bluuebunny/crossref_metadata_2025 huggingface dataset:
Metodologias ativas de ensino em saúde e ambientes reais de prática: uma revisão
Authors: Leitão Lia Maria Bastos Peixoto , Vianna Isabel Carvalho , Delmiro Ana Lúcia do Carmo , Cruz Josiane Pereira Leite da , Motoyama Paula Vitória Pereira , Teixeira Filho Manuel Sampaio , Bessa Olivia Andrea Alencar Costa
Published: October 2021

Introdução: Diante da demanda para a elaboração de estratégias de ensino adaptadas para realidade atual, o conhecimento sobre metodologias ativas de ensino-aprendizagem tem grande valor, para a educação médica. Há diversos tipos de metodologias ativas e aquelas baseadas em casos-problema tem sido implementadas na graduação médica de forma mais precoce; apesar de ser parte integrante e necessária do currículo das instituições de ensino médico, não há consenso sobre sua forma de orientação, aplicabilidade e avaliação. Propõe-se revisar a literatura sobre as metodologias de ensino-aprendizagem em ambientes reais, conhecendo seus benefícios e a aplicações. Materiais e Métodos: O presente estudo trata-se de uma revisão integrativa da literatura na qual foram incluídos 23 artigos e 1 capítulo de livro entre os anos 1992 e 2018, em língua portuguesa e inglesa, sendo exploradas as bases de dados PubMed, SciELO, Lilacs e Periódicos CAPES. Discussão: Os métodos propostos para orientação, avaliação e feedback são variados, adaptáveis e estão em constante modificação. “Preceptor em um minuto”, “O momento em cinco minutos” e “Método SNAPPS” são diferentes maneiras de discussão nesses cenários a fim de facilitar o processo de interação estudante-paciente-preceptor. Estratégias de aprendizagem em ambientes reais apresentam benefícios em relação ao aprendizado de conteúdos teóricos estritos, pois coloca o aluno em ambiente de atuação verídico e estimula a elaboração de raciocínio diagnóstico sistematizado, que exige a recuperação de conhecimentos prévios. Acredita-se que o profissional que seja formado com essas metodologias ativas terá um perfil de autonomia, autodidatismo e atitude profissional proativa e com base científica. Conclusão: Não há “regra prática” para inserção das metodologias ativas no currículo das universidades, seu uso deve ser adaptado à realidade e ao perfil de cada instituição. Ressalta-se que o professor/preceptor deve refletir sobre seus métodos de ensino, buscando entender sua metodologia e ressignificar a sua atuação, estimulando a busca de tarefas mais ativas e eficientes.
PT-BR: Radioterapia PSMA-ligante dirigida com Lutécio 177 como um tratamento para câncer de próstata resistente a castração: uma revisão sistemática
Authors: Helmich Lucca Paolo Hsu , Arruda Marcelo Augusto Magalhães de , Sapienza Marcelo Tatit
Published: October 2021

O câncer de próstata é o segundo mais prevalente no mundo, sendo uma importante causa de mortalidade dentre homens idosos. Sua forma mais séria é o câncer metastático resistente a terapia hormonal, sendo difícil de controlar pois não responde tanto a quimioterapia quanto a privação de androgénos. Um novo tratamento, baseado em moléculas ligantes de PSMA, quelado ao átomo Lutécio-177, é uma terapia potencial para esse perfil de paciente, com evidências que esta causa regressão tumoral. O objetivo dessa revisão sistemática é avaliar a segurança e eficiência dessa nova terapia baseada na literatura atual
New species of Crella (Pytheas) Topsent, 1890 and Crellomima Rezvoi, 1925 (Crellidae, Poecilosclerida, Demospongiae) from Chilean shallow and Argentinean deep waters, with a synthesis on the known phylogenetic relationships of crellid sponges
Authors: FERNANDEZ JULIO C.C. , GASTALDI MARIANELA , ZAPATA-HERNÁNDEZ GERMÁN , PARDO LUIS M. , THOMPSON FABIANO L. , HAJDU EDUARDO
Published: October 2021

Here, we describe four new species of Crellidae Dendy, 1922 and discuss characters and relationships from published molecular phylogenies including crellid sponges. New species proposed are Crella (Pytheas) chiloensis Fernandez, Gastaldi, Pardo & Hajdu, sp. nov., from southern Chile (15 m depth), C. (P.) desventuradae Fernandez, Gastaldi, Zapata-Hernández & Hajdu, sp. nov., from Desventuradas Archipelago (10–20 m depth), Crella (P.) santacruzae Fernandez, Gastaldi, Thompson & Hajdu, sp. nov., from deep waters off Argentina (750 m depth) and Crellomima sigmatifera Fernandez, Gastaldi & Hajdu, sp. nov., from the Chilean fjords region (ca. 20 m depth). These new species are set apart from each other and from known species mainly due to aspects of their spiculation. Chelae microscleres and acanthostyles supply characters that might be used to infer phylogenetic relationships and to verify the monophyly of Crella Gray, 1867 and Crellidae, which has seemingly been contradicted by preliminary molecular data available in the systematics’ literature. Our own interpretation of phylogenetic affinities, in the light of morphological characters from previous taxonomic studies, argues for a classification reassessment of materials (vouchers) included in these molecular phylogenies, especially in the case of Crella incrustans (Carter, 1885). We argue that currently available molecular phylogenetic outcomes for crellid sponges are not supportive of the polyphyly of Crella and Crellidae.
Investigation of Oxidation Behaviors of Al-Mg Alloys with a Grain Refiner at High Temperature
Authors: Ha Seong-Ho , Shah Abdul Wahid , Kim Bong-Hwan , Yoon Young-Ok , Lim Hyun-Kyu , Kim Shae K.
Published: October 2021

