bluuebunny/crossref_metadata_2025 huggingface dataset:
Susceptibility-based imaging aids accurate distinction of pediatric-onset MS from myelin oligodendrocyte glycoprotein antibody-associated disease
Authors: Sacco Simone , Virupakshaiah Akash , Papinutto Nico , Schoeps Vinicius A , Akula Amit , Zhao Haojun , Arona Jennifer , Stern William A , Chong Janet , Hart Janace , Zamvil Scott S , Sati Pascal , Henry Roland G , Waubant Emmanuelle
Published: October 2023

Background:

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) and pediatric-onset multiple sclerosis (POMS) share clinical and magnetic resonance imaging (MRI) features but differ in prognosis and management. Early POMS diagnosis is essential to avoid disability accumulation. Central vein sign (CVS), paramagnetic rim lesions (PRLs), and central core lesions (CCLs) are susceptibility-based imaging (SbI)-related signs understudied in pediatric populations that may help discerning POMS from MOGAD.

Methods:

T2-FLAIR and SbI (three-dimensional echoplanar imaging (3D-EPI)/susceptibility-weighted imaging (SWI) or similar) were acquired on 1.5T/3T scanners. Two readers assessed CVS-positive rate (%CVS+), and their average score was used to build a receiver operator curve (ROC) assessing the ability to discriminate disease type. PRLs and CCLs were identified using a consensual approach.

Results:

The %CVS+ distinguished 26 POMS cases (mean age 13.7 years, 63% females, median EDSS 1.5) from 14 MOGAD cases (10.8 years, 35% females, EDSS 1.0) with ROC = 1, p < 0.0001, (cutoff 41%). PRLs were only detectable in POMS participants (mean 2.1±2.3, range 1–10), discriminating the two conditions with a sensitivity of 69% and a specificity of 100%. CCLs were more sensitive (81%) but less specific (71.43%).

Conclusion:

The %CVS+ and PRLs are highly specific markers of POMS. After proper validation on larger multicenter cohorts, consideration should be given to including such imaging markers for diagnosing POMS at disease onset.
Identity position and pedagogical agency negotiation in teaching EAP writing: A case study
Authors: Weng Zhenjie
Published: October 2023

In language education, little classroom-based research has been conducted regarding novice teachers of English for academic purposes (EAP), and even less on teaching EAP at graduate level and on graduate teaching assistants (GTAs), a significant but overlooked teacher population at universities. Thus, this ethnographic case study focuses on the exploration of a GTA’s self-positioning in a graduate-level EAP composition class, with which he was unfamiliar as he taught it for the first time. Classroom field notes, audio-recordings, and interviews, in addition to supportive data, were collected and analysed through the lens of positioning and agency. The analysis of the data revealed that the teacher took up three core identity positions: a considerate teacher of English as a second language (ESL), an experienced and knowledgeable researcher, and a limited writing teacher. The findings further indicated that the possession of or the lack of knowledge on research, EAP writing, students, and genre pedagogy influenced the teacher’s agency in constructing identity positions and making pedagogical decisions. The study contributes to the limited investigation of EAP research and further explores the relationship among teacher knowledge, identity positions, and pedagogical agency. The study bears implications for the teaching of EAP writing and professional training.
Visualising state biographical narratives: A rhetorical analysis of Chinese and North Korean propaganda photographs
Authors: Hellmann Olli , Oppermann Kai
Published: October 2023

Biographical narratives generate a continuous sense of political community across the state’s past, present and future, and provide the state with ontological security. Building on growing International Relations scholarship that highlights the power of visuals in shaping global politics, our article proposes visual rhetorical analysis as a tool to interrogate how governments employ images to tell their biographical narratives. The rhetorical approach transcends the methodological divide in the current ‘visual turn’ literature between the cognitive psychological and poststructuralist perspectives. We illustrate the analytical value of the rhetorical approach through an empirical study of how the totalitarian regimes of China and North Korea communicate their biographical narratives – the ‘rightful great power’ narrative and the ‘family state’ narrative, respectively – through propaganda imagery of their leaders. To this end, we develop a close semiotic reading of selected photographs of Xi Jinping and Kim Jong-un in different narrative settings.
Research into journalism in Spain: Sizeable, but neither international nor impactful
Authors: Salvador-Mata Bertran , Cortinas-Rovira Sergi , Herrero-Solana Víctor
Published: October 2023

Until 2021, studies of scientific disciplines took as their object of study papers published in journals from certain subject categories. This paper is one of the firsts to analyse research into journalism in Spain using the Clarivate InCites analytics platform algorithm that groups papers together according to their citation relations (Citation Topics, CT) rather than by the category of the journals themselves. A unique universe was obtained made up of 63,694 items on the Web of Science, this being the global output of the CT ‘Journalism’ (1980–2022, both included). Spain is the world’s third producer by number of items (4635), but only seventh in citations (and has the lowest proportion of citations per paper, 7.151). Most of the papers (34.01%) are published in Q3 (unlike the rest of the countries analysed, which publish more in Q1 and Q2) and in national journals (61%, even more than the US or the UK, 52% and 47%, respectively), edited by small, non-commercial publishers. Only 40.6% of the items are in the WoS Flagship citation index databases (SCIE, SSCI and AHCI). Most Spanish journals publish national research in proportions around 80%. Spanish research tends to collaborate internationally to a lesser extent (16.5%) than the other European countries analysed, and no significant change has been apparent over the last years. Spanish research into journalism is very productive but has little international presence, obtains few citations per paper, and shows no clear signs of progress towards greater international collaboration.
Social Risk Determinants for Successful Same Calendar Day Discharge in Total Joint Arthroplasty
Authors: Lutz Rex W. , Ponzio Danielle Y. , Thalody Hope S. , Patrizio Harrison A. , Czymek Miranda M. , Ast Michael , Post Zachary D. , Ong Alvin C.
Published: October 2023

Background:

While many studies have examined the impact of comorbidities on the success of same calendar day discharge (SCDD) in total joint arthroplasty (TJA), literature surrounding the impact of social determinants is lacking.

