bluuebunny/crossref_metadata_2025 huggingface dataset:
Augmented Reality for Immersive and Enhanced Medical Education
Authors: Hernandez Olivia K. , Patterson Emily S.
Published: June 2023

It is necessary to educate medical students to prepare them for the healthcare world they will enter upon completion of their training. This pertains to not only the content of the education, but also the experiences during the instruction, and the application of the learning. However, during their time in training, a student will likely not encounter all the ailments that they will while working. This means that their education should be supplemented to help them be better prepared. We propose augmented reality (AR) virtual patients as a method to assist in the delivery of this supplementation. This paper’s focus is on enhancing the usefulness of AR by providing learners with interactions with a variety of virtual patients. The target audience for this topic includes medical educators, medical school students, residents, educators interested in AR, and designers of educational AR systems. The mentioned topics can even apply to continuing education or refresher courses for physicians. A review of aspects that can allow AR to be more immersive and beneficial to those learning about various ailments is provided. Elements of AR for medical education training are discussed to enhance the relevance and applicability of the learning experience. These include presenting multiple simultaneous ailments and the ability to modify AR patient characteristics, which can be accomplished more quickly and with more possibilities than when using manikins.
Screening Technologies to Support Infection Prevention and Control in Long-Term Care
Authors: Wheeler Laura , Attef Maryam , Trudel Chantal , Chan Adrian D.C. , Wallace Bruce
Published: June 2023

Many clinical environments implemented Coronavirus Disease 2019 (COVID-19) screening technologies at entry points to identify and isolate cases. Despite the widespread adoption of screening technologies in vulnerable care settings, such as in long-term care (LTC) homes, implementations and protocols have yet to be thoroughly reviewed in the literature. Therefore, the Dynamic Sustainability Framework was applied to identify the limitations of various screening technology implementations. Based on identified limitations, design recommendations are put forward to support healthcare planning and design teams of long-term care homes, and clinical facilities to improve infection prevention and control (IPC).
Identification of Known Use-Related Problems in Artificial Intelligence Medical Imaging Devices
Authors: Chen Yuhao , Ruan Shihui , Plant Kevin , Du Shimeng
Published: June 2023

As Artificial Intelligence (AI) advances, it is included into more and more medical device systems to carry out these systems’ intended functions. Given AI’s ability to learn from real-world use and its capability to continuously improve performance, manufacturers of medical devices are utilizing AI to innovate their products to better assist health care providers. However, like application of other types of medical devices, the application of AI in medical care might pose different types of potential risks to the patients, the users themselves, and to the use environment. For manufactures to successfully ensure the safety of AI medical devices, it is crucial to identify known problems by investigating use-related, user interface, and user interaction in-cidents that have occurred in comparable medical devices. The objective of this study is to identify potential use-related problems of DeepView® Wound Imaging System that assesses the healing potential of thermal burn wounds by analyzing multispectral images with an ML algorithm. We use a variety of sources of information on reports and recalls of medical devices that are associated with deaths, serious injuries and mal-functions. After examining relevant reports and recalls, 19 use-related problems were identified. An in-depth analysis was then conducted, considering each identified use-related problem and determining how it relates to the specific features and functionality of DeepView® Wound Imaging System as well as identifying patterns and commonalities among them. The information gained from this analysis can be beneficial in enhancing the safety of AI medical devices by providing a deeper understanding of the reasons for failure, to avoid similar issues in the future, and ultimately to improve patient safety and public health.
Weaving viewpoints into healthcare policy
Authors: Arnold Tim , Fuller Helen J.A. , Wilson Darren P.
Published: June 2023

This paper describes a set of approaches for evaluating and designing healthcare policy content. These approaches draw from multiple viewpoints in human factors, systems thinking, safety science, and human-centered design (HCD). Six groupings of approaches drawing from different viewpoints are included that address philosophical underpinnings, policy networks and information systems, embedded references to available expertise, customizable modular elements, usability and HCD, and linguistic considerations. For each grouping, an example is provided along with lessons learned and limitations of each approach. Because these approaches emphasize different vantage points and flexibility in design, they can be useful for inquiring into a variety of policy design considerations. Viewing bodies of policy through these perspectives can help us to address questions about how they support healthcare work and how they may work as a system of policies together towards positive outcomes.
Applying user Experience Principles to Food Distribution in Nursing Homes
Authors: Jones Renee , Montalvo Fernando , Sasser Jordan , Smither Janan A. , McConnell Daniel S.
Published: June 2023

Research on patient experiences within healthcare systems tend to report a variety negative encounters. This can be especially observed in food distribution systems within nursing homes. While nursing homes have various practices and structures that affect a resident’s physical and mental health, the process of food distribution considerably relates to issues of autonomy. Because loss of independence may lead to increased rates of elderly loneliness and depression, mealtimes and the process of food distribution are an integral part of improving a resident’s quality of life and encouraging socialization and self-sufficiency. Moreover, developing patient experiences within food distribution systems, whether centralized or decentralized, will likely improve resident’s autonomy and self-efficacy, reduce frustration, and enhance their overall mental and physical health. The present study utilizes Arhippainen’s User Experience heuristics to identify manners of augmenting patient experiences relating to food distribution in nursing homes by addressing patients’ needs, values, and desires. By utilizing these heuristics, patient experiences and assessments of healthcare systems would become more personalized and fulfilling to the individuals.
From Discovery to Implementation and Interoperability of a New Smart Infusion Pump Designed for Usability and Patient Safety
Authors: Krause Sheryl , Dulak David
Published: June 2023

