bluuebunny/crossref_metadata_2025 huggingface dataset:
Reversing expansion of Calamagrostis epigejos in Carpathian mountain grasslands by mowing and application of hemiparasitic Rhinanthus alectorolophus
Authors: Galvánek Dobromil , Uhliarová Eva , Ujházy Karol , Ujházyová Mariana , Janišová Monika , Těšitel Jakub
Published: May 2024

Questions

The expansion of Calamagrostis epigejos poses a significant threat to the biodiversity of mountain grasslands. We asked whether grasslands dominated by C. epigejos can be restored through mowing and the application of hemiparasitic Rhinanthus alectorolophus.

Location

Carpathian Violion caninae alliance mountain grassland close to Vrchslatina, Veporské vrchy Mts, Slovakia.

Methods

We conducted a before–after control–impact experiment in a grassland entirely dominated by C. epigejos: six blocks, each with four treatment combinations: (i) mowing once in summer, (ii) mowing in summer and autumn, (iii) mowing in summer and seed sowing of R. alectorolophus, (iv) mowing in summer and autumn along with seed sowing of R. alectorolophus. We monitored the above‐ground biomass of C. epigejos, R. alectorolophus, the combined above‐ground biomass of other species, and the vegetation composition annually from 2014 to 2017. Linear mixed‐effect models and redundancy analysis (RDA) were employed to analyze the effects of the treatments on C. epigejos and community parameters.

Results

Sowing established R. alectorolophus at the plots mown twice in the first year, but its density strongly declined in subsequent years. R. alectorolophus and mowing twice significantly reduced C. epigejos biomass and herb layer cover. They also increased community evenness and the ratio between other species and C. epigejos biomass with a more pronounced effect on the plots where R. alectorolophus was applied. Mowing twice led to increased species richness, evenness, the number of target grassland species and their proportion in the community. R. alectorolophus had an additional positive impact on community evenness and the proportion of target species. RDA identified R. alectorolophus as the main driver of the directional community change triggered by the experimental treatments.

Conclusion

Mowing twice per season proves to be an efficient restoration management strategy for mountain grasslands dominated by C. epigejos. Sowing R. alectorolophus, however, may be employed as an additional measure to accelerate the decline of C. epigejos at the outset of the restoration process and enhance community structure and composition.
Characteristic morphology and immunohistochemical patterns of clear cell papillary renal cell tumours may be observed in renal cell carcinomas, a critical pitfall in renal biopsy cytopathology
Authors: Lin Xiaoqi
Published: May 2024

Background

Clear cell papillary renal cell tumour (CCPRCT) was renamed from previous clear cell papillary renal cell carcinoma (CCPRCC) in the latest WHO Classification of Tumours. It is essential to differentiate RCC from CCPRCT in renal mass biopsies (RMB).

Design

RMB cases with subsequent resections were reviewed. The pathology reports and pertinent clinical information were recorded.

Results

Fifteen cases displaying either CCPRCT morphology (20% diffuse, 67% focal) or immunohistochemical patterns (cup‐like CA9: 20% diffuse, 47% focal; CK7: 33% diffuse, 40% focal) were identified. One case was positive for TFE3. TSC mutation was identified in one case. Both cases exhibited both CCPRCT morphology and immunohistochemical patterns for CA9 and CK7, with focal high‐grade nuclei. RMB diagnoses were as follows: 6 (40%) as CCRCC, 2 (13%) as CCPRCT, 2 (13%) as CCRCC versus CCPRCT, 2 (13%) as CCRCC versus PRCC, 1 (7%) as RCC with TSC mutation versus CCPRCT, 1 (7%) as TFE3‐rearranged RCC versus PRCC, and 1 (7%) as cyst with low‐grade atypia. 71% of patients underwent nephrectomy, 21% received systemic treatment for stage 4 RCCs, and 7% with ablation for small renal mass (1.6 cm) with low‐grade CCRCC.

Conclusions

Our study highlights that morphologic and immunochemical features of CCPRCT may be present in RCCs, including RCC‐TFE3 expression and TSC‐associated RCC, a critical pitfall to misdiagnose aggressive RCC as indolent CCPRCT and result in undertreatment. Careful examination of morphology and immunostains for CA9, CK7, and TFE3, as well as molecular tests, is crucial for distinguishing aggressive RCC from indolent CCPRCT.
Toward a phenomenology of politics: Vulnerability, autonomy, and the making of “hard” corporeal selves in Chile's migrant campamentos
Authors: Seward Delaporte Pablo
Published: May 2024

How do people experience vulnerability, and what can this experience tell us about how states help those living in precarious conditions? According to the Chilean state, people who live in vulnerable encampments do so strictly out of necessity, not choice, and vulnerability is best addressed by demolishing encampments, resettling their communities, and giving the poor opportunities to recover their economic and moral autonomy. Based on 15 months of ethnographic research in predominantly migrant informal settlements in Chile's northern border city of Antofagasta, this article shows how the state's project to demolish vulnerable encampments is in tension with migrant women community leaders’ own personal and collective projects of autonomy. Examining one migrant woman community leader's use of the moral concept of “hardness” to express her ethics of autonomy, I attend to ordinary instances where women helping the state resettle their communities instead subtly undermined the state's resettlement plan. This case advances feminist theories of politics and vulnerability that examine how the domain of the political is reconfigured through women's “domestic” work in the everyday. Psychological anthropology, with its recent turn to critical phenomenology, has much to add to this phenomenology of the critical, of politics.
Computed tomographic‐planned repair of short incomplete sagittal fractures of the proximal phalanx
Authors: Smith Matthew R. W. , Barker William H. J. , Williamson Stuart M.
Published: May 2024

Background

Short incomplete sagittal fractures of the proximal phalanx are common in racehorses. Configurations vary; surgical planning has been performed using radiography which has limited ability to differentiate between common configurations. Computed tomographic (CT) imaging accurately maps fracture configuration and may be contributory to case management.