Studies to investigate the oxidation behavior of Al–Mg alloys with Al-5 mass%Ti-1 mass%B master alloy as a grain refiner at high temperature were conducted. The Scheil-Gulliver cooling calculation showed that, in 0.2 mass%Ti-inoculated alloy, TiAl3 was formed before
the primary Al formation, which may act as a grain refiner. The optical microstructures showed a significant grain refinement after the addition of 0.2 mass%Ti using Al-5 mass%Ti-1 mass%B master alloy. Moreover, the oxidized cross-sections, throughout the oxidation time, show coarse and dark
areas (regarded as oxide clusters), which were nonuniformly distributed in the matrix after oxidation at 500 °C under an ambient atmosphere. In addition, an accumulation of oxygen by diffusion for a long duration led to the growth of blisters after 50 h. At the oxidation temperature, Mg3Ti2Al18
was found to be only stable Ti-containing phase and possibly formed MgO by the interaction with the diffused oxygen.
Design of Photoelectric Detection System Used for Atmospheric Microdroplets and Modulation Transfer Function Model of Gaussian Beam
Authors: Ping Yang
Published: October 2021

Atmospheric corrosion is an electrochemical corrosion process of metal materials in the atmospheric environment. Microdroplet phenomenon is an experimental phenomenon in the early stage of atmospheric corrosion, which is closely related to atmospheric corrosion. Photoelectric detection
of microdroplet phenomenon has become a technical means to study atmospheric corrosion. A set of microdroplet photoelectric detection systems with small size, high integration, and low detection limit is designed and constructed. First, the microdroplet optical chip is designed and fabricated.
The microdroplet chip with a single function is replaced by the microdroplet chip with optical microlenses, and the miRNA is detected on the photoelectric platform of the optical chip. The optical fiber is adopted to replace the traditional objective lens to excite the optical path, reduce
the volume of the spatial optical path, and realize the miniaturization of the photoelectric detection system. Based on this system, the nonlinear relationship between atmospheric turbulence effect and atmospheric optical parameters is analyzed with Gaussian beams propagating in the atmosphere.
In the experiment, the detection range of the photoelectric detection system is 5 nM~100 nM, and the linear correlation is 0.9958. The signals of Cy3 and Cy5 are detected by two groups of photomultiplier tube (PMT) to realize the detection of miRNA. Microlenses enhance the intensity of the
photoelectric signal and reduce the detection limit. Microdroplets are used to encapsulate miRNA, reduce the amount of detection material, and solve the degradation of detection material by RNase. The modulation transfer function model of Gaussian beam is established with the assistance of
the photoelectric detection system, which is suitable for the case that cannot be ignored in Kolmogorov turbulence under the action of internal/external scale.
The Integrated Carbon Observation System in Europe
Authors: Heiskanen Jouni , Brümmer Christian , Buchmann Nina , Calfapietra Carlo , Chen Huilin , Gielen Bert , Gkritzalis Thanos , Hammer Samuel , Hartman Susan , Herbst Mathias , Janssens Ivan A. , Jordan Armin , Juurola Eija , Karstens Ute , Kasurinen Ville , Kruijt Bart , Lankreijer Harry , Levin Ingeborg , Linderson Maj-Lena , Loustau Denis , Merbold Lutz , Myhre Cathrine Lund , Papale Dario , Pavelka Marian , Pilegaard Kim , Ramonet Michel , Rebmann Corinna , Rinne Janne , Rivier Léonard , Saltikoff Elena , Sanders Richard , Steinbacher Martin , Steinhoff Tobias , Watson Andrew , Vermeulen Alex T. , Vesala Timo , Vítková Gabriela , Kutsch Werner
Published: October 2021

Since 1750, land-use change and fossil fuel combustion has led to a 46% increase in the atmospheric carbon dioxide (CO2) concentrations, causing global warming with substantial societal consequences. The Paris Agreement aims to limit global temperature increases to well below 2°C above preindustrial levels. Increasing levels of CO2 and other greenhouse gases (GHGs), such as methane (CH4) and nitrous oxide (N2O), in the atmosphere are the primary cause of climate change. Approximately half of the carbon emissions to the atmosphere are sequestered by ocean and land sinks, leading to ocean acidification but also slowing the rate of global warming. However, there are significant uncertainties in the future global warming scenarios due to uncertainties in the size, nature, and stability of these sinks. Quantifying and monitoring the size and timing of natural sinks and the impact of climate change on ecosystems are important information to guide policy-makers’ decisions and strategies on reductions in emissions. Continuous, long-term observations are required to quantify GHG emissions, sinks, and their impacts on Earth systems. The Integrated Carbon Observation System (ICOS) was designed as the European in situ observation and information system to support science and society in their efforts to mitigate climate change. It provides standardized and open data currently from over 140 measurement stations across 12 European countries. The stations observe GHG concentrations in the atmosphere and carbon and GHG fluxes between the atmosphere, land surface, and the oceans. This article describes how ICOS fulfills its mission to harmonize these observations, ensure the related long-term financial commitments, provide easy access to well-documented and reproducible high-quality data and related protocols and tools for scientific studies, and deliver information and GHG-related products to stakeholders in society and policy.
Childhood Adversities and Unmet Needs of Older Chinese Adults: The Mediation Effects of Family Relationships
Authors: Hu Bo , Wei Mingyu
Published: October 2021