Clinicians increasingly rely on technology designed for efficiency, ease of use, and patient safety; this is especially true for large volume infusion pumps. Drug Error Reduction Systems administered via smart infusion pumps offer beneficial safety options for intravenous medication administration, though they may increase complexity. Fort HealthCare successfully implemented smart pump technology designed by a new vendor (Ivenix, Inc.), including eventual integration with the electronic health record, in an expedited timeline through continual collaboration with key stakeholders and ongoing quality improvement.
Effectively Incorporating Human Factors into Ocular Device Development
Authors: Pisa Andrea , Fosker Natasha , Quigg Timothy
Published: June 2023

With the growing prevalence of metabolic disorders (Rupenthal, 2019) and the over-60s population set to increase from today’s 10% of the global population to over 20% in 2050 (Gaudana, Jwala, Boddu, & Mitra, 2009), incidence of ocular disease is rising (Royal College of Ophthalmologists, 2018). This is having a significant impact on the demand for ophthalmology care with a 30-40% increase predicted between 2018- 2038 (Royal College of Ophthalmologists, 2018). Together with leading pharmaceutical partners, Crux Product Design have worked on a range of cutting-edge ocular device development programs aimed to provide better outcomes for patients globally. This paper covers the novel approach to Human Factors applied within these programs, demonstrating the value added when going beyond the regulatory minimum and how successful incorporation of these methods starts with team culture, early and regular usability activities and the careful translation of insights into tangible design improvements.
Quality of Life of South Asian Older Adults in Hong Kong: Policy Implications for a Multicultural Active Aging Framework
Authors: Shum Terence Chun Tat
Published: June 2023

In Hong Kong, the number of South Asian (Indian, Pakistani, and Nepalese) older adults is projected to increase. However, academic and policy research in Hong Kong exploring the aging experience among ethnic minority older adults remains scarce. Drawing on in-depth interviews with South Asian older adults in Hong Kong, this paper examines the challenges they face in the economic, health, and social domains to maintain their quality of life in old age. Our analysis illustrates the significant cultural values, family obligations, and ethnic networks that shape the quality of life of South Asians in Hong Kong. These findings can help advance active aging policy in Hong Kong as they examine how to enhance the quality of life and facilitate social integration among ethnic minority older adults in this multicultural society.
Slip and convective flow of Williamson nanofluid influenced by Brownian motion and thermophoresis mechanism in a horizontal microchannel
Authors: Felicita A , Venkatesh P , Gireesha BJ , Krishnamurthy MR
Published: June 2023

The current work is an attempt to explicate the repercussions caused by the transmission of heat as well as mass along with the enhancement of heat transmission for a steady MHD Williamson nano-substance flowing through the microchannel with slip and convective boundary conditions. The consequence of magnetic field and viscous dissipation on the flow is recorded. The simultaneous impact of the two well-known slip-mechanisms Brownian movement and thermophoresis is elaborated explicitly. The governed non-linear systems obtained were illustrated numerically via Runge-Kutta Fehlberg 4–5th order method based on shooting scheme. The pertinent features of assorted parameters have been scrutinized with the aid of graphs. Results reveal that magnetic parameter along with buoyancy ratio parameter was observed to decline the velocity whereas Weissenberg number displays both rising and depleting conduct on velocity. Temperature was reported to boost with Brownian motion and thermophoresis parameter whereas concentration profile declines with the same. Also drag across the enclosures of the microchannel with wall heat flux are computed and studied through graphs.
Competence Attrition: A linguistic theory of the effects of external competence acquisition for organizations
Authors: Guercini Simone , Lechner Christian
Published: June 2023

What happens to old competences in organizations when new competences are acquired? In this paper, we propose a competence attrition theory to explain the effects of acquiring new competences on previously acquired ones. While the presumed positive role of available competences for the acquisition of new competences has been the subject of extensive research, the potentially negative effect of the acquisition of external competences on the availability and use of existing competences has not been sufficiently theorized. We aim to do so by extending existing learning and absorptive capacity theories with insights from linguistics on competence attrition. Specifically, informed by parallel patterns in language acquisition and attrition, we develop a set of focused propositions on competence acquisition and attrition in organizations. We end the paper by discussing the implications of our theorizing for existing theory and research.
Omphalocele: clinical and epidemiological profile of patients born in a tertiary care center in Rio de Janeiro
Authors: Pereira Matheus Sarabion Vilela , Vieira Daniela Koeller Rodrigues , Leite Maria de Fátima M. P. , Villar Maria Auxiliadora Monteiro , Farias Carla Verona Barreto
Published: June 2023

Background

The objective of this paper is to describe the clinical and epidemiological profile and the early outcomes of patients with omphalocele born in a fetal medicine, pediatric surgery, and genetics reference hospital in Rio de Janeiro - Brazil. To determine its prevalence, describe the presence of genetic syndromes, and congenital malformations, emphasizing the characteristics of congenital heart diseases and their most common types.