Objectives

(i) Describe a surgical technique for CT‐planned repair of short incomplete sagittal fractures of the proximal phalanx and (ii) report case outcomes.

Study design

Retrospective case series (2019–2023).

Methods

CT‐planned surgical repair of short incomplete sagittal fractures of the proximal phalanx was performed under radiographic control. Following repair, screw position was assessed with CT. Case records, radiographic and CT images were reviewed. Follow‐up information was obtained from referring veterinarians, race records and owner/trainers.

Results

Ten fractures were confined to the dorsal cortex and subchondral bone. One fracture extended the full dorsoplantar depth of the bone. One fracture was confined to the subchondral bone centrally. Screw repair was planned using CT, to cross the fracture, or to position as close as possible while avoiding penetration of the articular surface. Surgery was performed under radiographic control, and subsequent CT examination confirmed screw placement as planned. Fractures healed radiographically in all 10 imaged cases. All horses were sound at follow‐up examination. One horse was retired to stud after surgery. Eleven horses returned to full training and 10 raced.

Main limitations

The case outcomes reported are only relevant to similar populations of Thoroughbred racehorses. The lack of a cohort of control horses limits conclusions that can be drawn relating to the contribution of this surgery to case management.

Conclusions

CT planned repair of short incomplete sagittal fractures of the proximal phalanx, with screws positioned according to fracture location, can be reliably performed and is associated with good outcomes.
Biogeographic isolation and climate shape the evolutionary heritage of Neotropical inselbergs
Authors: Pinto‐Junior Herval Vieira , Heringer Gustavo , Diniz Écio Souza , Müller Larissa Areal de Carvalho , Villa Pedro Manuel , Meira‐Neto João Augusto Alves , Neri Andreza Viana
Published: May 2024

Aim

Quaternary climatic shifts can explain the current distribution of ancient ecosystems as well as the current distributions of gradients that hold species richness and diversity of several lineages in old, climatically buffered, infertile landscapes (OCBILs) as inselbergs. Thus, the combination of phylogenetic approaches and temporal landscape connectivity allows disentangling the mechanisms involved in the origin of the disjunct distribution of plant species and the evolutionary heritage of Neotropical inselbergs.

Location

Brazilian Atlantic Forest and Caatinga.

Time Period

Pliocene until the current period.

Major Taxa

Angiosperms.

Methods

We used a compiled data set of 42 inselbergs across the Atlantic Forest and Caatinga biomes in eastern Brazil to describe their structure and phylogenetic diversity and map the landscape resistance distances and the effects of resistance on their phylogenetic beta diversity. We also aimed to identify the effectiveness of protected areas and gaps in the conservation of plant species in Brazilian inselbergs.

Results

We found evidence of dispersal limitation in the inselberg species pool and a latitudinal gradient in plant species richness and phylogenetic diversity across the Neotropical inselberg landscape, with greater isolation between the northeastern and southeastern core areas. Our findings indicate that inselbergs can lead to a high turnover of phylogenetic diversity, thus imposing distinctiveness on the evolutionary lineages of the inselberg flora.

Main Conclusions

Our results suggest that the current distribution of inselberg's flora in isolated ecosystems may result from a more connected distribution of this flora in the past, as postulated by the Pleistocene habitat fluctuations. However, the patterns of diversity have probably been influenced by events much older than Quaternary climate shifts, due to inselbergs climate stability areas (refugia) since ancient periods. Conservation of mountain vegetation is a crucial strategy for maintaining biodiversity and distinct phylogenetic lineages in the current rapid global climate and land use change scenario.
Prevalence and molecular epidemiology of carbapenemase‐producing Enterobacterales isolated from dog and cat faeces submitted to veterinary laboratories in the USA
Authors: Dietrich Jaclyn , LeCuyer Tessa E. , Hendrix G. Kenitra , Burbick Claire R. , Jacob Megan E. , Byrne Barbara A. , Olsen Karen , Mitchell Maria , Ceric Olgica , Lin Rachel , Joneson Jessica , Lintner Megan , Fox Alexandra , McClendon Diamond , Alexander Trevor , Joyce Kayla , Byrd Melissa , Clinton Jason , Snipes Keith , Peak Laura , Cole Stephen D.
Published: May 2024

Aims

To estimate the prevalence of carbapenemase‐producing Enterobacterales (CPE) carriage among pets using faecal specimens submitted to veterinary diagnostic laboratories throughout the US. A secondary aim was to employ whole‐genome sequencing (WGS) to characterize isolates of CPE from companion animals and compare them to publicly available CPE genomes.