Purpose:

We sought to investigate the relationship between various social determinants and success of SCDD after primary total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods:

We conducted a retrospective review of 1160 THA and 1813 TKA performed at a single academic institution between November 2020 and August 2022. Social factors including substance use, occupation, marital status, income, and participation in physical exercise were included. In addition, aspects of discharge planning were reviewed such as living situation and transportation details.

Results:

Overall, 952 (32%) patients had successful SCDD, whereas 2021 (68%) patients were discharged on postoperative day 1 (POD1) or greater. Successful SCDD patients were more likely to have health care (4.8% vs 2.5%) and active (5.4% vs 4.6%) rather than sedentary occupations, be married (79.6% vs 67.4%), have access to transportation (95.6% vs 92.9%), live in a higher median income area ($64,044 [16,183] vs $61,572 [14,594]), and exercise weekly (62.6% vs 23.9%). Interestingly, the successful patients had more stories in their homes (1.62 [0.56] vs 1.43 [0.53]), more stairs to enter their homes (5.19 [5.22] vs 4.60 [5.24]), lived farther from the hospital (43.3 [138.0] vs 32.0 [75.9] miles), and a higher prevalence of alcohol use (60.7% vs 44.7%) and tobacco use (19.3% vs 17.3%).

Conclusion:

These findings may help arthroplasty surgeons to better understand the social factors that contribute to successful SCDD in TJA patients, ultimately aiding in patient selection and preoperative counseling.
Cardiomyopathy
Authors: Ullah Dr Jakir
Published: October 2023

Cardiomyopathy is a heart muscle disorder that cannot be attributed to ischemic heart disease or abnormal loading conditions such as hypertension and valvular heart disease. It can lead to the development of arrhythmia and heart failure, and is also the leading cause of sudden cardiac death in young people. Early detection is vital for delaying or preventing complications. This review discusses the four major subtypes, i.e. hypertrophic, dilated, restricted, and arrhythmogenic cardiomyopathy, which are likely to be encountered in primary care.
The geopolitics of democracy: The US against Russia and China
Authors: Kollaros Vasilis
Published: October 2023

After the collapse of the Soviet Union, American democracy set an example for the rest of the world, having proved its resilience to the authoritarian regime of the USSR during the Cold War. However, in recent years, China, which has adopted a different model of governance, a mixture of political authoritarianism and economic capitalism, has directly challenged the quality and credibility of American democracy. The more Beijing grows economically, the more it challenges Western institutions and the international order. It believes that there are alternative paths to prosperity.

Russia, a classically authoritarian regime, agrees with China, with which it has developed close political and economic relations. The inherent problems of American democracy, especially under the Trump administration, have been used by Beijing and Moscow to support their arguments. The Russo-Ukraine war, aside from other interpretations, can be characterised as a dispute between democratic and authoritarian regimes.
Follicular adenoma with bizarre nuclei and wild-type P53 expression: A case report and literature review
Authors: Nguyen Daniel , Htun Nyein Nyein , Wang Beverly
Published: October 2023

Introduction

Thyroid cancer is the most common endocrine tumor in humans. Follicular adenoma/carcinoma is the second most common subtype. Multiple histological patterns have been identified. Follicular adenoma with bizarre nuclei is one of the patterns associated with p53 mutation and has an unclear clinical prognosis.

Case report

A 74-year-old female presented with incidental findings of elevated TSH levels and normal thyroid markers. Ultrasound was performed and revealed multiple bilateral thyroid nodules measuring up to 1.9 cm. Fine needle aspiration was performed, and cytology showed one Bethesda category 5 nodule. Total thyroidectomy with neck dissection was performed, and the pathology showed follicular adenoma with bizarre nuclei. Based on the results of immunohistochemistry, the neoplastic cells exhibited staining for wild-type p53 and low levels of the proliferation index Ki-67.