Methods

Using Latin-American Collaborative Study of Congenital Malformations (ECLAMC) database and records review, a retrospective cross-sectional study was performed, including all patients born with omphalocele between January 1st, 2016, and December 31st, 2019.

Results

During the period of the study, our unity registered 4,260 births, 4,064 were live births and 196 stillbirths. There were 737 diagnoses of any congenital malformation, among them 38 cases of omphalocele, 27 were live born, but one was excluded for missing data. 62.2% were male, 62.2% of the women were multiparous and 51.3% of the babies were preterm. There was an associated malformation in 89.1% of the cases. Heart disease was the most common (45.9%) of which tetralogy of Fallot was the most frequent (23.5%). Mortality rate was 61.5%.

Conclusions

Our data showed a good correspondence with the existing literature. Most patients with omphalocele had other malformations, especially congenital heart disease. No pregnancy was interrupted. The presence of concurrent defects showed a huge impact on prognosis, since, even if most survived birth, few remained alive and received hospital discharge. Based on these data, fetal medicine and neonatal teams must be able to adjust parents counseling about fetal and neonatal risks, especially when other congenital diseases are present.
Do mindfulness-based interventions change brain function in people with substance dependence? A systematic review of the fMRI evidence
Authors: Lorenzetti Valentina , Gaillard Alexandra , Beyer Emillie , Kowalczyk Magdalena , Kamboj Sunjeev K. , Manning Victoria , Gleeson John
Published: June 2023

Background

Substance use disorders (SUDs) affect ~ 35 million people globally and are associated with strong cravings, stress, and brain alterations. Mindfulness-based interventions (MBIs) can mitigate the adverse psychosocial outcomes of SUDs, but the underlying neurobiology is unclear. Emerging findings were systematically synthesised from fMRI studies about MBI-associated changes in brain function in SUDs and their associations with mindfulness, drug quantity, and craving.

Methods

PsycINFO, Medline, CINAHL, PubMed, Scopus, and Web of Science were searched. Seven studies met inclusion criteria.

Results

Group by time effects indicated that MBIs in SUDs (6 tobacco and 1 opioid) were associated with changes in the function of brain pathways implicated in mindfulness and addiction (e.g., anterior cingulate cortex and striatum), which correlated with greater mindfulness, lower craving and drug quantity.

Conclusions

The evidence for fMRI-related changes with MBI in SUD is currently limited. More fMRI studies are required to identify how MBIs mitigate and facilitate recovery from aberrant brain functioning in SUDs.
Identifying labour market pathways after a 30-day-long sickness absence –a three-year sequence analysis study in Finland
Authors: Perhoniemi Riku , Blomgren Jenni , Laaksonen Mikko
Published: June 2023

Background

Return-to-work (RTW) process often includes many phases. Still, multi-state analyses that follow relevant labour market states after a long-term sickness absence (LTSA), and include a comprehensive set of covariates, are scarce. The goal of this study was to follow employment, unemployment, sickness absence, rehabilitation, and disability pension spells using sequence analysis among all-cause LTSA absentees.

Methods

Register data covered full-time and partial sickness allowance, rehabilitation, employment, unemployment benefits, and permanent and temporary disability pension (DP), retrieved for a 30% representative random sample of Finnish 18–59 years old persons with a LTSA in 2016 (N = 25,194). LTSA was defined as a ≥ 30-day-long full-time sickness absence spell. Eight mutually exclusive states were constructed for each person and for 36 months after the LTSA. Sequence analysis and clustering were used to identify groups with different labour market pathways. In addition, demographic, socioeconomic, and disability-related covariates of these clusters were examined using multinomial regressions.

Results

We identified five clusters with emphases on the different states: (1) rapid RTW cluster (62% of the sample); (2) rapid unemployment cluster (9%); (3) DP after a prolonged sickness absence cluster (11%); (4) immediate or late rehabilitation cluster (6%); (5) other states cluster (6%). Persons with a rapid RTW (cluster 1) had a more advantaged background than other clusters, such as a higher frequency of employment and less chronic diseases before LTSA. Cluster 2 associated especially with pre-LTSA unemployment and lower pre-LTSA earnings. Cluster 3 was associated especially with having a chronic illness before LTSA. Those in cluster 4 were on average younger and had a higher educational level than others. Especially clusters 3 and 4 were associated with a LTSA based on mental disorders.