Methods and Results

To estimate the prevalence of CPE in companion animals in the USA, a multicenter surveillance study including 8 different veterinary diagnostic laboratories from across the USA was conducted. Briefly, remnant faecal specimens from dogs and cats were screened using two selective agar plates (CHROMID Carba and MacConkey with 1 mg/L cefotaxime and 0.125 mg/L meropenem) and presumptive CPE isolates screened by the modified carbapenemase inactivation method for carbapenemase production. A total of 2393 specimens were screened and yielded 196 isolates for carbapenemase screening. A total of 5 isolates from 4 dogs and 1 cat at 3 different veterinary diagnostic laboratories were confirmed to produce a carbapenemase (0.21%). Whole‐genome sequencing (WGS) revealed two E. coli (ST167) isolates that both produced an NDM‐5 carbapenemase, two Enterobacter hormaechei (ST171) isolates that produced an NDM‐5 carbapenemase and a KPC‐4 carbapenemase respectively and one Klebsiella oxytoca (ST199) that produced an Oxa‐48‐type carbapenemase. Both E. coli isolates were found to be within at least 22 SNPs of previously characterized canine and human CPE isolates.

Conclusions

This study demonstrates that the prevalence of CPE among companion animals is relatively low (0.21%) but that given the genetic relatedness of animal isolates to human isolates, additional surveillance is needed.
La Revolución cubana y el regreso de la historia: los desafíos del socialismo cubano en la era de la turbulencia global
Authors: Cubilledo Gorostiaga Daniel
Published: May 2024

Este libro analiza los orígenes y fundamentos de las reformas actuales en Cuba, consideradas como las más profundas en la historia del socialismo cubano. Para esto, se exploran los desafíos del proyecto emancipador de la Revolución de 1959 en un contexto doméstico, regional y mundial que ha sufrido importantes transformaciones, en particular desde el fin de la Guerra Fría y el comienzo de la crisis del Periodo Especial. Por un lado, se destaca la actualización del modelo económico y social iniciada por el expresidente Raúl Castro desde el 2008 y continuada por el actual mandatario, Miguel Díaz-Canel, que, si bien se presenta como una reforma principalmente económica, tiene fuertes implicaciones políticas e incluso ideológicas. Por otro lado, se estudian las relaciones con Estados Unidos y, en específico, el proceso de normalización que Barack Obama impulsó y que posteriormente la administración de Donald Trump revirtió. La Revolución cubana y el regreso de la historia muestra cómo se reproduce la hegemonía en las revoluciones sociales antisistémicas cuando las estructuras históricas en las que surgieron cambian de manera significativa, desde una perspectiva amplia y transdisciplinar que combina la sociología histórica, la disciplina de las relaciones internacionales y el aparato conceptual de Antonio Gramsci.
The whistleblowers
The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No
Carl Elliott
Norton, 2024. 368 pp.
Authors: Alford C. Fred
Published: May 2024

A bioethicist probes the costs of exposing wrongdoing in medical research
Plants in the human gaze
The Light Eaters: How the Unseen World of Plant Intelligence Offers a New Understanding of Life on Earth
Zoë Schlanger
Harper, 2024. 304 pp.
Authors: Haswell Elizabeth
Published: May 2024

Must other species be like us to earn our respect?
Taking climate-smart governance to the high seas
Authors: Santos Catarina Frazão , Agardy Tundi , Brooks Cassandra , Gjerde Kristina M. , Payne Cymie , Wedding Lisa M. , Xavier José C. , Crowder Larry B.
Published: May 2024

Comprehensive spatial planning in international waters is key to achieving ocean sustainability
Plan to alter access to health data draws ire
Authors: Wadman Meredith
Published: May 2024

Universities could no longer store Medicare and Medicaid data, and costs would rise
Biologically significant interaction of human herpesvirus 8 viral interferon regulatory factor 4 with ubiquitin-specific protease 7
Authors: Yang Zunlin , Nicholas John
Published: May 2024

Human herpesvirus 8 (HHV-8), associated with Kaposi sarcoma, primary effusion lymphoma (PEL), and multicentric Castleman disease, encodes four interferon regulatory factor homologs, vIRFs 1–4, that interact with and inhibit various mediators of host-cell defense against virus infection. A cellular protein targeted by all the vIRFs is ubiquitin-specific protease 7 (USP7); while replication-modulatory and latently infected PEL-cell pro-viability phenotypes of USP7 targeting have been identified for vIRFs 1–3, the significance of the interaction of vIRF-4 with USP7 has remained undetermined. Here we show, through genetic ablation of the vIRF-4-USP7 interaction in infected cells, that vIRF-4 association with USP7 is necessary for optimal expression of vIRF-4 and normal HHV-8 replication. Findings from experiments on transfected and infected cells identified ubiquitination of vIRF-4 via K48-linkage and USP7-binding-associated suppression of vIRF-4 ubiquitination and, in infected cells, increased vIRF-4 expression. Analysis of IFN-I induction and associated signaling as a function of vIRF-4 and its interaction with USP7 identified a role of each in innate-immune suppression. Finally, activation via K63-polyubiquitination of the innate-immune signaling mediator TRAF3 was found to be suppressed by vIRF-4 in a USP7-binding-associated manner in infected cells, but not in transfected cells, likely via binding-regulated expression of vIRF-4. Together, our data identify the first examples of vIRF ubiquitination and a vIRF substrate of USP7, enhanced expression of vIRF-4 via its interaction with USP7, and TRAF3-inhibitory activity of vIRF-4. The findings address, for the first time, the biological significance of the interaction of vIRF-4 with USP7 and reveal a mechanism of vIRF-4-mediated innate-immune evasion and pro-replication activity via TRAF3 regulation.