Ensuring equality and adequacy of care for older adults is vitally important. This study investigates the relationships between childhood adversities and unmet long-term care needs of older adults in China and the mediation effects of family relationships. The data came from a nationally representative sample of older Chinese adults aged 60 and over with long-term care needs ( N = 2186). We conducted mediation analyses and decomposed the total effects of childhood adversities on unmet needs into direct and indirect effects. The probability of unmet needs is significantly higher among older adults experiencing childhood adversities. Satisfaction with marriage mediates the association between childhood adversities and unmet personal care needs. Relationships with children mediate the association between childhood adversities and unmet domestic care needs. The causes of unmet needs can be traced back to early life, which underscores the importance of concerted efforts in family, education and long-term care policies to tackle unmet needs.
Messaging in the Malaysian Workplace: Communication, Social Media and Employee Wellbeing
Authors: Wahab Norsyamihah Abdul , Bahfen Nasya
Published: October 2021

This article attempts to identify the impact of social media and new messaging processes on the well-being of Malaysian workers (specifically middle managers). It explores Malaysian workplace use of electronic communication methods and how managers view the impact of tablets, social networking apps and similar technologies on their social and emotional well-being, including their capacity to relate to and interact with other employees. In the Malaysian capital Kuala Lumpur, 27 middle managers were interviewed in five focus groups, with the middle managers representing various public and private sector organizations. The findings reveal that social media and e-mail dominate workplace communication among these Kuala Lumpur–based managers; emotional and mental health concerns (like pressure to be constantly available) for themselves and the people they managed motivated some middle managers to preference face-to-face interaction. This was particularly true of certain contexts, like when providing one-on-one feedback on performance. The past decade has seen the widespread and rapid adoption of social media, messaging and other communication technologies in the workplace. It is hoped that this study contributes to an understanding of the impact of this change on employee well-being in Malaysia.
Ubiquinol-cytochrome c reductase core protein 1 contributes to cardiac tolerance to acute exhaustive exercise
Authors: Yi Tingting , Chen Huifang , Zhan Jian , Li Yu , Long Zonghong , Wu Zhuoxi , Yang Mi , Peng Taotao , Li Hong
Published: October 2021

Ubiquinol-cytochrome c reductase core protein 1 (UQCRC1) is an indispensable component of mitochondrial complex III. It plays a key role in cardioprotection and maintaining mitochondrion function. However, the exact role of UQCRC1 in maintaining cardiac function has not been reported by in vivo models. Also, the exact biological functions of UQCRC1 are far from fully understood. UQCRC1+/− mice had decreased both mRNA and protein expression of UQCRC1 in the left ventricular myocardia, and these mice had reduced tolerance to acute exhaustive exercise including decreased time and distance with higher apoptosis rate, higher expression level of cleaved CASPASE 3, and higher ratio of cleaved PARP1 to full-length PARP1. Moreover, UQCRC1 knockdown led to increased LV interventricular septal thicknesses both at systole and diastole, as well as decreased LV volume both at end-systole and end-diastole. Finally, UQCRC1 gene disruption resulted in mitochondrial vacuolation, fibril disarrangement, and more severe morphological and structural changes in mitochondria after acute exhaustive exercise. In conclusion, UQCRC1 contributes to cardiac tolerance to acute exhaustive exercise in mice, and it may be an essential component of complex III, playing a crucial role in maintaining cardiac functions.
Quantitative prediction model for affinity of drug–target interactions based on molecular vibrations and overall system of ligand-receptor
Authors: Wang Xian-rui , Cao Ting-ting , Jia Cong Min , Tian Xue-mei , Wang Yun
Published: October 2021

Background

The study of drug–target interactions (DTIs) affinity plays an important role in safety assessment and pharmacology. Currently, quantitative structure–activity relationship (QSAR) and molecular docking (MD) are most common methods in research of DTIs affinity. However, they often built for a specific target or several targets, and most QSAR and MD methods were based either on structure of drug molecules or on structure of receptors with low accuracy and small scope of application. How to construct quantitative prediction models with high accuracy and wide applicability remains a challenge. To this end, this paper screened molecular descriptors based on molecular vibrations and took molecule-target as a whole system to construct prediction models with high accuracy-wide applicability based on dissociation constant (Kd) and concentration for 50% of maximal effect (EC50), and to provide reference for quantifying affinity of DTIs.