Conclusions

Among long-term sickness absentees, clear groups can be identified with both differing labour market pathways after LTSA and differing backgrounds. Lower socioeconomic background, pre-LTSA chronic diseases and LTSA caused by mental disorders increase the likelihood for pathways dominated by long-term unemployment, disability pensioning and rehabilitation rather than rapid RTW. LTSA based on a mental disorder can especially increase the likelihood for entering rehabilitation or disability pension.
Sociodemographic inequalities in mortality from drowning in the Baltic countries and Finland in 2000–2015: a register-based study
Authors: Stickley Andrew , Baburin Aleksei , Jasilionis Domantas , Krumins Juris , Martikainen Pekka , Kondo Naoki , Shin Jae Il , Inoue Yosuke , Leinsalu Mall
Published: June 2023

Background

Drowning is an important public health problem. Some evidence suggests that the risk of drowning is not distributed evenly across the general population. However, there has been comparatively little research on inequalities in drowning mortality. To address this deficit, this study examined trends and sociodemographic inequalities in mortality from unintentional drowning in the Baltic countries and Finland in 2000–2015.

Methods

Data for Estonia, Latvia and Lithuania came from longitudinal mortality follow-up studies of population censuses in 2000/2001 and 2011, while corresponding data for Finland were obtained from the longitudinal register-based population data file of Statistics Finland. Deaths from drowning (ICD-10 codes W65–W74) were obtained from national mortality registries. Information was also obtained on socioeconomic status (educational level) and urban-rural residence. Age-standardised mortality rates (ASMRs) per 100 000 person years and mortality rate ratios were calculated for adults aged 30–74 years old. Poisson regression analysis was performed to assess the independent effects of sex, urban-rural residence and education on drowning mortality.

Results

Drowning ASMRs were significantly higher in the Baltic countries than in Finland but declined by nearly 30% in all countries across the study period. There were large inequalities by sex, urban-rural residence and educational level in all countries during 2000–2015. Men, rural residents and low educated individuals had substantially higher drowning ASMRs compared to their counterparts. Absolute and relative inequalities were significantly larger in the Baltic countries than in Finland. Absolute inequalities in drowning mortality declined in all countries across the study period except between urban and rural residents in Finland. Changes in relative inequalities were more variable during 2000–2015.

Conclusion

Despite a sharp reduction in deaths from drowning in the Baltic countries and Finland in 2000–2015, drowning mortality was still high in these countries at the end of the study period with a substantially larger risk of death seen among men, rural residents and low educated individuals. A concerted effort to prevent drowning mortality among those most at risk may reduce drownings considerably in the general population.
Remote learning and mental health during the societal lockdown: a study of primary school students and parents in times of COVID-19
Authors: Ye Frank Tian-Fang , Gao Xiaozi , Sin Kuen-Fung , Yang Lan
Published: June 2023

Background

The COVID-19 pandemic has brought challenges to families around the world. The prolonged school closures in Hong Kong have forced young students to stay at home and adapt to remote learning for over a year, putting their mental health conditions at risk. Focusing on primary school students and their parents, the main objective of our research is to investigate the socioemotional factors and their associations with mental health conditions.

Methods

A total of 700 Hong Kong primary schoolers (mean age = 8.2) reported their emotional experiences, loneliness, and academic self-concept via a user-friendly online survey; 537 parents reported depression and anxiety, perceived child depression and anxiety, and social support. Responses from students and parents were paired to account for the family context. Structural Equation Modeling was used for correlations and regressions.

Results

The results of students’ responses showed that positive emotional experiences were negatively associated with loneliness and positively related to academic self-concept among students. Furthermore, the paired sample results showed that, during the one-year societal lockdown and remote learning period, the socioemotional factors were associated with mental health conditions among primary school students and their parents. Among our family sample in Hong Kong, evidence supports the unique negative association between students-reported positive emotional experiences and parents-reported child depression and anxiety, as well as between social support and parents’ depression and anxiety.

Conclusions

These findings highlighted the associations between socioemotional factors and mental health among young primary schoolers during the societal lockdown. We thus call for more attention to the societal lockdown and remote learning context, especially since the social distancing practice could be “the new normal” for our society to handle the future pandemic crisis.
Do the instruments used to assess fibromyalgia symptoms according to American College of Rheumatology criteria generate similar scores in other chronic musculoskeletal pain?
Authors: Pontes-Silva André , de Sousa Ana Paula , Dibai-Filho Almir Vieira , de Souza Marcelo Cardoso , DeSantana Josimari Melo , Avila Mariana Arias
Published: June 2023

Background

As with fibromyalgia, several musculoskeletal disorders are characterized by chronic pain, raising a clinical question – do the instruments used to assess fibromyalgia symptoms according to ACR criteria (ACR criteria) generate similar scores in other chronic musculoskeletal pain?

Objective

To compare the symptoms among fibromyalgia and other chronic musculoskeletal pain. Additionally, we also compared the most researched outcomes in fibromyalgia (i.e., present pain at rest and after movement; fatigue; pain severity and impact; function, global impact, and fibromyalgia symptom).

Methods

A cross-sectional study. Participants over 18 years old were included if they presented report of chronic musculoskeletal pain (≥ 3 months) and after that, they were divided into two groups (fibromyalgia and chronic pain). They answered the Fibromyalgia Impact Questionnaire-Revised (FIQ-R), Brief Pain Inventory (BPI), Numerical Pain Rating Scale (NPRS) for pain and fatigue, WPI, and SSS.