IMPORTANCE

HHV-8 homologs of cellular interferon regulatory factors (IRFs), involved in host-cell defense against virus infection, interact in an inhibitory fashion with IRFs and other mediators of antiviral innate immunity. These interactions are of demonstrated or hypothesized importance for successful primary, productive (lytic), and latent (persistent) infection by HHV-8. While HHV-8 vIRF-4 is known to interact physically with USP7 deubiquitinase, a key regulator of various cellular proteins, the functional and biological significance of the interaction has not been addressed. The present study identifies the interaction as important for HHV-8 productive replication and, indeed, for vIRF-4 expression and reveals a new function of vIRF-4 via inhibition of the activity of TRAF3, a pivotal mediator of host-cell antiviral activity through activation of cellular IRFs and induction of type-I interferons. These findings identify potential targets for the development of novel anti-HHV-8 agents, such as those able to disrupt vIRF-4–USP7 interaction or vIRF-4-stabilizing USP7 activity.
Defective
pgsA
contributes to increased membrane fluidity and cell wall thickening in
Staphylococcus aureus
with high-level daptomycin resistance
Authors: Freeman Christian D. , Hansen Tayte , Urbauer Ramona , Wilkinson Brian J. , Singh Vineet K. , Hines Kelly M.
Published: May 2024

Daptomycin is a membrane-targeting last-resort antimicrobial therapeutic for the treatment of infections caused by methicillin- and/or vancomycin-resistant
Staphylococcus aureus
. In the rare event of failed daptomycin therapy, the source of resistance is often attributable to mutations directly within the membrane phospholipid biosynthetic pathway of
S. aureus
or in the regulatory systems that control cell envelope response and membrane homeostasis. Here we describe the structural changes to the cell envelope in a daptomycin-resistant isolate of
S. aureus
strain N315 that has acquired mutations in the genes most commonly reported associated with daptomycin resistance:
mprF
,
yycG
, and
pgsA
. In addition to the decreased phosphatidylglycerol (PG) levels that are the hallmark of daptomycin resistance, the mutant with high-level daptomycin resistance had increased branched-chain fatty acids (BCFAs) in its membrane lipids, increased membrane fluidity, and increased cell wall thickness. However, the successful utilization of isotope-labeled straight-chain fatty acids (SCFAs) in lipid synthesis suggested that the aberrant BCFA:SCFA ratio arose from upstream alteration in fatty acid synthesis rather than a structural preference in PgsA. Transcriptomics studies revealed that expression of pyruvate dehydrogenase (
pdhB
) was suppressed in the daptomycin-resistant isolate, which is known to increase BCFA levels. While complementation with an additional copy of
pdhB
had no effect, complementation of the
pgsA
mutation resulted in increased PG formation, reduction in cell wall thickness, restoration of normal BCFA levels, and increased daptomycin susceptibility. Collectively, these results demonstrate that
pgsA
contributes to daptomycin resistance through its influence on membrane fluidity and cell wall thickness, in addition to phosphatidylglycerol levels.

IMPORTANCE

The cationic lipopeptide antimicrobial daptomycin has become an essential tool for combating infections with
Staphylococcus aureus
that display reduced susceptibility to β-lactams or vancomycin. Since daptomycin's activity is based on interaction with the negatively charged membrane of
S. aureus
, routes to daptomycin-resistance occur through mutations in the lipid biosynthetic pathway surrounding phosphatidylglycerols and the regulatory systems that control cell envelope homeostasis. Therefore, there are many avenues to achieve daptomycin resistance and several different, and sometimes contradictory, phenotypes of daptomycin-resistant
S. aureus
, including both increased and decreased cell wall thickness and membrane fluidity. This study is significant because it demonstrates the unexpected influence of a lipid biosynthesis gene,
pgsA
, on membrane fluidity and cell wall thickness in
S. aureus
with high-level daptomycin resistance.
1-Aryl-3-nitro- and 3-Bromo-3-nitroprop-2-en-1-ones: Synthesis and Structural Features
Authors: Adyukov I. S. , Pelipko V. V. , Baichurin R. I. , Litvinov I. A. , Makarenko S. V.
Published: May 2024

A method for producing a number of (E)-1-aryl-3-nitroprop-2-en-1-ones based on a synthetic condensation–dehydration strategy has been optimized. New (Z)-1-aryl-3-bromo-3-nitroprop-2-en-1-ones have been synthesised from (E)-1-aryl-3-nitroprop-2-en-1-ones using halogenation-dehydrohalogenation strategy to (E)-1-aryl-3-nitroprop-2-en-1-ones. The fine structure of nitro- and bromonitroenketones and it’s features were determined by 1H–1H NOESY NMR and X-ray diffraction analysis.
Trust in healthcare: methodological and conceptual insights from mixed-method research in Lao People’s Democratic Republic
Authors: Haenssgen Marco J , Elliott Elizabeth M , Phommachanh Sysavanh , Phomkong Sylivanh , Kounnavong Sengchanh , Kubota Shogo
Published: May 2024

Background

Global health foregrounds trust as a key requirement for the achievement of international health initiatives, but it remains an elusive concept that is often mobilised without consideration of its dimensions, drivers and downstream behavioural consequences. This paper aims to contribute to the conceptual development and measurement of ‘patient trust in primary healthcare’ from the lower middle-income country perspective of rural Lao PDR.