Results

After comprehensive comparison, the results showed that RF models are optimal models to analyze and predict DTIs affinity with coefficients of determination (R2) are all greater than 0.94. Compared to the quantitative models reported in literatures, the RF models developed in this paper have higher accuracy and wide applicability. In addition, E-state molecular descriptors associated with molecular vibrations and normalized Moreau-Broto autocorrelation (G3), Moran autocorrelation (G4), transition-distribution (G7) protein descriptors are of higher importance in the quantification of DTIs.

Conclusion

Through screening molecular descriptors based on molecular vibrations and taking molecule-target as whole system, we obtained optimal models based on RF with more accurate-widely applicable, which indicated that selection of molecular descriptors associated with molecular vibrations and the use of molecular-target as whole system are reliable methods for improving performance of models. It can provide reference for quantifying affinity of DTIs.
Genome-wide DNA methylation profile changes associated with shell colouration in the Yesso scallop (Patinopecten yessoensis) as measured by whole-genome bisulfite sequencing
Authors: Yuan Changzi , Mao Junxia , Sun Hongyan , Wang Yiying , Guo Ming , Wang Xubo , Tian Ying , Hao Zhenlin , Ding Jun , Chang Yaqing
Published: October 2021

Background

Mollusca, a phylum of highly rich species, possess vivid shell colours, but the underlying molecular mechanism remains to be elucidated. DNA methylation, one of the most common epigenetic modifications in eukaryotes, is believed to play a vital role in various biological processes. However, analysis of the effects of DNA methylation on shell colouration has rarely been performed in molluscs, limiting the current knowledge of the molecular mechanism of shell colour formation.

Results

In the present study, to reveal the role of epigenetic regulation in shell colouration, WGBS, the “gold standard” of DNA methylation analysis, was first performed on the mantle tissues of Yesso scallops (Patinopecten yessoensis) with different shell colours (brown and white), and DNA methylomes at single-base resolution were generated. About 3% of cytosines were methylated in the genome of the Yesso scallop. A slight increase in mCG percentage and methylation level was found in brown scallops. Sequence preference of nearby methylated cytosines differed between high and low methylation level sites and between the brown- and white-shelled scallops. DNA methylation levels varied among the different genomic regions; all the detected regions in the brown group exhibited higher methylation levels than the white group. A total of 41,175 DMRs (differentially methylated regions) were detected between brown and white scallops. GO functions and pathways associated with the biosynthesis of melanin and porphyrins were significantly enriched for DMRs, among which several key shell colour-related genes were identified. Further, different correlations between mRNA expression levels and DNA methylation status were found in these genes, suggesting that DNA methylation regulates shell colouration in the Yesso scallop.

Conclusions

This study provides genome-wide DNA methylation landscapes of Yesso scallops with different shell colours, offering new insights into the epigenetic regulatory mechanism underlying shell colour.
Cultivation of common bacterial species and strains from human skin, oral, and gut microbiota
Authors: Fleming Elizabeth , Pabst Victor , Scholar Zoe , Xiong Ruoyun , Voigt Anita Y. , Zhou Wei , Hoyt Amelia , Hardy Rachel , Peterson Anna , Beach Ryan , Ondouah-Nzutchi Yvette , Dong Jinhong , Bateman Lucinda , Vernon Suzanne D. , Oh Julia
Published: October 2021

Background

Genomics-driven discoveries of microbial species have provided extraordinary insights into the biodiversity of human microbiota. In addition, a significant portion of genetic variation between microbiota exists at the subspecies, or strain, level. High-resolution genomics to investigate species- and strain-level diversity and mechanistic studies, however, rely on the availability of individual microbes from a complex microbial consortia. High-throughput approaches are needed to acquire and identify the significant species- and strain-level diversity present in the oral, skin, and gut microbiome. Here, we describe and validate a streamlined workflow for cultivating dominant bacterial species and strains from the skin, oral, and gut microbiota, informed by metagenomic sequencing, mass spectrometry, and strain profiling.

Results

Of total genera discovered by either metagenomic sequencing or culturomics, our cultivation pipeline recovered between 18.1–44.4% of total genera identified. These represented a high proportion of the community composition reconstructed with metagenomic sequencing, ranging from 66.2–95.8% of the relative abundance of the overall community. Fourier-Transform Infrared spectroscopy (FT-IR) was effective in differentiating genetically distinct strains compared with whole-genome sequencing, but was less effective as a proxy for genetic distance.

Conclusions

Use of a streamlined set of conditions selected for cultivation of skin, oral, and gut microbiota facilitates recovery of dominant microbes and their strain variants from a relatively large sample set. FT-IR spectroscopy allows rapid differentiation of strain variants, but these differences are limited in recapitulating genetic distance. Our data highlights the strength of our cultivation and characterization pipeline, which is in throughput, comparisons with high-resolution genomic data, and rapid identification of strain variation.
Digital health device measured sleep duration and ideal cardiovascular health: an observational study
Authors: Leopold Jane A. , Antman Elliott M.
Published: October 2021

Background

Studies relying on self-reported sleep data suggest that there is an association between short and long sleep duration and less than ideal cardiovascular health. Evidence regarding the feasibility of using digital health devices to measure sleep duration and assess its relationship to ideal cardiovascular health are lacking. The objective of the present study was to utilize digital health devices to record sleep duration and examine the relationship between sleep duration and ideal cardiovascular health.