Conclusions

We report a rare case of thyroid follicular adenoma with bizarre nuclei. In contrast to previous reports of this tumor, our patient showed a p53 wild-type pattern using immunohistochemistry. More studies are needed to better understand the etiology and clinical prognosis of this tumor.
‘The big crossroad’: Parenting, risk and educational transitions in Singapore
Authors: Göransson Kristina
Published: October 2023

Singapore’s education system is globally recognized for its high academic standards. In this paper, I explore how Singaporean parents navigate sentiments of uncertainty and risk in relation to their children’s education. While academic achievements are still considered crucial to foster a competitive population, there has been a shift of attention in education policy towards social-emotional skills and holistic education. This reconceptualization of learning is partly grounded in a concern about children’s psychological well-being, but it is also construed as essential to thrive in the 21st century. The findings show that parents’ sentiments of uncertainty and risk management are complicated, and indeed heightened, by the paradoxical expectations with regard to children’s education. Sentiments of fear of regret and guilt were particularly conspicuous in the parents’ narratives and heightened during specific educational transitions, such as the Primary School Leaving Examination.
Surgeon Preferences Worldwide in Wound Drain Utilization in Open Lumbar Fusion Surgery for Degenerative Pathologies
Authors: Cabrera Juan P. , Gary Matthew F. , Muthu Sathish , Yoon S. Tim , Kim Ho-Joong , Cho Samuel K. , Ćorluka Stipe , Lewis Stephen J. , Kato So , Buser Zorica , Wang Jeffrey C. , Hsieh Patrick C. ,   The AO Spine Knowledge Forum Degenerative
Published: October 2023

Study Design

Cross-sectional survey.

Objective

Although literature does not recommend routine wound drain utilization, there is a disconnect between the evidence and clinical practice. This study aims to explore into this controversy and analyze the surgeon preferences related to drain utilization, and the factors influencing drain use and criterion for removal.

Methods

A survey was distributed to AO Spine members worldwide. Surgeon demographics and factors related to peri-operative drain use in 1 or 2-level open fusion surgery for lumbar degenerative pathologies were collected. Multivariate analyses by drain utilization, and criterion of removal were conducted.

Results

231 surgeons participated, including 220 males (95.2%), orthopedics (178, 77.1%), and academic/university-affiliated (114, 49.4%). Most surgeons preferred drain use (186, 80.5%) and subfascial drains (169, 73.2%). Drains were removed based on duration by 52.87% of the surgeons, but 27.7% removed drains based on outputs. On multivariable analysis, significant predictors of drain use were surgeon’s aged 35-44 (OR = 11.9, 95% CI = 1.2-117.2, P = .034), 45-54 (29.1, 3.1-269.6, P = .003), 55-64 (8.9, 1.4-56.5, .019), and wound closure using coaptive films (6.0, 1.2-29.0, P = .025). Additionally, surgeons from Asia Pacific (OR = 5.19, 95% CI = 1.65-16.38, P = .005), Europe (3.55, 1.22-10.31, P = .020), and Latin America (4.40, 1.09-17.83, .038) were more likely to remove drain based on time duration, but surgeons <5 years of experience (10.23, 1.75-59.71, P = .010) were more likely to remove drains based on outputs.

Conclusions

Most spine surgeons worldwide prefer to place a subfascial wound drain for degenerative open lumbar surgery. The choice for drain placement is associated with the surgeon’s age and use of coaptive films for wound closure, while the criterion for drain removal is associated with the surgeons’ region of practice and experience.
Coastal narratives and Baltic ecotones: Painting beaches and boulders at the water’s edge
Authors: Gapp Isabelle
Published: October 2023

This paper evaluates Nils Kreuger’s and Teodors Ūders’ engagement with the sea on two sides of the Baltic coast, noting the diffusion of landscape, seascape, and coastline in paintings of Öland and Halland in Sweden, and the Dunte seaside in Latvia. Extending a discussion of artist encounters with coastal seaside communities reveals the ecological and cultural complexities characteristic of this environment. Kreuger’s paintings, while experimenting with tone, light, and form are rooted in the distinctive island landscape of Öland and the weather-beaten coastline of Halland. While for Ūders, the Dunte seaside presented a return to a ‘primeval’ nature, associating symbolism, impressionism, and realism with coastal life. In borrowing ideas from the natural sciences to describe visual culture, I contend with historic methods of ecological and agricultural cultivation, and contemporary ecocritical readings of art history, with regards to the Baltic coastal ecotone. The interaction with the sea and coast, on two sides of the Baltic, grapples with the regional identity, cultural specificity, and ecological variables of the shore; from woodland clearing and seaweed cultivation to the distinctiveness of the grasses, beaches, boulders, and water. This critical evaluation is not simply concerned with images of ecosystem damage and decline; rather these paintings are aware of the respective topographies, ecologies, and landscapes of the Swedish and Latvian Baltic coastline. As such, I consider these paintings not only within the social, historical, and visual narrative of Nordic and Baltic coastal art history, but as records of cultural and ecological memory.
Molecular characteristics and antimicrobial resistance profiles of Carbapenem-Resistant Klebsiella pneumoniae isolates at a tertiary hospital in Nanning, China
Authors: Wei Xianzhen , Li Qiuxiang , He Yu , Li Linlin , Li Shan , Li Taijie
Published: October 2023

Purpose

Carbapenem resistantKlebsiella pneumoniaeis associated with nosocomial infections and can cause high mortality, which poses great threat to human health. This study was aimed at investigating the molecular epidemiology and antimicrobial resistance profiles of carbapenem resistantKlebsiella pneumoniaeisolates and providing clues for management and control of carbapenem resistantKlebsiella pneumoniaeinfections.

Methods

A total of 2324Klebsiella pneumoniaestrains were isolated from the First Affiliated Hospital of Guangxi Medical University from June 2018 to October 2020, and 103 carbapenem resistantKlebsiella pneumoniaestrains from inpatients were collected, and the specimens mainly came from the sputum, urine, secretions, and blood. The antimicrobial susceptibility tests were performed using the VITEK 2 Compact system or the Kirby–Bauer disk-diffusion method. The resistance genes were detected by polymerase chain reaction and sequencing. The homology analysis of carbapenem resistantKlebsiella pneumoniaestrains was performed by multilocus sequence typing.