Results

A total of 166 participants were included in this study into two independent groups (chronic pain, n = 83; fibromyalgia, n = 83). We observed significant differences (p < 0.05) and large effect sizes (Cohen’s d, ≥ 0.7) in clinical outcomes comparisons between groups (i.e., widespread pain; symptom severity; present pain at rest and after movement; fatigue; pain severity and impact; function, global impact, and fibromyalgia symptoms).

Conclusion

Fibromyalgia patients (2016 ACR criteria) compared to other chronic musculoskeletal pain patients have higher levels of pain (at rest or after movement) and fatigue, greater impairment in both functionality and global impact, and worse symptoms. Therefore, the WPI and SSS instruments should be used exclusively to assess fibromyalgia symptoms.
Association of oral status with frailty among older adults in nursing homes: a cross-sectional study
Authors: Liu Siyue , Guo Yicong , Hu Zhao , Zhou Feixiang , Li Shaojie , Xu Huilan
Published: June 2023

Background

The oral status of an individual is a vital aspect of their overall health. However, older adults in nursing homes have a higher prevalence of frailty and poor oral health, particularly in the context of global aging. The objective of this study is to explore the association between oral status and frailty among older adults residing in nursing homes.

Methods

The study involved 1280 individuals aged 60 and above from nursing homes in Hunan province, China. A simple frailty questionnaire (FRAIL scale) was used to evaluate physical frailty, while the Oral Health Assessment Tool was used to assess oral status. The frequency of tooth brushing was classified as never, once a day, and twice or more a day. The traditional multinomial logistic regression model was used to analyze the association between oral status and frailty. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated while controlling for other confounding factors.

Results

The study found that the prevalence of frailty among older adults living in nursing homes was 53.6%, while the prevalence of pre-frailty was 36.3%. After controlling for all potential confounding factors, mouth changes requiring monitoring (OR = 2.10, 95% CI = 1.34–3.31, P = 0.001) and unhealthy mouth (OR = 2.55, 95% CI = 1.61–4.06, P < 0.001) were significantly associated with increased odds of frailty among older adults in nursing homes. Similarly, both mouth changes requiring monitoring (OR = 1.91, 95% CI = 1.20–3.06, P = 0.007) and unhealthy mouth (OR = 2.24, 95% CI = 1.39–3.63, P = 0.001) were significantly associated with a higher prevalence of pre-frailty. Moreover, brushing teeth twice or more times a day was found to be significantly associated with a lower prevalence of both pre-frailty (OR = 0.55, 95% CI = 0.34–0.88, P = 0.013) and frailty (OR = 0.50, 95% CI = 0.32–0.78, P = 0.002). Conversely, never brushing teeth was significantly associated with higher odds of pre-frailty (OR = 1.82, 95% CI = 1.09–3.05, P = 0.022) and frailty (OR = 1.74, 95% CI = 1.06–2.88, P = 0.030).

Conclusions

Mouth changes that require monitoring and unhealthy mouth increase the likelihood of frailty among older adults in nursing homes. On the other hand, those who brush their teeth frequently have a lower prevalence of frailty. However, further research is needed to determine whether improving the oral status of older adults can change their level of frailty.
Reply to “A better interpretation of data regarding the opioid switching to methadone”
Authors: Ding Haiying , Song Yu , Xin Wenxiu , Sun Jiao , Zhong Like , Zhou Qinfei , He Chaoneng , Gong Liyan , Fang Luo
Published: June 2023

In our article ?Methadone switching for refractory cancer pain’ (BMC palliative care, 2022) we explore the efficacy, safety and economics of methadone in treatment of patients with refractory cancer pain in China. Professor Mercadante provided a better interpretation of data regarding the opioid switching to methadone in the Matters Arising. In this article, we answered the questions in Mercadante et al.’s comments one by one.
Influencing factors of knowledge, attitude and behavior in children’s palliative care among pediatric healthcare workers: a cross-sectional survey in China
Authors: Zhu Lihui , Zhang Na , Hu Yaojia , Xu Yi , Luo Tingwei , Xiang Yuqiong , Jiang Sishan , Zhang Zhiqiang , Chen Muhua , Xiong Yuee
Published: June 2023

Background

Palliative care has become a key medical field worldwide. Although research relating to adult palliative care is well-established, less is known about children’s palliative care (CPC). Therefore, this study investigated the knowledge, attitude and behavior of pediatric healthcare workers (PHWs) regarding CPC and analyzed the influencing factors for the implementation and development of CPC.

Methods

A cross-sectional survey of 407 PHWs was carried out in a Chinese province from November 2021 to April 2022. The questionnaire consisted of two parts: a general information form and questions on the knowledge, attitude and behavior of PHWs about CPC. Data were analyzed using t-test, ANOVA and multiple regression analysis.

Results

The total score of the PHWs’ knowledge, attitude and behavior about CPC was 69.98, which was at a moderate level. PHWs’ CPC knowledge, attitude, and behavior are positively correlated.The most important influencing factors were working years, highest education, professional title, job position, marital status, religion, grade of hospital (I, II or III), type of medical institution, experience of caring for a terminally ill child/kinsfolk and total hours of CPC education and training received.