Methods

A two-phase mixed-method research design was implemented between January 2021 and April 2023. Phase 1 involved exploratory qualitative research to understand the local expressions and dimensions of patient trust in primary healthcare, with 25 semistructured interviews and 17 focus group discussions (120 participants) in eight villages in Bokeo Province. Phase 2 involved explanatory research to assess patterns of trust systematically at scale in 14 villages across four provinces, wherein 26 cognitive interviews, 17 expert interviews and non-participant community observations informed a community census survey with 1838 participants. We analysed qualitative data through content-oriented thematic analysis and developed an 8-item trust scale on that basis. Quantitative data analysis used descriptive statistical and regression analysis.

Results

We found that trust in primary healthcare is readily understood and intrinsically valuable in rural Lao PDR. Key dimensions included communication, respectful care, relationship, fairness, integrity, reputation, assurance of treatment and competence. The survey highlighted that reputation, competence, integrity and respectful care had the lowest trust scores. Health centre operations predicted the local expressions of trust. The behavioural consequences of trust were limited to a positive statistical association with antenatal care uptake among pregnant women but outweighed by alternative measures that also captured the availability of healthcare facilities.

Conclusions

Overall, the development of our quantitative trust scale offers a process model for future researchers. We conclude that interpersonal, institutional and service-related trust require more explicit recognition in health system development and integration into health policy.
126: THE EFFECT OF ESTABLISHING RAPID RESPONSE NURSING TEAM IN OUTCOME OF PATIENTS CARE IN EMERGENCY WARD
Authors: Yeke-Fallah Leili , Eskandari Zahra , Shahrokhi Akram , Javadi Amir
Published: May 2024

Background and aims:

Rapid response nursing team evaluates the patients in the early stages of clinical exacerbation and prevents unexpected cardiopulmonary arrest. The present study aimed to determine the effect of rapid response nursing team in outcome of patients care in the emergency ward.

Methods:

This clinical trial was conducted on 714 patients in the emergency ward in selected hospitals affiliated to Alborz University of Medical Sciences in 2013. The patients were randomly divided into a control and an intervention group. Rapid response nursing team comprised an intensive care nurse and an anesthesia technician who were in the emergency on a 24/7 basis. If the patient's clinical conditions exacerbated, they immediately attended him, evaluated his clinical condition precisely, and took necessary nursing measures for the patients in the case group, but those in the control group received the conventional treatment in the emergency ward. Patients' conditions and the measures taken for them were precisely recorded for both groups and the data were analyzed in SPSS 16.

Results:

The results of the study showed that there is a significant relationship between establishing rapid response nursing team and outcome of patient care (p=0.028), reduced transfer to special care units (p=0.014) and reduced level of care in the first 24 hours of admission (p=0.001).

Conclusion:

Given the results, rapid response nursing team was effective in preventing unexpected cardiovascular arrests, increased successful cardiopulmonary resuscitation, and reduced transfer of patients to special care units and higher levels of care.
132: THE EFFECT OF TRAINING INTERVENTION ON STUDENTS' EVIDENCE-BASED MEDICINE LITERATURE SEARCHING SKILLS, IN TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Authors: Abdekhoda Mohammadhiwa , Salehi Narges , Dehnad Afsaneh
Published: May 2024

Background and aims:

Evidence-Based Medicine (EBM) is an important issue requiring skills in locating, evaluating and applying the best evidence in a clinical setting. This study evaluated the effect of training intervention on students' skills in EBM literature Search.

Methods:

This was a cross sectional study in which 90 post graduate students in Tabriz University of Medical Sciences were selected randomly. Participants take part in 12 Sessions, in which EBM literature search skills were presented by highly qualified Teachers (HQT). Pre- and post-questionnaires and skills tests were developed to measure student' skills concerning EBM literature search. Data were then analyzed by SPSS using T-Test.

Results:

Statistically, significant improvement in students' ability in designing search strategies and formulating a clinical question based on PICO were found. Also, students' familiarity with EBM resources and databases significantly improved. The data showed a statistically significant increase in students' competency score concerning finding the best clinical evidence and critical appraisal of articles, after intervention versus took place.

Conclusion:

The findings of this study suggest that intervention is an effective method for developing search skills when finding and applying EBM literature is considered. This should be considered in curriculums by educational managers and policy makers.
136: THE ESTABLISHMENT AND CONTINUITY OF HAEMOVIGILANCE SYSTEM ACCORDING TO STAFF TRAINING IN THE USE OF BLOOD AND COMPONENTS IN ALZAHRA HOSPITAL IN TABRIZ IN 2013
Authors: Bahramzadeh Behzad , Shams Masoumeh Samadi
Published: May 2024

Background and aims:

Haemovigilance is defined as the surveillance of adverse reactions occurring in donors and in recipients of blood components. A surveillance system for transfusion-related adverse reactions was started in 2010 in Iran. From 863 hospitals in Iran, 542 center runs (63 percent).The ultimate purpose of haemovigilance is to prevent the repetition of adverse events and reactions.

Methods:

According to national haemovigilance guideline, the training course for the target group was held. First, pretest from the target group was taken and after theoretical and practical training, posttest was taken. After the Six months of training, test was performed again and using statistical methods, the test results were analyzed.

