results

EfficientNet-B0 was selected as the optimal network to build feature detection models. In the internal dataset of whole-slide images, the prediction accuracy of E-MOD-plus was 81.3% (95% confidence interval: 71.4–90.5%) and the area under the receiver operating characteristic curve was 0.793 (95% confidence interval: 0.650 to 0.925); in the external dataset of 229 tissue microarray images, the prediction accuracy was 86.5% (95% confidence interval: 82.4–90.0%) and the area under the receiver operating characteristic curve was 0.669 (95% confidence interval: 0.496 to 0.843).

Conclusions

E-MOD-plus was objective and accurate in the detection of pathological features as well as the grading of oral epithelial dysplasia, and had potential to assist pathologists in clinical practice.
Voices of conference attendees: how should future hybrid conferences be designed?
Authors: Ram Sai Sreenidhi , Stricker Daniel , Pannetier Carine , Tabin Nathalie , Costello Richard W , Stolz Daiana , Eva Kevin W , Huwendiek Sören
Published: April 2024

Background

With conference attendees having expressed preference for hybrid meeting formats (containing both in-person and virtual components), organisers are challenged to find the best combination of events for academic meetings. Better understanding what attendees prioritise in a hybrid conference should allow better planning and need fulfilment.

Methods

An online survey with closed and open-ended questions was distributed to registrants of an international virtual conference. Responses were then submitted to descriptive statistical analysis and directed content analysis.

Results

823 surveys (Response Rate = 4.9%) were received. Of the 813 who expressed a preference, 56.9% (N = 463) desired hybrid conference formats in the future, 32.0% (N = 260) preferred in-person conferences and 11.1% (N = 90) preferred virtual conferences. Presuming a hybrid meeting could be adopted, 67.4% (461/684) preferred that virtual sessions take place both during the in-person conference and be spread throughout the year. To optimise in-person components of hybrid conferences, recommendations received from 503 respondents included: prioritising clinical skills sessions (26.2%, N = 132), live international expert presentations and discussions (15.7%, N = 79) and interaction between delegates (13.5%, N = 68). To optimise virtual components, recommendations received from 486 respondents included: prioritising a live streaming platform with international experts’ presentations and discussions (24.3%, N = 118), clinical case discussions (19.8%, N = 96) and clinical update sessions (10.1%, N = 49).

Conclusions

Attendees envision hybrid conferences in which organisers can enable the vital interaction between individuals during an in-person component (e.g., networking, viewing and improving clinical skills) while accessing virtual content at their convenience (e.g., online expert presentations with latest advancements, clinical case discussions and debates). Having accessible virtual sessions throughout the year, as well as live streaming during the in-person component of hybrid conferences, allows for opportunity to prolong learning beyond the conference days.
A qualitative study on the health system-related needs in women survivors of rape
Authors: Asadi Leila , Noroozi Mahnaz , Salimi Hajar , Jambarsang Sara , Mardani Fardin
Published: April 2024

Background

Rape, as an adverse incidence, leads to irreparable complications and consequences in women. Provision of health services to women survivors of rape requires catering for their real needs and identifying current deficits as well as barriers. The present study aimed to explore health system-related needs in women survivors of rape.

Methods

In the present qualitative study, the participants consisted of 39 individuals, including 19 women survivors of rape and 20 individuals with work experience in providing services to women survivors of rape. The participants were selected using the purposive sampling method with a maximum variation in Isfahan, Iran. Data were collected through in-depth interviews as well as field notes and were concurrently analyzed via conventional qualitative content analysis method.

Results

After analyzing the interviews, the health system-related needs of women survivors of rape were classified into two main categories: 1- The need for efficient medical care services with three sub-categories, namely “receiving services with respect for privacy and confidentiality”, “non-judgmental behavior and approach”, and “the need to receive empathy and the feeling of not being alone”, and 2- The need for desirable conditions and structure to provide services with two sub-categories, namely “the need to receive comprehensive and integrated services”, and “establishing specialized centers for providing services to survivors”.

Conclusions

Overall, explaining and highlighting the health system-related needs of women survivors of rape could provide a suitable basis for policy-making and planning according to their real needs. Receiving continuous services in separate centers with confidentiality and empathy could reduce the worries and concerns of women survivors of rape and help improve their health.
Barriers and facilitators of implementation of new antibacterial technologies in patient care: an interview study with orthopedic healthcare professionals at a university hospital
Authors: Vonken Lieve , de Bruijn Gert-Jan , Noordink Annika , Kremers Stef , Schneider Francine
Published: April 2024

Background

Antimicrobial resistance is a major global health threat. Therefore, promising new antibacterial technologies that could minimize our dependence on antibiotics should be widely adopted. This study aims to identify the barriers and facilitators of the adoption of new antibacterial technologies in hospital patient care.

Methods

Semi-structured interviews, based on the Consolidated Framework for Implementation Research, were conducted with healthcare professionals related to the orthopedics department of an academic hospital in The Netherlands.

Results

In total, 11 healthcare professionals were interviewed. Scientific evidence for the effectiveness of the technology was the most explicitly mentioned facilitator of adoption, but other (often contextual) factors were also considered to be important. At the level of the inner and outer setting, high costs and lacking coverage, competition from other firms, and problems with ordering and availability were the most explicit perceived barriers to adoption. Participants did not collectively feel the need for new antibacterial technologies.

Conclusions

Barriers and facilitators of the adoption of new antibacterial technologies were identified related to the technology, the hospital, and external factors. The implementation climate might have an indirect influence on adoption. New antibacterial technologies that are scientifically proven effective, affordable, and easily obtainable will most likely be adopted.