Conclusions

In this study, PHWs in a Chinese province had the lowest scores on the knowledge dimension of CPC, with moderate attitude and behavior and various influencing factors. In addition to professional title, highest education and working years, it is also worth noting that the type of medical institution and marital status also affected the score. Continuing education and training of PHWs in CPC should be emphasized by the administrators of relevant colleges and medical institutions. Future research should start with the above-mentioned influencing factors and focus on setting up targeted training courses and evaluating the post-training effects.
The impact of clinical placement site, community clinic versus tertiary hospital, on midwifery students’ clinical learning experience in Sierra Leone: a cohort study
Authors: Mann Julie , Brooks Meredith B. , Kella Frederica , Euller Laura , Adelman Sara , Sonnie Mustapha , van de Water Brittney
Published: June 2023

Background

In midwifery education, the clinical learning experience (CLE) is a critical component to gaining competency and should comprise greater than 50% of a student’s education. Many studies have identified positive and negative factors affecting students’ CLE. However, few studies have directly compared the difference in CLE based on placement at a community clinic versus a tertiary hospital.

Methods

The aim of this study was to examine how clinical placement site, clinic or hospital, impacts students’ CLE in Sierra Leone. A once 34-question survey was given to midwifery students attending one of four public midwifery schools in Sierra Leone. Median scores were compared for survey items by placement site using Wilcoxon tests. The relationship between clinical placement and student’s experience were assessed using multilevel logistic regression.

Results

Two-hundred students (hospitals students = 145 (72.5%); clinic students = 55 (27.5%) across Sierra Leone completed surveys. Most students (76%, n = 151) reported satisfaction with their clinical placement. Students placed at clinics were more satisfied with opportunities to practice/develop skills (p = 0.007) and more strongly agreed preceptors treated them with respect (p = 0.001), helped improve their skills (p = 0.001), provided a safe environment to ask questions (p = 0.002), and had stronger teaching/mentorship skills (p = 0.009) than hospital students. Students placed at hospitals had greater satisfaction in exposure to certain clinical opportunities including completing partographs (p < 0.001); perineal suturing (p < 0.001); drug calculations/administration (p < 0.001) and estimation of blood loss (p = 0.004) compared to clinic students. The odds of students spending more than 4 h per day in direct clinical care were 5.841 (95% CI: 2.187–15.602) times higher for clinic students versus hospital students. There was no difference between clinical placement sites in regards to number of births students attended (OR 0.903; 95% CI: 0.399, 2.047) or number of births students managed without a preceptor/clinician present (OR 0.729; 95% CI: 0.285, 1.867).

Conclusion

The clinical placement site, hospital or clinic, impacts midwifery students’ CLE. Clinics offered students significantly greater attributes of a supportive learning environment and access to direct, hands-on opportunities for patient care. These findings may be helpful for schools when using limited resources to improve the quality of midwifery education.
Correlated cryo-SEM and CryoNanoSIMS imaging of biological tissue
Authors: Meibom Anders , Plane Florent , Cheng Tian , Grandjean Gilles , Haldimann Olivier , Escrig Stephane , Jensen Louise , Daraspe Jean , Mucciolo Antonio , De Bellis Damien , Rädecker Nils , Martin-Olmos Cristina , Genoud Christel , Comment Arnaud
Published: June 2023

Background

The development of nanoscale secondary ion mass spectrometry (NanoSIMS) has revolutionized the study of biological tissues by enabling, e.g., the visualization and quantification of metabolic processes at subcellular length scales. However, the associated sample preparation methods all result in some degree of tissue morphology distortion and loss of soluble compounds. To overcome these limitations an entirely cryogenic sample preparation and imaging workflow is required.

Results

Here, we report the development of a CryoNanoSIMS instrument that can perform isotope imaging of both positive and negative secondary ions from flat block-face surfaces of vitrified biological tissues with a mass- and image resolution comparable to that of a conventional NanoSIMS. This capability is illustrated with nitrogen isotope as well as trace element mapping of freshwater hydrozoan Green Hydra tissue following uptake of 15N-enriched ammonium.

Conclusion

With a cryo-workflow that includes vitrification by high pressure freezing, cryo-planing of the sample surface, and cryo-SEM imaging, the CryoNanoSIMS enables correlative ultrastructure and isotopic or elemental imaging of biological tissues in their most pristine post-mortem state. This opens new horizons in the study of fundamental processes at the tissue- and (sub)cellular level.

Teaser

CryoNanoSIMS: subcellular mapping of chemical and isotopic compositions of biological tissues in their most pristine post-mortem state.
Improving clinical suspicion of acute mesenteric ischemia among patients with acute abdomen: a cross-sectional study from an intestinal stroke center
Authors: Nuzzo Alexandre , Peoc’h Katell , Vaittinada Ayar Prabakar , Tran-Dinh Alexy , Weiss Emmanuel , Panis Yves , Ronot Maxime , Garzelli Lorenzo , Eloy Philippine , Ben Abdallah Iannis , Castier Yves , Corcos Olivier
Published: June 2023

Background

Early diagnosis of acute mesenteric ischemia (AMI) is essential for a favorable outcome. Selection of patients requiring a dedicated multiphasic computed tomography (CT) scan remains a clinical challenge.