Results:

From all of the target groups, the educational haemovigilance system was implemented to 75 percent and the average of pre-test in nine different sections was 15.2 and after training, the mean was 18.96 which represent an increase 18.8 percent in training course. The results show that the haemovigilance system is effective in hospitals.

Conclusion:

Haemovigilance is an effective tool for identifying adverse effects of blood components. Increased knowledge of haemovigilance among physicians and nurses can lead to improved transfusion safety. Efforts to identify and eliminate the complications associated with blood transfusions and improve them, to reduce the death rate, infection and reduce the amount of disability, health promotion and ultimately the patients' satisfaction enhancement. The most important factor in the success of haemovigilance system is cooperation and coordination between hospitals and blood centers.
137: THE EVALUATION OF A DRUG USE PREVENTION PROGRAM AMONG ADOLESCENCES BASED ON MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS PROGRAM (MAPP) – ISFAHAN: 1392
Authors: Dastgerdi Zohreh Fathian , Eslami Ahmadali
Published: May 2024

The propagation of teen drug use cessation programs internationally are increased in recent decade. Use of evidence-based teen drug use prevention program might help more decrease the prevalence of drug use among teens. Mobilizing for Action through Planning and Partnerships (MAPP) is a community-wide strategic planning tool Facilitated by public health leadership to help communities prioritize public health issues and identify resources for addressing them. In 2007–2010, twelves departments received grant awards to implement their intervention strategies according to Mapp approaches in prevention of substance use.

Method:

A semi experimental study was conducted in 6 phases according to planning model MAPP in 720 adolescents from 14 to 18 years old in Isfahan. The cognitive–behavioral program including knowledge, self-efficacy, social skills, outcome expectancies and perceived social support was planned by speech, discussion, Visit the exhibition, role playing, parent education methods in 4 month.

Results:

The results of intervention showed significant differences between control and intervention group in knowledge, outcome expectancies, social skills and self- efficacy but did not significantly increase in perceived social support toward substance use.

Conclusion:

The final results showed that educational interventions with MAPP approach had an expected effect to increase skills related to substance use behavior in adolescents and could be used as a planning model in drug use prevention programs.
14: ANIMAL BITE EPIDEMIOLOGY AND SURVEILLANCE FOR RABIES POST EXPOSURE PROPHYLAXIS, IRAN
Authors: kasseri Hamid , Lotfi Masoud , Shahkarami Babak
Published: May 2024

Background and aims:

Animal bites are a significant threat to human health because of fatality of subsequent infections such as rabies. The aim of this study was to determine the epidemiology of animal bites during a five-year period in Shush County.

Methods:

In a descriptive cross sectional study, all cases of animal bites referred to the health centers in Shush County were investigated during 2004–2008. The necessary data were recorded on the special questionnaire that contains questions about bite animal, age, sex, occupation, treatment, the bite site on the body and so forth.

Results:

Out of a total of 2283 cases, 1771 people (77.6%) were male. Most cases were related to age groups 10–20 (33.4%). The average incidence rate of animal bite during these years was determined as 2.82 cases per 1000 people. Almost 86.5% and 13.5% of the cases occurred in rural areas and urban areas, respectively. Nearly 30% and 20.4% of cases were students and farmers, respectively. A total of 2155 (94.4%) and 86 (3.8%) bites occurred by the dog and cat, respectively. The greatest bite place on the body was in the feet (81.4%). During the study period, 2162 cases (94.7%) were treated with an incomplete regimen, and 120 cases (5.3%) were treated with a complete regimen.

Conclusion:

Because the cost of prevention after biting for the health system is high, so, preventive programs must be concentrated on public health instruction, particularly in villagers, students, farmers and the owners of the domestic animals.
140: THE IMPACT OF E-LEARNING ON ASPECTS OF HEALTH-PROMOTING LIFESTYLE NURSES
Authors: Darkhor Shokofe , Estebsari Fatemeh , Charati Jamshid Yazdani
Published: May 2024

Background and aims:

One of the most important measures of health promoting behaviors as determinants of health are the underlying cause of many diseases, not having known and Health promotion and disease prevention are related directly to these behaviors . Six important part of promoting healthy lifestyles, including relationships between individual responsibility for health, spiritual development, stress management, nutrition and physical activity Aim of this study is the effect of empowerment on nurses' health-promoting lifestyle.

Methods:

This is a quasi-experimental study with pre-test and post-test. 100 nurses sampling and divided into intervention and control groups randomly. Nurses are randomly selected. Educational content prepared based on pre-test results and Training was conducted via text message and creates a channel in the telegram as a healthy lifestyle for two weeks for the intervention group. Data were collected by demographic and health-promoting lifestyle questionnaire, knowledge, attitudes, self-efficacy, self-esteem and self-control takes place. The tests were analyzed after 6 weeks.

Results:

The e-learning intervention had the effect of significantly increasing nurses' post intervention Health-Promoting Lifestyle Profile total scores. No significant changes were observed in the post intervention scores of the control group subjects.

Conclusion:

Tailored e-learning is an effective and accessible intervention for enhancing health-promoting behavior among nurses.
149: TRAINING EFFECTIVE SEARCH SKILLS IN EVIDENCE-BASED MEDICINE IN THE CLINIC IN BUSHEHR`S PERSIAN GULF MARTYRS HOSPITAL IN 2016: A DESCRIPTIVE STUDY
Authors: zareivenovel Mojgan , khosravi Abdolrasoul
Published: May 2024

Background and aims:

Effective information search and access to the right information at the right time, has become one of the ideals medical purposes for physicians. If for any reason physicians do not get an immediate response and appropriate to their clinical questions, a big problem and serious fault in various processes including diagnosis and treatment in health care happen. Medical librarian or Information professionals are expert in the acquisition, integration, and implementation of updated and reliable information and can help to solve this problem. Thus, the present study investigates a fundamental solution in this context to solve the problem by using and enjoyment of the medical librarian in teaching expertise.