Results

Antimicrobial susceptibility results showed that the 103 carbapenem resistantKlebsiella pneumoniaestrains were resistant to most common antibiotics. Resistance genes detection showed that the carbapenem resistantKlebsiella pneumoniaeisolates mainly carried metallo-beta-lactamase, and the predominant gene was NDM-1. The homology analysis found that the major ST type were ST11, follow by ST15 and ST17.

Conclusion

The carbapenem resistantKlebsiella pneumoniaeisolates in our study shown resistance to most common antibiotics. Of the 103 carbapenem resistantKlebsiella pneumoniaestrains, 91 strains (88.35%) carried carbapenemases genes, and NDM was the predominant carbapenemase gene detected. ST11 was the major ST typing of carbapenem resistantKlebsiella pneumoniaein our hospital. Our finding may play a role in control and management of the carbapenem resistantKlebsiella pneumoniaeinfections and guiding clinical antibiotic therapy. In addition, metallo-beta-lactamase should be served as a key target to be monitored in carbapenem resistantKlebsiella pneumoniaeinfection.
CePP2C19 confers tolerance to drought by regulating the ABA sensitivity in Cyperus esculentus
Authors: Li Jia , Liu Xinyi , Ahmad Naveed , Wang Yifei , Ge Hengshuo , Wang Yijin , Liu Weican , Li Xiaowei , Wang Nan , Wang Fawei , Dong Yuanyuan
Published: October 2023

Background

Tiger nut (Cyperus esculentus) is widely known as an additional source of food, oil and feed worldwide. The agricultural production of tiger nut has been greatly hindered by drought stress, reducing both yield and quality. Protein phosphatase 2 C (PP2Cs) plays an important role in plant responses to drought stress however, the molecular mechanism of PP2Cs in tiger nuts still unclear.

Results

In this study, we identified a putative group A PP2C-encoding gene (CePP2C19) from tiger nut using transcriptome analysis, which is highly induced by drought stress. The transient expression assay suggested that CePP2C19 was localized to nucleus. Furthermore, the interaction between CePP2C19 and CePYR1, a coreceptor for ABA signaling, was first detected using a yeast two-hybrid assay and then verified using a bimolecular fluorescence complementation (BiFC) analysis. In addition, the transgenic Arabidopsis lines overexpressing CePP2C19 exhibited extreme tolerance to ABA and mannitol stresses during seed germination and root growth. At the mature stage, overexpression of CePP2C19 resulted in a higher tolerance to drought stress in transgenic Arabidopsis, as confirmed by a visible phenotype and several physiological parameters. Noticeably, the silencing of CePP2C19 by virus-induced gene silencing (VIGS) showed obvious reduction in drought tolerance in tiger nut plants.

Conclusions

The CePP2C19 emerges as a pivotal gene involved in the ABA signaling pathway, which likely reduce ABA sensitivity and thus enhances drought tolerance in Cyperus esculentus.
Constructing within and between hospital physician social networks for modeling physician research participation
Authors: Bobak Carly A. , Mohan Deepika , Murphy Megan A. , Barnato Amber E. , O’Malley A. James
Published: October 2023

Background

Physician participation in clinical trials is essential for the progress of modern medicine. However, the demand for physician research partners is outpacing physicians’ interest in participating in scientific studies. Understanding the factors that influence physician participation in research is crucial to addressing this gap.

Methods

In this study, we used a physician’s social network, as constructed from patient billing data, to study if the research choices of a physician’s immediate peers influence their likelihood to participate in scientific research. We analyzed data from 348 physicians across 40 hospitals. We used logistic regression models to examine the relationship between a physician’s participation in clinical trials and the participation of their social network peers, adjusting for age, years of employment, and influences from other hospital facilities.

Results

We found that the likelihood of a physician participating in clinical trials increased dramatically with the proportion of their social network-defined colleagues at their primary hospital who were participating ($$OR=1.05$$

O
R
=
1.05

for a 1% increase in the proportion of participating peers, $$p=1.05\times 10^{-7}$$

p
=
1.05
×

10

-
7

). Additionally, physicians who work regularly at multiple facilities were more likely to participate ($$OR=7.28$$

O
R
=
7.28

, $$p=0.03$$

p
=
0.03

) and increasingly so as the extent to which they have social network ties to colleagues at hospitals other than their primary hospital increases ($$OR=1.12$$

O
R
=
1.12

, $$p=0.05$$

p
=
0.05

). These findings suggest an inter-hospital peer participation process.

Conclusion

Our study provides evidence that the social structure of a physician’s work-life is associated with their decision to participate in scientific research. The results suggest that interventions aimed at increasing physician participation in clinical trials could leverage the social networks of physicians to encourage participation. By identifying factors that influence physician participation in research, we can work towards closing the gap between the demand for physician research partners and the number of physicians willing to participate in scientific studies.
“I don’t see the whole picture of their health”: a critical ethnography of constraints to interprofessional collaboration in end-of-life conversations in primary care
Authors: Carter Celina , Mohammed Shan , Upshur Ross , Kontos Pia
Published: October 2023

Context

Interprofessional collaboration is recommended in caring for frail older adults in primary care, yet little is known about how interprofessional teams approach end-of-life (EOL) conversations with these patients.