Methods

A total of 307 participants transmitted sleep duration data from digital health devices and answered the Life’s Simple 7 survey instrument to assess ideal cardiovascular health. Sleep duration was defined as adequate (7 to < 9 h per night) or non-adequate (< 7 h and ≥ 9 h).

Results

We identified three sleep-cardiovascular health phenogroups: resilient (non-adequate sleep and ideal cardiovascular health), uncoupled (adequate sleep and non-ideal cardiovascular health) or concordant (sleep and cardiovascular health metrics were aligned). Participants in the resilient phenogroup (n = 83) had better cardiovascular health factor profiles (blood pressure, blood glucose and cholesterol levels) and behaviors (healthy weight, diet, exercise, smoking) than participants in the concordant (n = 171) and uncoupled (n = 53) phenogroups. This was associated with higher Life’s Simple 7 Health Scores in the resilient phenogroup compared to the concordant and uncoupled phenogroups (7.8 ± 0.8 vs. 7.0 ± 1.4 vs. 5.6 ± 0.7, P < 0.01).

Conclusion

This study identified three distinct sleep-ideal cardiovascular health phenogroups and highlights the advantage of incorporating sleep assessments into studies of cardiovascular health. Future studies should focus on the relationship between sleep-cardiovascular phenogroups and clinical outcomes.

Clinical Trial Registration Clinicaltrials.gov NCT02958098. Date of registration: November 11, 2016.
Willingness of patients with chronic disease in rural China to contract with family doctors: implication for targeting characteristics
Authors: Li Jie , Li Jie , Fu Peipei , Chen Yan , Tang Xue , Li Zhixian , Yang Shijun , Yan Chen , Li Wenjuan , Gui Zhen , Zhou Chengchao
Published: October 2021

Background

Rural residents with chronic conditions have a stronger need for health services, which should make using family doctor contract services a priority. This study aimed to evaluate the rate of willingness among rural residents with chronic conditions to contract with family doctors and examine its determinants.

Methods

A cross-sectional study was conducted from May, 2018 to June, 2018 in Shandong Province in China. A total of 769 rural unsigned residents with chronic conditions were included in the analysis. Using the Andersen model as the theoretical framework, logistic regression models were chosen to analyse the factors associated with willingness to contract with family doctors.

Results

This study found that the rate of willingness to contract with family doctors among chronic patients in rural Shandong was 46.7%. A higher willingness was observed in those living a further distance from the village clinic (more than 600 m: OR = 1.85, 95%CI =1.17–2.93), having received publicity for family doctor contract services (OR = 1.71, 95% CI = 1.06–2.76), reporting need for utilizing a chronic disease management program (OR = 3.36, 95% CI = 2.20–5.23), and reporting need for higher medical insurance reimbursement (OR = 1.91, 95% CI = 1.28–2.83).

Conclusions

The prevalence of contract willingness was relatively low among unsigned rural residents with chronic conditions in rural Shandong, China. The need factors were powerful factors affecting their willingness to contract with family doctors. The government should therefore strengthen targeted publicity and education to rural residents with chronic conditions and provide targeted healthcare services, such as chronic disease management programs and medical services with higher reimbursement rates, to promote their willingness to contract with family doctors.
Association between glucocorticoids treatment and viral clearance delay in patients with COVID-19: a systematic review and meta-analysis
Authors: Li Jianbo , Liao Xuelian , Zhou Yue , Wang Luping , Yang Hang , Zhang Wei , Zhang Zhongwei , Kang Yan
Published: October 2021

Background

Evidence of glucocorticoids on viral clearance delay of COVID-19 patients is not clear.

Methods

In this systematic review and meta-analysis, we searched for studies on Medline, Embase, EBSCO, ScienceDirect, Web of Science, Cochrane Library, and ClinicalTrials.gov from 2019 to April 20, 2021. We mainly pooled the risk ratios (RRs) and mean difference (MD) for viral clearance delay and did subgroup analyses by the severity of illness and doses of glucocorticoids.

Results

38 studies with a total of 9572 patients were identified. Glucocorticoids treatment was associated with delayed viral clearance in COVID-19 patients (adjusted RR 1.52, 95% CI 1.29 to 1.80, I2 = 52%), based on moderate-quality evidence. In subgroup analyses, risk of viral clearance delay was significant both for COVID-19 patients being mild or moderate ill (adjusted RR 1.86, 95% CI 1.35 to 2.57, I2 = 48%), and for patients of being severe or critical ill (adjusted RR 1.59, 95% CI 1.23 to 2.07, I2 = 0%); however, this risk significantly increased for patients taking high doses (unadjusted RR 1.85, 95% CI 1.08 to 3.18; MD 7.19, 95% CI 2.78 to 11.61) or medium doses (adjusted RR 1.86, 95% CI 0.96 to 3.62, I2 = 45%; MD 3.98, 95% CI 3.07 to 4.88, I2 = 4%), rather those taking low doses (adjusted RR 1.38, 95% CI 0.94 to 2.02, I2 = 59%; MD 1.46, 95% CI −0.79 to 3.70, I2 = 82%).