Methods:

This was a descriptive study. Training how to do effective search to access information in the frame of workshop to fourth-year medical students in the Persian Gulf hospitals set a timetable (one month), 8 sessions and per section took an hour and a half meeting held. In order to assess the training, the students were taken pre-test and post-test. The sample size of 57which included the entering medical students of 2013 who had recently entered to clinical stage of treatment. Students randomly assigned to the Intervention group included 29 and control group 28. Information gathered through the Self-administered questionnaire and its validity and reliability have been highlighted by 10 professors of library and information field. Data analysis was performed using statistical software SPSS16.

Results:

The results were determined by using chi-square test shown the student satisfaction after attending a workshop and 90 percent of the physician evaluated medical librarians useful to provide updated information on evidence-based medicine.

Conclusion:

Training students who have recently entered to the clinical stage, for doing effective search on evidence-based medical information in order to meet the needs of the medical community and reduce medical errors that occur in clinical practice, is necessary.
157: ASSESSING THE METHODOLOGICAL QUALITY OF DECISION SUPPORT SYSTEM (DSS) SYSTEMATIC REVIEWS BY AMSTAR CHECKLIST
Authors: Sadeghi-Ghyassi Fatemeh , Fathifar Zahra , Hasankandi Hossein Saeedi
Published: May 2024

Background and aims:

It is all accepted that high-quality evidence is essential for clinical decision making. As Haynes “6S pyramid”, systems including decision support systems are at the top of this pyramid as the highest level of evidence. There are numerous systematic reviews which have assessed various aspects in this field. The aim of this study is evaluating the methodological quality of decision support system (DSS) systematic reviews.

Methods:

A comprehensive literature search using MEDLINE (via Ovid), Embase, PubMed and Cochrane Library was conducted until September August 2016. The search was limited to systematic reviews and with no language restriction. Meta- reviews were excluded. Only results of searching for “decision support systems” or “decision support system” keywords and limited to title of documents were included in this study. Two independent authors screened the results. Disagreement was resolved by discussion. The assessment of multiple systematic reviews (AMSTAR) checklist was used to assess methodological quality of selected studies. Data were extracted into Excel 2013.

Results:

A total of 47 systematic reviews (SRs) were enrolled which only 7 of them had meta-analysis. About 25.5% of studies were published in specialized publications. There was a dramatic increase in the number of SRs in recent decade and near to 66% of studies were published from 2011. The mean AMSTAR score of SRs was 6.78 (out of 9) and 9.71 (out of 11) for SRs with meta-analysis. Meanwhile 52.5% of SRs received a score between 7 and 8 while 70% of them scored more than 7. Near 83% of studies performed a reasonable comprehensive literature search, presented characteristics of the included studies and also stated conflict of interest. It was remarkable that 76.6% of studies had not a list of excluded studies. In more than 95% of SRs the scientific quality of the included studies was mentioned in conclusions.

Conclusion:

It seems that the quality of reporting in the field of DSS is acceptable. But although the score of literature search was good, lack of full presentation of search strategies was observed. Few meta-analyses in the included studies was notable and most of SRs stated heterogeneity as the reason. It seems that because of the overall view in AMSTAR scoring methods and its questions, it is hard to determine the specific bias and failures in the quality assessment of systematic reviews.
169: DEVELOPMENT OF A SCALE FOR MEASURING EVIDENCE-SEARCHING CAPABILITY: A MODIFIED DELPHI STUDY
Authors: Chi Ching-Chi , Tsai Yu-Shiun , Fang Tien-Pei
Published: May 2024

Background and aims:

The ability to acquire the best evidence efficiently is important for busy healthcare professionals who have to make decision within a limited time. However, the current available assessment tools in evidence-based medicine (EBM), e.g. Berlin questionnaire and Fresno test, were not designed for examining evidence-searching capability. The objective of this study was to develop a scale for measuring evidence-searching skills.

Methods:

We use 2-round modified Delphi technique and organised a workforce of 7 experts who provided comments on a draft 33-item scale and rated each item on a 5-point Likert-type scale. All items rated less than 3 by any expert were removed. The items were modified or merged after authors' discussion considering experts' comments. When all items were rated ≥3 by all experts with an interquartile range (IQR) of ≤1, a consensus was achieved. In a pilot test, the searching capability of two examinees was assessed by two raters and re-assessed two weeks later for reliability. In a further pilot test, the searching capability of another eight examinees was assessed by two raters and the reliability of the scale was examined.

Results:

All 7 experts completed the two rounds. In Round 1, 33 items were removed and 11 items were merged into 4 items, leaving 17 items remained in the scale. In Round 2, 17 items were removed. The final consensus scale consisted of 15 items, all rated 4 or 5 with a mean of 4.79 and an IQR of 1 or less. The full details of the scale will be presented. In the pilot tests, the inter-rater correlation was 0.911 (95% confidence interval 0.821–0.956), while the intra-rater correlation coefficient was 1. The Cronbach's alpha was 0.903.