Methods

In this cross-sectional diagnostic study conducted from 2016 to 2018, we compared the presentation of AMI patients admitted to an intestinal stroke center to patients with acute abdominal pain of another origin admitted to the emergency room (controls).

Results

We included 137 patients—52 with AMI and 85 controls. Patients with AMI [median age: 65 years (interquartile range 55–74)] had arterial and venous AMI in 65% and 35% of cases, respectively. Relative to controls, AMI patients were significantly older, more likely to have risk factors or a history of cardiovascular disease, and more likely to present with sudden-onset and morphine-requiring abdominal pain, hematochezia, guarding, organ dysfunction, higher white blood cell and neutrophil counts, and higher plasma C-reactive protein (CRP) and procalcitonin concentrations. On multivariate analysis, two independent factors were associated with the diagnosis of AMI: the sudden-onset (OR = 20, 95%CI 7–60, p < 0.001) and the morphine-requiring nature of the acute abdominal pain (OR = 6, 95%CI 2–16, p = 0.002). Sudden-onset and/or morphine-requiring abdominal pain was present in 88% of AMI patients versus 28% in controls (p < 0.001). The area under the receiver operating characteristic curve for the diagnosis of AMI was 0.84 (95%CI 0.77–0.91), depending on the number of factors.

Conclusions

Sudden onset and the need for morphine are suggestive of AMI in patients with acute abdominal pain and should prompt multiphasic CT scan including arterial and venous phase images for confirmation.
Whose knowledge counts? Involving communities in intervention and trial design using community conversations
Authors: Burgess Rochelle A. , Shittu Funmilayo , Iuliano Agnese , Haruna Ibrahim , Valentine Paula , Bakare Ayobami Adebayo , Colbourn Tim , Graham Hamish R. , McCollum Eric D. , Falade Adegoke G. , King Carina ,   on behalf of the INSPIRING Project Consortium, Ahmed Tahlil , Ahmar Samy , Cassar Christine , Isah Adamu , Osebi Adams , Magama Abdullahi , Seriki Ibrahim , Olowookere Temitayo Folorunso , McCalla Matt , Uchendu Obioma , Salako Julius , Bakare Damola , Olojede Omotayo
Published: June 2023

Background

Current debates in Global Health call for expanding methodologies to allow typically silenced voices to contribute to processes of knowledge production and intervention design. Within trial research, this has typically involved small-scale qualitative work, with limited opportunities for citizens to contribute to the structure and nature of the trial. This paper reports on efforts to move past typical formative trial work, through adaptation of community conversations (CCs) methodology, an action-oriented approach that engages large numbers of community members in dialogue. We applied the CC method to explore community perspectives about pneumonia and managing the health of children under-5 in Northern Nigeria to inform our pragmatic cluster randomised controlled trial evaluating a complex intervention to reduce under-5 mortality in Nigeria.

Methods

We conducted 12 rounds of community conversations with a total of 320 participants, in six administrative wards in Kiyawa Local Government Area, Jigawa state, our intervention site. Participants were male and female caregivers of children under five. Conversations were structured around participatory learning and action activities, using drawings and discussion to reduce barriers to entry. During activities participants were placed in subgroups: younger women (18–30 years of age), older women (31–49 years) and men (18 years above). Discussions were conducted over three 2-h sessions, facilitated by community researchers. Following an initial analysis to extract priority issues and perspectives on intervention structure, smaller focus group discussions were completed with participants in five new sites to ensure all 11 administrative wards in our study site contributed to the design.

Results

We identified enabling and limiting factors which could shape the future trial implementation, including complex power relationships within households and wider communities shaping women’s health decision-making, and the gendered use of space. We also noted the positive engagement of participants during the CC process, with many participants valuing the opportunity to express themselves in ways they have not been able to in the past.

Conclusions

CCs provide a structured approach to deep meaningful engagement of everyday citizens in intervention and trial designs, but require appropriate resources, and commitment to qualitative research in trials.

Trial registration

ISRCTN39213655. Registered on 11 December 2019.
Not every estimate counts – evaluation of cell composition estimation approaches in brain bulk tissue data
Authors: Toker Lilah , Nido Gonzalo S. , Tzoulis Charalampos
Published: June 2023

Background

Variation in cell composition can dramatically impact analyses in bulk tissue samples. A commonly employed approach to mitigate this issue is to adjust statistical models using estimates of cell abundance derived directly from omics data. While an arsenal of estimation methods exists, the applicability of these methods to brain tissue data and whether or not cell estimates can sufficiently account for confounding cellular composition has not been adequately assessed.

Methods

We assessed the correspondence between different estimation methods based on transcriptomic (RNA sequencing, RNA-seq) and epigenomic (DNA methylation and histone acetylation) data from brain tissue samples of 49 individuals. We further evaluated the impact of different estimation approaches on the analysis of H3K27 acetylation chromatin immunoprecipitation sequencing (ChIP-seq) data from entorhinal cortex of individuals with Alzheimer’s disease and controls.