Conclusions

Glucocorticoids treatment delayed viral clearance in COVID-19 patients of taking high doses or medium doses, rather in those of taking low doses of glucocorticoids.
Changes in practice patterns in Japan from before to after JSDT 2013 guidelines on hemodialysis prescriptions: results from the JDOPPS
Authors: Tomo Tadashi , Larkina Maria , Shintani Ayumi , Ogawa Tomonari , Robinson Bruce M. , Bieber Brian , Henn Lisa , Pisoni Ronald L.
Published: October 2021

Background

The Japanese Society for Dialysis Therapy (JSDT) published in 2013 inaugural hemodialysis (HD) guidelines. Specific targets include 1.4 for single-pool Kt/V (spKt/V) with a minimum dose of 1.2, minimum dialysis session length of 4 hours, minimum blood flow rate (BFR) of 200 mL/min, fluid removal rate no more than 15 mL/kg/hr, and hemodiafiltration (HDF) therapy for certain identified symptoms. We evaluated the effect of these guidelines on actual practice in the years spanning 2005 – 2018.

Methods

Analyses were carried out to describe trends in the above HD prescription practices from December 2005 to April 2013 (before guideline publication) to August 2018 based on prevalent patient cross-sections from approximately 60 randomly selected HD facilities participating in the Japan Dialysis Outcomes and Practice Patterns Study.

Results

From April 2006 to August 2017 continual rises occurred in mean spKt/V (from 1.35 to 1.49), and percent of patients having spKt/V>1.2 (71% to 85%). Mean BFR increased with time from 198.3 mL/min (April 2006) to 218.4 mL/min (August 2017) , along with percent of patients with BFR >200 ml/min (65% to 85%). HDF use increased slightly from 6% (April 2006 and August 2009) to 8% by April 2013, but increased greatly thereafter to 23% by August 2017. In contrast, mean HD treatment time showed little change from 2006-2017, whereas mean UFR declined from 11.3 in 2006 to 8.4 mL/Kg/hour in 2017.

Conclusions

From 2006 – 2018 Japanese HD patients experienced marked improvement in reaching the spKt/V target specified by the 2013 JSDT guidelines. This may have been due to moderate increase in mean BFR even though mean HD session length did not change much. In addition, HDF use increased dramatically in this time period. Other HD delivery changes during this time, such as increased use of super high flux dialyzers, also merit study. While we cannot definitively conclude a causal relationship between the publication of the guidelines and the subsequent practice changes in Japan, those changes moved practice closer to the recommendations of the guidelines.
Changes in the availability of medical oxygen and its clinical practice in Ethiopia during a national scale-up program: a time series design from thirty-two public hospitals
Authors: Tolla Habtamu Seyoum , Asemere Yigeremu Abebe , Desale Alebel Yaregal , Woyessa Dinkineh Bikila , Fekadu Zinabie Feleke , Belete Alemayehu Berhanu , Battu Audrey , Lam Felix
Published: October 2021

Background

Oxygen therapy is a lifesaving treatment, however, in Ethiopia, oxygen is not readily available in many healthcare facilities. In 2015, the Federal Ministry of Health launched a national roadmap to increase access to oxygen. This study aims to evaluate whether availability of oxygen and its clinical practice in public hospitals of Ethiopia changed during the time the roadmap was being implemented.

Methods

Between December 2015 and December 2019, a multifaceted approach was undertaken to increase access to oxygen in public facilities in Ethiopia. The activities included formation of new policies, development of guidelines, procurement and maintenance of oxygen equipment, and training of healthcare workers. To evaluate whether access and use of oxygen changed during this period, facility-based surveys were conducted between December 2015 to December 2019. Primary data, including medical record reviews, were collected from 32 public hospitals bi-annually. A chi-square test that claimed P < 0.05 used to assess the statistical significance differences.

Results

The study was conducted in 32 public hospitals of Ethiopia, where capacity building and technical support interventions implemented. Of these 32 facilities, 15 (46.9%) were general hospitals, 10 (31.2%) were referral hospitals, and 7 (21.9%) were primary hospitals. Functional availability of oxygen has shown a statistically significant increase from 62 to 100% in the pediatric in-patient departments of general and referral hospitals (p-value < 0.001). Similarly, functional availability of pulse oximetry has shown a statistically significant increase from 45 to 96%. With regard to clinical practices, the blood oxygen saturation (SpO2) measurement at diagnosis increased from 10.2 to 75%, and SpO2 measurement at admission increased 20.5 to 83%.