Objective

To understand the factors shaping nurses’ and allied health clinicians’ involvement, or lack of involvement in EOL conversations in the primary care of frail older adults.

Methods/setting

A critical ethnography of a large interprofessional urban Family Health Team in Ontario, Canada. Data production included observations of clinicians in their day-to-day activities excluding direct patient care; one-to-one semi-structured interviews with clinicians; and document review. Analysis involved coding data using an interprofessional collaboration framework as well as an analysis of the normative logics influencing practice.

Participants

Interprofessional clinicians (n = 20) who cared for mildly to severely frail patients (Clinical Frailty Scale) at the Family Health Team.

Results

Findings suggest primary care nurses and allied health clinicians have the knowledge, skills, and inclination to engage frail older adults in EOL conversations. However, the culture of the clinic prioritizes biomedical care, and normalizes nurses and allied health clinicians providing episodic task-based care, which limits the possibility for these clinicians’ engagement in EOL conversations. The barriers to nurses’ and allied health clinicians’ involvement in EOL conversations are rooted in neoliberal-biomedical ideologies that shapes the way primary care is governed and practiced.

Conclusions

Our findings help to explain why taking an individual-level approach to addressing the challenge of delayed or avoided EOL conversations, is unlikely to result in practice change. Instead, primary care teams can work to critique and redevelop quality indicators and funding models in ways that promote meaningful interprofessional practice that recognize the expertise of nursing and allied health clinicians in providing high quality primary care to frail older patients, including EOL conversations.
Genotype-phenotype spectrum and prognosis of early-onset Marfan syndrome
Authors: Kemezyte Aurelija , Gegieckiene Ruta , Burnyte Birute
Published: October 2023

Background

Marfan syndrome is a genetic connective tissue disorder affecting skeletal, ocular, and cardiovascular organ systems. Previous research found that pathogenic variants clustered in exons 24–32 of fibrillin-1 (FBN1) gene result in more severe clinical phenotypes. Furthermore, genotype-phenotype correlation studies suggested that more severe cardiovascular phenotypes were related to variants held responsible for haploinsufficiency. Our objective was to analyze the differences in clinical manifestations and genotypes of individuals with early-onset Marfan syndrome and to assess their impact on management strategies.

Methods

We analyzed clinical and genetic data of a new patient with early-onset Marfan syndrome together with 51 previously reported ones in the PubMed database between 1991 and 2022.

Results

Analysis showed 94% (49/52) of pathogenic variants clustered in exons 24–32 of the FBN1. The most common skeletal features were arachnodactyly (98%), reduced elbow extension (48%), pectus deformity (40%), and scoliosis (39%). Haploinsufficiency variants were reported as having poor outcome in 87.5% of the cases. Among patients carrying variants that substitute a cysteine for another amino acid and those that do not change cysteine content, cardiac intervention was found to be associated with a better outcome (p = 0.035 vs. p = 0.002). Variants that create an extra cysteine residue were found to be associated with a higher risk of ectopia lentis. Additionally, children up to 36-months-old were more often reported as still alive at the time of publication compared to newborns (p < 0.01).

Conclusions

Our findings have implications for prognosis, because different genotype groups and their resulting phenotype may require personalized care and management.
Knowledge and attitude toward oral health behavior of overseas students during the COVID-19 pandemic
Authors: Susanti Isi , Pisarnturakit Pagaporn Pantuwadee , Sanchavanakit Neeracha
Published: October 2023

Background

The COVID-19 pandemic has impacted overseas students, including their oral health. Due to movement restrictions, limited living allowances, dental treatment costs, and health insurance fees, overseas students might be more concerned about their oral health. The objective of the present study was to determine the association of knowledge and attitude toward oral healthcare behavior of overseas university students staying in Thailand between January 2020 to July 2022 and explore the experiences of their oral health problems.

Methods

A cross-sectional study was conducted using an online survey in English operated through the Google platform by convenience sampling among overseas Chulalongkorn University students. A newly developed self-administered questionnaire on knowledge and attitude toward oral health-related behavior and experiences in oral health problems was completed voluntarily. Descriptive statistics, Chi-square test, t-test, ANOVA, and Pearson correlations were employed using IBM SPSS version 29.

Results

Of 311 overseas students, 55.6% were male. The average age of students was 27.5 ± 4.5 years. 68.81% of students were from ASEAN countries, and 73.31% studied in non-health science programs. The study fields, health and non-health sciences, were associated with knowledge score (p < 0.001) and attitude score (p = 0.004), whereas the type of health insurance had an association with behavior score (p = 0.014) and the student’s perspective about dental visits (p = 0.014). Three hundred fifty-nine cases of oral health problems were experienced by 47.3% of overseas students. These problems consisted primarily of tooth hypersensitivity (21.2%), gingivitis (15.3%), caries (14%), cracked or broken tooth (10%), severe toothache (9%), fallen out filling (8%), and wisdom tooth pain (7.8%). There was an association between oral healthcare behavior and oral health problems (p < 0.001), and a negative correlation was found between behavior score and the number of oral health problems (p < 0.001, r=-0.204).