Conclusion:

This study is the first to develop a scale for measuring evidence-searching skills. The scale fills in the gap in objective assessment of knowledge-acquiring ability, and may be used in improving the training of evidence-searching skills.
175: EVALUATING THE PRINCIPLES IN WHICH THE DECISIONS ABOUT PIVOTAL MATTERS IN IRANIAN HEALTH SYSTEM ARE MADE
Authors: Doshmangir Leila , Rashidian Arash
Published: May 2024

Background and aims:

This study aimed to evaluate the basis in which the decisions about pivotal matters in Iranian health system are made and how these decisions are in accordance with the best available evidence.

Methods:

To conduct this qualitative study, in the first step, four main issues with a high degree of importance, novelty and significant impact on health system were selected as follows: outsourcing clinical and Para-clinical services and health sectors to the private sector, global payment system to the hospitals and listing or delisting of pharmaceuticals from insurance coverage. In the next step, along with reviewing reports, documents and papers, semi-structured interviews were conducted with policymakers, experts and officials involved in the formulation and implementation of the selected issues. In the following step, a comprehensive search was carried out to find the research studies on the mentioned topics (fundamental evidence of policy-making). In the final stage, the results of the interviews and documentary analysis were compared with the best acquired evidence from the research studies. As a result, analytical model about decision making and interpretation method of evidence informed policy making in the health system were extracted.

Results:

In Iranian health system, evidence production is limited and the produced evidence is moderately applied in decision-making. Most decisions are made subconsciously, intuitively, fast, with low cognitive load and based on experiences. In recent years, due to the increasing number of researchers, awareness about modern methods of research and using evidence in decision-making is increasing gradually in the health system.

Conclusion:

Developing the importance and role of using evidence in making better decisions and policies for health managers and policy-makers and localizing global evidence are proper ways to enhance the use of evidence-informed decision-making approach in Iranian health system.
191: PEER TUTORING FOR EVIDENCE BASED PRACTICE FOR STUDENTS OF MEDICAL SCIENCES
Authors: Tabrizi Negar Taleschian , Yaaghoubian Barmak , Pashazadeh Fariba , Hajebrahimi Sakineh
Published: May 2024

Background and aims:

Iranian Student Center for Evidence Based Medicine (ISCEBM) has been pioneer in using innovative and creative teaching methods to deliver and spread the concepts of evidence Based Practice (EBP). Many studies found peer tutoring as an effective method to train tutees. The aim of this study was to evaluate the experience of students participating in the peer assisted learning workshops of this center on EBP and methodology of research.

Methods:

ISCEBM held the second series of workshops on Evidence Based Practice and methodology of evidence based research. These workshops were held weekly for two months (June–July 2016) for undergraduate medical sciences students from different fields. The education was based on peer assisted learning using interactive group discussion methods and problem based learning. Tutors were selected from students of ISCEBM who were expert in this field moreover, each session was held under the supervision of a specialist who completed and corrected the speech of student tutors. A checklist containing questions about each trait of workshop using 5-point Likert scale and an open question about their ideas, were shared via web based electronic questionnaire.

Results:

Thirty participants who regularly participated in the workshops responded to the questionnaire. 46.2% believed peer education to be very effective in training concepts in a more understandable way rather than conventional teaching method. 92.3% found problem based learning very effective or effective. 84.6% believed continuous and weekly courses are more effective than intensive courses in one or two days. And 100% of responders were willing to participate in the next series of workshops. Participants indicated that peer tutoring “increased their self-confidence”, “helped them to comment freely”, “made them glad to see someone who understands them” and “made the lesson more attractive”.

Conclusion:

Peer tutoring was a successful experience in training students about EBP; however; larger projects involving larger number of participants can indicate the real impact of this method better.
192: PREDICTION OF ASTHMA CONTROL LEVELS USING DATA MINING METHODS: AN EVIDENCE-BASED APPROACH
Authors: Rezaei-Hachesu Peyman , Samad-Soltani Taha , Khara Ruhollah , Gheibi Mehdi , Moftian Nazila
Published: May 2024

Background and aims:

Asthma is a chronic lung disease and has a raising worldwide prevalence. Lack of timely and appropriate control for this condition leads to financial and physical injuries. The aim of this study is to prediction of asthma control levels by applying data mining algorithms.

Methods:

This is a cross-sectional study carried out in the city of Sanandaj in Iran. Samples consist of 600 referred patient patients who live with asthma to Tohid pulmonary clinic in Sanandaj In a period of two months in 2015. Data were collected based on the study's inclusion criteria. Preprocessing was performed and various algorithms include Support Vector Machine (SVM), Decision Tree (DT), K-Nearest Neighbor (KNN) and Naïve Bayesian was assessed. Finally results were evaluated by confusion matrix.

Results:

Features ranked by applying feature selection methods; after in next step, 19 Features of 24 was chosen as the most effective asthma control features. Cough has the highest InfoGain, Relief-F and GainRatio comparing with other features. Results shows KNN and NaiveBayes have the highest accuracy near to 98%.

Discussion:

Experts can analysis and design accurate decision support systems by using data mining methods in healthcare. These methods aims to reduction and optimal usage of data. Important factors in determination of asthma control level were identified by considering of accurate mining algorithms. Therefore, identification of high risk patients were performed and proper services were provided to them to prevent major complications.