Conclusions

Based on the intervention results, we conclude that multifaceted approaches targeting policy, healthcare workers’ capacity, increased device procurement, and device maintenance programs with on-site mentorship, can improve the availability of medical oxygen and pulse oximetry, as well as clinical practice of oxygen therapy in health facilities. Therefore, ensuring device availability along with regular technical support and close follow-up of healthcare workers and facilities are critical, and these interventions should be scaled further.
Embracing challenging complexity: exploring handwashing behavior from a combined socioecological and intersectional perspective in Sierra Leone
Authors: Lanfer Hanna Luetke , Reifegerste Doreen
Published: October 2021

Background

Handwashing with soap is a cost-effective, efficient health behavior to prevent various diseases. Despite its immense health benefits, the lowest prevalence of handwashing is found in low-income countries. Here, its practice is not only determined by individual behavior, but also heavily shaped by deprivations in the social and structural ecology. Moreover, handwashing barriers are not equally experienced as overlapping social identities (e.g., age and gender) intersect and create inequities between members of different social groups. To embrace the complexities of handwashing beyond individual-level behavior and singular social identities, a combined socioecological and intersectional perspective is employed. This multi-level approach with regards to intersecting privileges and disadvantages serves as a basis to promote this highly important health behavior.

Methods

This study used a qualitative, theory-based approach and combined data from two samples: experts in health promotion (n = 22) and local citizens stratified by gender and rural/urban location (n = 56). Data was collected in face-to-face interviews in Sierra Leone between November 2018 and January 2019 and analyzed using thematic analysis and typology of the qualitative data.

Results

The conceptualization of multi-level determinants of handwashing within a socioecological model showed the high relevance of inhibiting social and structural factors for handwashing practice. By establishing seven distinguishing social identity dimensions, data demonstrates that individuals within the same social setting yet with distinct social identities experience strikingly differing degrees of power and privileges to enact handwashing. While a local leader is influential and may also change structural-level determinants, a young, rural wife experiences multiple social and structural constraints to perform handwashing with soap, even if she has high handwashing intentions.

Conclusion

This study provides a holistic analytical framework for the identification of determinants on multiple levels and accumulating intersections of socially produced inequalities for handwashing and is applicable to other health topics. As the exploration of handwashing was approached from a solution-focused instead of a problem-focused perspective, the analysis can guide multi-level intervention approaches (e.g., using low-cost, participatory activities at the community level to make use of the available social capital).
STAT1: a novel candidate biomarker and potential therapeutic target of the recurrent aphthous stomatitis
Authors: Cao Mingchen , Li Lei , Xu Long , Fang Mengxiang , Xing Xiaomin , Zhou Changkai , Ren Wei , Wang Longyuan , Jing Fanbo
Published: October 2021

Background

The recurrent aphthous stomatitis (RAS) frequently affects patient quality of life as a result of long lasting and recurrent episodes of burning pain. However, there were temporarily few available effective medical therapies currently. Drug target identification was the first step in drug discovery, was usually finding the best interaction mode between the potential target candidates and probe small molecules. Therefore, elucidating the molecular mechanism of RAS pathogenesis and exploring the potential molecular targets of medical therapies for RAS was of vital importance.

Methods

Bioinformatics data mining techniques were applied to explore potential novel targets, weighted gene co-expression network analysis (WGCNA) was used to construct a co-expression module of the gene chip data from GSE37265, and the hub genes were identified by the Molecular Complex Detection (MCODE) plugin.

Results

A total of 16 co-expression modules were identified, and 30 hub genes in the turquoise module were identified. In addition, functional analysis of Hub genes in modules of interest was performed, which indicated that such hub genes were mainly involved in pathways related to immune response, virus infection, epithelial cell, signal transduction. Two clusters (highly interconnected regions) were determined in the network, with score = 17.647 and 10, respectively, cluster 1 and cluster 2 are linked by STAT1 and ICAM1, it is speculated that STAT1 may be a primary gene of RAS. Finally, genistein, daidzein, kaempferol, resveratrol, rosmarinic acid, triptolide, quercetin and (-)-epigallocatechin-3-gallate were selected from the TCMSP database, and both of them is the STAT-1 inhibitor. The results of reverse molecular docking suggest that in addition to triptolide, (-)-Epigallocatechin-3-gallate and resveratrol, the other 5 compounds (flavonoids) with similar structures may bind to the same position of STAT1 protein with different docking score.

Conclusions

Our study identified STAT1 as the potential biomarkers that might contribute to the diagnosis and potential therapeutic target of RAS, and we can also screen RAS therapeutic drugs from STAT-1 inhibitors.
Report of the “satisfaction” survey amongst public health services nurses in Port Said
Authors: Bellizzi Saverio , Padrini Susanna
Published: October 2021

Background

There is a paucity of evidence regarding the job experience of nurses in Egypt. An unpublished previous pilot study conducted in the Port Said Technical Nursing Institute, which was based on 36 participants, showed that almost half of nurses were satisfied with their job; on the other hand, nurses indicated low salaries and high work-loads as main reasons for dissatisfaction. We explored job satisfaction of nurses working in public health services of the Port Said Governorate to inform future healthcare policy.

Methods

A cross-sectional study including nurses from different public health services was conducted. Questionnaires were delivered in a sample of primary health care facilities as well as in the Port Said Governorate public hospital. Following a literature review, eight components were identified as contributors to job satisfaction; two closed questions for each of the eight components and two open questions were devised for a total of 18 questions.

Results

The final study population consisted of 285 individuals. Almost 40.0% of the participants felt safe in their clinical environment while around 10.0% disagree on this. Almost 70.0% of participants complained about high work-load due to shortage of staff in the respective clinical area. Almost 85.0% of nurses reported that their salary did not cover living cost while only 13.0% indicated earning a fair salary. Almost 60.0% agreed with the fact that they have regular opportunities to develop in their career.