Conclusion

The oral healthcare habits of overseas university students correlated positively with knowledge and attitude. A negative correlation was observed between behavior and the number of oral health problems. Furthermore, studying in health science programs impacted students’ knowledge and attitude toward oral health, while dental treatment coverage insurance affected decisions for dental visits.
Facilitators and barriers of mHealth interventions during the Covid-19 pandemic: systematic review
Authors: Amiri Parastoo , Nadri Hamed , Bahaadinbeigy Kambiz
Published: October 2023

Background

With the spread of Covid-19 disease, health interventions related to the control, prevention, and treatment of this disease and other diseases were given real attention. The purpose of this systematic review is to express facilitators and barriers of using mobile health (mHealth) interventions during the Covid-19 pandemic.

Methods

In this systematic review, original studies were searched using keywords in the electronic database of PubMed until August 2022. The objectives and outcomes of these studies were extracted. Finally, to identify the facilitators and barriers of mHealth interventions, a qualitative content analysis was conducted based on the strengths, weaknesses, opportunities, and threats (SWOT) analysis method with Atlas.ti 8 software. We evaluated the studies using the Mixed Methods Appraisal Tool (MMAT).

Results

In total, 1598 articles were identified and 55 articles were included in this study. Most of the studies used mobile applications to provide and receive health services during the Covid-19 pandemic (96.4%). The purpose of the applications was to help prevention (17), follow-up (15), treatment (12), and diagnosis (8). Using SWOT analysis, 13 facilitators and 18 barriers to patients’ use of mHealth services were identified.

Conclusion

Mobile applications are very flexible technologies that can be customized for each person, patient, and population. During the Covid-19 pandemic, the applications designed due to lack of interaction, lack of time, lack of attention to privacy, and non-academic nature have not met their expectations of them.
A named General Practitioner (GP) is associated with an increase of hospital days in a single predictor analysis: a follow-up of 15 years
Authors: Lautamatti Emmi , Mattila Kari J. , Suominen Sakari , Sillanmäki Lauri , Sumanen Markku
Published: October 2023

Background

Continuity of care constitutes the basis of primary health care services and is associated with decreased hospitalization. In Finland, accessibility to primary care and increased use of hospital services are recognized challenges for the health care system.

Objectives

The aim of the study was to determine whether having a named GP is associated with hospital service use.

Methods

The data are part of the Health and Social Support study (HeSSup) based on a random Finnish working-age population sample. The cohort of the study comprised participants of postal surveys in 1998 (n = 25,898) who returned follow-up questionnaires both in 2003 and 2012 (n = 11,924). Background characteristics were inquired in the questionnaires, and hospitalization was derived from national registries (Hilmo-register).

Results

A named GP was reported both in 2003 and 2012 only by 34.3% of the participants. The association between hospital days and a named GP was linearly rising and statistically significant in a single predictor model. The strongest associations with hospital use were with health-related factors, and the association with a named GP was no longer significant in multinomial analysis.

Conclusion

A named GP is associated with an increased use of hospital days, but in a multinomial analysis the association disappeared. Health related factors showed the strongest association with hospital days. From the perspective of the on-going Finnish health and social services reform, continuity of care should be emphasized.
Spatio-temporal analysis of sheep and goat pox outbreaks in Uganda during 2011–2022
Authors: Nizeyimana Gerald , Vudriko Patrick , Erume Joseph , Mubiru Frank , Eneku Wilfred , Biryomumaisho Savino , Mwebe Robert , Arinaitwe Eugene , Ademun Rose , Atim Stella , Ayebazibwe Chrisostom , Muhanguzi Dennis , Tweyongyere Robert
Published: October 2023

Background

Sheep and goat pox (SGP) caused by sheep poxvirus (SPV) and goat poxvirus (GPV) respectively; are transboundary and World Organisation for Animal Health (WOAH)-notifiable viral diseases. There is barely any coherent information about the distribution and prevalence of SGP for Uganda. We therefore conducted this study to describe the temporal and spatial distribution of SGP suspected outbreaks in Uganda for the period 2011–2020 as well as serologically confirm presence of SGP antibodies in suspected SGP outbreaks reported in 2021–2022.

Results

Thirty-seven [37] SGP outbreaks were reported across the country during the study period. North-eastern region [that comprises of Karamoja region] had the highest number of outbreaks [n = 17, 45%]; followed by Central [n = 9, 2.4%], Northern [n = 8, 2.2%] and Western region [n = 3, 0.08%]. Reports from district veterinary personnel indicate that the prevalence of; and mortality rate and case fatality rate associated with SGP were 0.06%, 0.02% and 32% respectively. There was a steady increase in the number of reported SGP outbreaks [x̄ = 4] over the study period. Seropositivity of SGPV antibodies in outbreak sheep and goats that were investigated during the study period [2021–2022] was [n = 41, 27%, 95 CI;]

Conclusion

Our analyses of SGPV passive and active reports indicate that SGP is present in Uganda with a decade long average of four outbreaks per annum. During this period, about a third of all SGPV-clinically infected animals died. SPG is therefore a major constraint to small ruminant health and productivity in Uganda. Introduction of animals from infected herds and breach in farm biosecurity were the most important predictors of SGP outbreaks. In addition to the already existing SGP commercial vaccines, small ruminant screening for SGPV before introducing them to naïve herds and ensuring on farm biosecurity should be part of the SGP control tool pack for Ugandan small ruminant farmers.
Ultrasound evaluation of diaphragmatic function in patients with idiopathic pulmonary fibrosis: a retrospective observational study
Authors: Milesi Jules , Boussuges Alain , Habert Paul , Bermudez Julien , Reynaud-Gaubert Martine , Delliaux Stéphane , Bregeon Fabienne , Coiffard Benjamin
Published: October 2023

Introduction

The diaphragm function assessed by ultrasound has been well-studied in COPD, asthma, and intensive care. However, there are only a few studies on diffuse interstitial lung disease, while dyspnea and quality of life are major issues in the management that may depend on the diaphragm.