Results

We show that even closely adjacent tissue samples from the same Brodmann area vary greatly in their cell composition. Comparison across different estimation methods indicates that while different estimation methods applied to the same data produce highly similar outcomes, there is a surprisingly low concordance between estimates based on different omics data modalities. Alarmingly, we show that cell type estimates may not always sufficiently account for confounding variation in cell composition.

Conclusions

Our work indicates that cell composition estimation or direct quantification in one tissue sample should not be used as a proxy to the cellular composition of another tissue sample from the same brain region of an individual—even if the samples are directly adjacent. The highly similar outcomes observed among vastly different estimation methods, highlight the need for brain benchmark datasets and better validation approaches. Finally, unless validated through complementary experiments, the interpretation of analyses outcomes based on data confounded by cell composition should be done with great caution, and ideally avoided all together.
Recent advances in pre-conditioned mesenchymal stem/stromal cell (MSCs) therapy in organ failure; a comprehensive review of preclinical studies
Authors: Kahrizi Mohammad Saeed , Mousavi Elnaz , Khosravi Armin , Rahnama Sara , Salehi Ali , Nasrabadi Navid , Ebrahimzadeh Farnoosh , Jamali Samira
Published: June 2023

Mesenchymal stem/stromal cells (MSCs)‐based therapy brings the reassuring capability to regenerative medicine through their self‐renewal and multilineage potency. Also, they secret a diversity of mediators, which are complicated in moderation of deregulated immune responses, and yielding angiogenesis in vivo. Nonetheless, MSCs may lose biological performance after procurement and prolonged expansion in vitro. Also, following transplantation and migration to target tissue, they encounter a harsh milieu accompanied by death signals because of the lack of proper tensegrity structure between the cells and matrix. Accordingly, pre-conditioning of MSCs is strongly suggested to upgrade their performances in vivo, leading to more favored transplantation efficacy in regenerative medicine. Indeed, MSCs ex vivo pre-conditioning by hypoxia, inflammatory stimulus, or other factors/conditions may stimulate their survival, proliferation, migration, exosome secretion, and pro-angiogenic and anti-inflammatory characteristics in vivo. In this review, we deliver an overview of the pre-conditioning methods that are considered a strategy for improving the therapeutic efficacy of MSCs in organ failures, in particular, renal, heart, lung, and liver.
TRPA1 promotes the maturation of embryonic stem cell-derived cardiomyocytes by regulating mitochondrial biogenesis and dynamics
Authors: Ding Qianqian , Liu Xianji , Qi Yanxiang , Yao Xiaoqiang , Tsang Suk Ying
Published: June 2023

Background

Cardiomyocytes derived from pluripotent stem cells (PSC-CMs) have been widely accepted as a promising cell source for cardiac drug screening and heart regeneration therapies. However, unlike adult cardiomyocytes, the underdeveloped structure, the immature electrophysiological properties and metabolic phenotype of PSC-CMs limit their application. This project aimed to study the role of the transient receptor potential ankyrin 1 (TRPA1) channel in regulating the maturation of embryonic stem cell-derived cardiomyocytes (ESC-CMs).

Methods

The activity and expression of TRPA1 in ESC-CMs were modulated by pharmacological or molecular approaches. Knockdown or overexpression of genes was done by infection of cells with adenoviral vectors carrying the gene of interest as a gene delivery tool. Immunostaining followed by confocal microscopy was used to reveal cellular structure such as sarcomere. Staining of mitochondria was performed by MitoTracker staining followed by confocal microscopy. Calcium imaging was performed by fluo-4 staining followed by confocal microscopy. Electrophysiological measurement was performed by whole-cell patch clamping. Gene expression was measured at mRNA level by qPCR and at protein level by Western blot. Oxygen consumption rates were measured by a Seahorse Analyzer.

Results

TRPA1 was found to positively regulate the maturation of CMs. TRPA1 knockdown caused nascent cell structure, impaired Ca2+ handling and electrophysiological properties, and reduced metabolic capacity in ESC-CMs. The immaturity of ESC-CMs induced by TRPA1 knockdown was accompanied by reduced mitochondrial biogenesis and fusion. Mechanistically, we found that peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), the key transcriptional coactivator related to mitochondrial biogenesis and metabolism, was downregulated by TRPA1 knockdown. Interestingly, overexpression of PGC-1α ameliorated the halted maturation induced by TRPA1 knockdown. Notably, phosphorylated p38 MAPK was upregulated, while MAPK phosphatase-1 (MKP-1), a calcium-sensitive MAPK inhibitor, was downregulated in TRPA1 knockdown cells, suggesting that TRPA1 may regulate the maturation of ESC-CMs through MKP-1-p38 MAPK-PGC-1α pathway.

Conclusions

Taken together, our study reveals the novel function of TRPA1 in promoting the maturation of CMs. As multiple stimuli have been known to activate TRPA1, and TRPA1-specific activators are also available, this study provides a novel and straightforward strategy for improving the maturation of PSC-CMs by activating TRPA1. Since a major limitation for the successful application of PSC-CMs for research and medicine lies in their immature phenotypes, the present study takes a big step closer to the practical use of PSC-CMs.

Graphical abstract