Conclusion

Increasing job satisfaction among nurses in Egypt is critical to ensure quality of care for patients. Issues such as salary, staffing and cooperation with colleagues deserve specific attention.
Individual social contact data and population mobility data as early markers of SARS-CoV-2 transmission dynamics during the first wave in Germany—an analysis based on the COVIMOD study
Authors: Tomori Damilola Victoria , Rübsamen Nicole , Berger Tom , Scholz Stefan , Walde Jasmin , Wittenberg Ian , Lange Berit , Kuhlmann Alexander , Horn Johannes , Mikolajczyk Rafael , Jaeger Veronika K. , Karch André
Published: October 2021

Background

The effect of contact reduction measures on infectious disease transmission can only be assessed indirectly and with considerable delay. However, individual social contact data and population mobility data can offer near real-time proxy information. The aim of this study is to compare social contact data and population mobility data with respect to their ability to reflect transmission dynamics during the first wave of the SARS-CoV-2 pandemic in Germany.

Methods

We quantified the change in social contact patterns derived from self-reported contact survey data collected by the German COVIMOD study from 04/2020 to 06/2020 (compared to the pre-pandemic period from previous studies) and estimated the percentage mean reduction over time. We compared these results as well as the percentage mean reduction in population mobility data (corrected for pre-pandemic mobility) with and without the introduction of scaling factors and specific weights for different types of contacts and mobility to the relative reduction in transmission dynamics measured by changes in R values provided by the German Public Health Institute.

Results

We observed the largest reduction in social contacts (90%, compared to pre-pandemic data) in late April corresponding to the strictest contact reduction measures. Thereafter, the reduction in contacts dropped continuously to a minimum of 73% in late June. Relative reduction of infection dynamics derived from contact survey data underestimated the one based on reported R values in the time of strictest contact reduction measures but reflected it well thereafter. Relative reduction of infection dynamics derived from mobility data overestimated the one based on reported R values considerably throughout the study. After the introduction of a scaling factor, specific weights for different types of contacts and mobility reduced the mean absolute percentage error considerably; in all analyses, estimates based on contact data reflected measured R values better than those based on mobility.

Conclusions

Contact survey data reflected infection dynamics better than population mobility data, indicating that both data sources cover different dimensions of infection dynamics. The use of contact type-specific weights reduced the mean absolute percentage errors to less than 1%. Measuring the changes in mobility alone is not sufficient for understanding the changes in transmission dynamics triggered by public health measures.
Proceedings from the CIH-LMU 2021 Symposium: “Global Health Perspectives: Climate Change & Migration”
Authors: Lutchmun Wandini , Ablorde Aikins , Chang Han-Wen , Froeschl Guenter , Misganaw Equlinet , Sapkota Bhim Prasad , Scholze Sarah , Singo Josephine , Hoffaeller Lisa
Published: October 2021

Climate change shapes human migration through the interaction of environmental changes with political, social, economic, and demographic drivers of mobility. Low-and middle-income countries bear the brunt of the health impacts of climate change and migration, despite their overall low contribution to greenhouse gas emissions. The CIHLMU Symposium 2021 aimed to explore the complex interconnections between climate change, migration and health from diverse global perspectives. A number of themes, such as the relationship between climate and trade, the role of technology, and the issue of responsibility were tackled. The speakers also highlighted the need for climate resilient health-systems, gender mainstreaming in climate strategies, collaboration between the Global North and South and urgently defining the ‘climate refugee’. It is crucial that the narrative around climate change moves from an environmental framing to encompass human health and migration within climate discussions and strategies.
Facilitators and barriers to the regulation of medical cannabis: a scoping review of the peer-reviewed literature
Authors: Ruheel Mohammad Ali , Gomes Zoya , Usman Sana , Homayouni Pargol , Ng Jeremy Y.
Published: October 2021

Background

In recent decades, several political, legislative, judicial, consumer, and commercial processes around the world have advanced legalization efforts for the use of medical cannabis (MC). As the use of MC evolves through legislative reform, with an increase in public acceptance and therapeutic potential, a need exists to further investigate the facilitators and barriers to MC regulation.

Methods

A scoping review was conducted to identify the facilitators and barriers associated with the implementation of MC regulations. MEDLINE, EMBASE, AMED and PsycINFO databases were systematically searched; no restrictions were placed on geographic location/jurisdiction. Eligible articles included those that evaluated the MC regulatory framework of one or more countries.

Results

Twenty-two articles were deemed eligible and included in this review. Themes identified include: (1) effects of conflicts, mindset, and ideology of state population, (2) the use of comparisons to analyze MC regulation, and (3) the need for more knowledge, advice, and empirical/clinical evidence to inform future MC policies.

Conclusion

Policymakers should be aware of facilitators to the MC regulation implementation process, such as the influence of state and federal congruence, increased transparency, and the incorporation of stakeholder concerns, in order to effectively respond to a growing societal acceptance of MC and its use among patients. Given a comprehensive understanding of these influential factors, policymakers may be better equipped to meet the consumer and commercial demands of a rapidly evolving MC regulatory environment.