Methods

We retrospectively included idiopathic pulmonary fibrosis (IPF) patients followed in our center (Marseille, France) between January 2020 and February 2023 who underwent diaphragmatic ultrasound. Our objectives were to describe the diaphragmatic function of IPFs compared to healthy controls and to correlate with clinical, functional, and lung density on CT-scan.

Results

24 IPF patients and 157 controls were included. The diaphragmatic amplitude in IPF was increased at rest (median of 2.20 cm vs 1.88 cm on the right, p < 0.007, and 2.30 cm vs 1.91 cm on the left, p < 0.03, in IPF and controls respectively) and decreased in deep breathing (median of 4.85 cm vs 5.45 cm on the right, p < 0.009, and 5.10 cm vs 5.65 cm on the left, p < 0.046, in IPF and controls respectively). Diaphragmatic thickness was significantly reduced at rest on the right side (median of 1.75 mm vs 2.00 mm, p < 0.02, in IPF and controls respectively) and in deep breathing on both sides compared to controls (mean of 3.82 mm vs 4.15 mm on the right, p < 0.02, and 3.53 mm vs 3.94 mm, on the left, p < 0.009, in IPF and controls respectively). Diaphragmatic amplitude in deep breathing was moderate to strongly correlated with FVC, DLCO, and 6MWT and negatively correlated with the dyspnea and lung density on CT scan.

Conclusion

The diaphragmatic amplitude and thickness were impaired in IPF compared to controls. Diaphragmatic amplitude is the parameter best correlated with clinical, functional, and lung density criteria. Further studies are needed to determine if diaphragmatic amplitude can be a prognostic factor in IPF.
Efficacy of IVIG therapy for patients with sepsis: a systematic review and meta-analysis
Authors: Pan Bo , Sun Pan , Pei Renjun , Lin Fangzhao , Cao Haijun
Published: October 2023

Background

Sepsis is an overwhelming reaction to infection that comes with high morbidity and mortality. It requires urgent interventions in order to improve outcomes. Intravenous immunoglobulins (IVIG) are considered as potential therapy in sepsis patients. Results of trials on IVIG as adjunctive therapy for sepsis have been conflicting due to the variability in population characteristics, country geography and drug dosage form in different studies.

Methods

A systematic article search was performed for eligible studies published up to January, 31, 2023, through the PubMed, Embase, Cochrane Library and Chinese National Knowledge Infrastructure database. The included articles were screened by using rigorous inclusion and exclusion criteria. Subgroup analyses were conducted according to different IVIG types, ages and economic regions. All analyses were conducted using Review Manager 5.4. Quality of studies and risk of bias were evaluated.

Results

In total, 31 randomized controlled trials were included with a sample size of 6,276 participants. IVIG could reduce the mortality (RR 0.86, 95% CI: 0.77–0.95, p = 0.005), the hospital stay (MD − 4.46, 95% CI: − 6.35 to − 2.57, p = 0.00001), and the APACHE II scores (MD − 1.65, 95% CI: − 2.89 to − 0.63, p = 0.001). Additionally, the results showed that IgM-enriched IVIG was effective in treating sepsis (RR 0.55, 95% CI: 0.40 − 0.76; p = 0.0003), while standard IVIG failed to be effective (RR 0.91, 95% CI: 0.81–1.02, p = 0.10). And the effect of IVIG in reducing neonatal mortality was inconclusive (RR 0.93, 95% CI: 0.81–1.05, p = 0.24), but it played a large role in reducing sepsis mortality in adults (RR 0.70, 95% CI: 0.57–0.86, p = 0.0006). Besides, from the subgroup of different economic regions, it indicated that IVIG was effective for sepsis in high-income (RR 0.89, 95% CI: 0.79–0.99, p = 0.03) and middle-income countries (RR 0.49, 95% CI: 0.28–0.84, p = 0.01), while no benefit was demonstrated in low-income countries (RR 0.56, 95% CI: 0.27–1.14, p = 0.11).

Conclusions

There is sufficient evidence to support that IVIG reduces sepsis mortality. IgM-enriched IVIG is effective in both adult and neonatal sepsis, while standard IVIG is only effective in adult sepsis. IVIG for sepsis has shown efficacy in high- and middle-income countries, but is still debatable in low-income countries. More RCTs are needed in the future to confirm the true clinical potential of IVIG for sepsis in low-income countries.
Meningioma animal models: a systematic review and meta-analysis
Authors: Andersen Mikkel Schou , Kofoed Mikkel Seremet , Paludan-Müller Asger Sand , Pedersen Christian Bonde , Mathiesen Tiit , Mawrin Christian , Wirenfeldt Martin , Kristensen Bjarne Winther , Olsen Birgitte Brinkmann , Halle Bo , Poulsen Frantz Rom
Published: October 2023

Background

Animal models are widely used to study pathological processes and drug (side) effects in a controlled environment. There is a wide variety of methods available for establishing animal models depending on the research question. Commonly used methods in tumor research include xenografting cells (established/commercially available or primary patient-derived) or whole tumor pieces either orthotopically or heterotopically and the more recent genetically engineered models—each type with their own advantages and disadvantages. The current systematic review aimed to investigate the meningioma model types used, perform a meta-analysis on tumor take rate (TTR), and perform critical appraisal of the included studies. The study also aimed to assess reproducibility, reliability, means of validation and verification of models, alongside pros and cons and uses of the model types.

Methods

We searched Medline, Embase, and Web of Science for all in vivo meningioma models. The primary outcome was tumor take rate. Meta-analysis was performed on tumor take rate followed by subgroup analyses on the number of cells and duration of incubation. The validity of the tumor models was assessed qualitatively. We performed critical appraisal of the methodological quality and quality of reporting for all included studies.

Results

We included 114 unique records (78 using established cell line models (ECLM), 21 using primary patient-derived tumor models (PTM), 10 using genetically engineered models (GEM), and 11 using uncategorized models). TTRs for ECLM were 94% (95% CI 92–96) for orthotopic and 95% (93–96) for heterotopic. PTM showed lower TTRs [orthotopic 53% (33–72) and heterotopic 82% (73–89)] and finally GEM revealed a TTR of 34% (26–43).

Conclusion

This systematic review shows high consistent TTRs in established cell line models and varying TTRs in primary patient-derived models and genetically engineered models. However, we identified several issues regarding the quality of reporting and the methodological approach that reduce the validity, transparency, and reproducibility of studies and suggest a high risk of publication bias. Finally, each tumor model type has specific roles in research based on their advantages (and disadvantages).

Systematic review registration: PROSPERO-ID CRD42022308833.
Evaluation of viral infection as an etiology of ME/CFS: a systematic review and meta-analysis
Authors: Hwang Jae-Hyun , Lee Jin-Seok , Oh Hyeon-Muk , Lee Eun-Jung , Lim Eun-Jin , Son Chang-Gue
Published: October 2023

Background

Myalgic encephalitis/chronic fatigue syndrome (ME/CFS) is a long-term disabling illness without a medically explained cause. Recently during COVID-19 pandemic, many studies have confirmed the symptoms similar to ME/CFS in the recovered individuals. To investigate the virus-related etiopathogenesis of ME/CFS, we conducted a systematic assessment of viral infection frequency in ME/CFS patients.

Methods

We conducted a comprehensive search of PubMed and the Cochrane Library from their inception through December 31, 2022, using selection criteria of viral infection prevalence in ME/CFS patients and controls. Subsequently, we performed a meta-analysis to assess the extent of viral infections' contribution to ME/CFS by comparing the odds ratio between ME/CFS patients and controls (healthy and/or diseased).

Results

Finally, 64 studies met our eligibility criteria regarding 18 species of viruses, including a total of 4971 ME/CFS patients and 9221 control subjects. The participants included healthy subjects and individuals with one of 10 diseases, such as multiple sclerosis or fibromyalgia. Two DNA viruses (human herpes virus (HHV)-7 and parvovirus B19, including their co-infection) and 3 RNA viruses (borna disease virus (BDV), enterovirus and coxsackie B virus) showed odds ratios greater than 2.0 compared with healthy and/or diseased subjects. Specifically, BDV exceeded the cutoff with an odds ratio of ≥ 3.47 (indicating a "moderate association" by Cohen’s d test) compared to both healthy and diseased controls.

Conclusion

This study comprehensively evaluated the risk of viral infections associated with ME/CFS, and identified BDV. These results provide valuable reference data for future studies investigating the role of viruses in the causation of ME/CFS.
Penile melanoma: a pathological report of two cases
Authors: Pósfai Boglárka , Szentkereszty Márton , Sánta Fanni , Bajory Zoltán , Simon Andrea , Kozéki Zsófia , Csányi Ildikó , Akgul Mahmut , Kuthi Levente
Published: October 2023

Background

Penile melanoma (PM) is a rare tumor, accounting for less than 2% of all penile cancers. PM can occur on the surface of the glans, foreskin, and opening of the urethra. Furthermore, PM primarily affects older individuals and is not associated with sun exposure. Currently, there is no specific staging system for genitourinary tract melanomas, so these tumors are typically staged using the criteria for cutaneous melanoma. Limited data in the literature suggests that PM generally has a poor clinical prognosis.

Case presentation

Here, we describe two cases of PM. The first case affected a 62-year-old male who presented with hematuria and a painful tumor in the distal urethra, leading to a suspicion of penile cancer. The second case involved a 68-year-old male who noticed a rapidly evolving dark spot on his foreskin. Histological analysis confirmed the presence of melanoma in both patients. The tumors showed a diffuse and strong PRAME-positivity and lacked BRAF mutation in both cases. Additionally, the second tumor harbored an activating CKIT mutation. An enhanced PD-L1 expression was observed in both tumors.

Conclusions

We presented two rare forms of mucosal melanoma and highlighted the entities in the differential diagnosis. Based on our experience PRAME is a helpful marker for making the diagnosis of PM, and PD-L1 can predict the success of the immunotherapy. We also emphasize the need for an organ-specific staging system for PMs.