bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuous high-frequency deep brain stimulation of the anterior insula modulates autism-like behavior in a valproic acid-induced rat model
Authors: Xiao Lifei , Jiang Shucai , Wang Yangyang , Gao Caibin , Liu Cuicui , Huo Xianhao , Li Wenchao , Guo Baorui , Wang Chaofan , Sun Yu , Wang Anni , Feng Yan , Wang Feng , Sun Tao
Published: December 2022

Background

Until now, the treatment of patients with autism spectrum disorder (ASD) remain a difficult problem. The insula is involved in empathy and sensorimotor integration, which are often impaired in individuals with ASD. Deep brain stimulation, modulating neuronal activity in specific brain circuits, has recently been considered as a promising intervention for neuropsychiatric disorders. Valproic acid (VPA) is a potential teratogenic agent, and prenatal exposure can cause autism-like symptoms including repetitive behaviors and defective sociability. Herein, we investigated the effects of continuous high-frequency deep brain stimulation in the anterior insula of rats exposed to VPA and explored cognitive functions, behavior, and molecular proteins connected to autism spectrum disorder.

Methods

VPA-exposed offspring were bilaterally implanted with electrodes in the anterior insula (Day 0) with a recovery period of 1 week. (Day 0–7). High-frequency deep brain stimulation was applied from days 11 to 29. Three behavioral tests, including three-chamber social interaction test, were performed on days 7, 13, 18, 25 and 36, and several rats were used for analysis of immediate early genes and proteomic after deep brain stimulation intervention. Meanwhile, animals were subjected to a 20 day spatial learning and cognitive rigidity test using IntelliCage on day 11.

Results

Deep brain stimulation improved the sociability and social novelty preference at day 18 prior to those at day 13, and the improvement has reached the upper limit compared to day 25. As for repetitive/stereotypic-like behavior, self- grooming time were reduced at day 18 and reached the upper limit, and the numbers of burried marbles were reduced at day 13 prior to those at day 18 and day 25. The improvements of sociability and social novelty preference were persistent after the stimulation had ceased. Spatial learning ability and cognitive rigidity were unaffected. We identified 35 proteins in the anterior insula, some of which were intimately linked to autism, and their expression levels were reversed upon administration of deep brain stimulation.

Conclusions

Autism-like behavior was ameliorated and autism-related proteins were reversed in the insula by deep brain stimulation intervention, these findings reveal that the insula may be a potential target for DBS in the treatment of autism, which provide a theoretical basis for its clinical application., although future studies are still warranted.
The dynorphin/kappa opioid receptor mediates adverse immunological and behavioral outcomes induced by repetitive blast trauma
Authors: Lee Suhjung Janet , Logsdon Aric F. , Yagi Mayumi , Baskin Britahny M. , Peskind Elaine. R. , Raskind Murray M. , Cook David G. , Schindler Abigail. G.
Published: December 2022

Background

Adverse pathophysiological and behavioral outcomes related to mild traumatic brain injury (mTBI), posttraumatic stress disorder (PTSD), and chronic pain are common following blast exposure and contribute to decreased quality of life, but underlying mechanisms and prophylactic/treatment options remain limited. The dynorphin/kappa opioid receptor (KOR) system helps regulate behavioral and inflammatory responses to stress and injury; however, it has yet to be investigated as a potential mechanism in either humans or animals exposed to blast. We hypothesized that blast-induced KOR activation mediates adverse outcomes related to inflammation and affective behavioral response.

Methods

C57Bl/6 adult male mice were singly or repeatedly exposed to either sham (anesthesia only) or blast delivered by a pneumatic shock tube. The selective KOR antagonist norBNI or vehicle (saline) was administered 72 h prior to repetitive blast or sham exposure. Serum and brain were collected 10 min or 4 h post-exposure for dynorphin A-like immunoreactivity and cytokine measurements, respectively. At 1-month post-exposure, mice were tested in a series of behavioral assays related to adverse outcomes reported by humans with blast trauma.

Results

Repetitive but not single blast exposure resulted in increased brain dynorphin A-like immunoreactivity. norBNI pretreatment blocked or significantly reduced blast-induced increase in serum and brain cytokines, including IL-6, at 4 h post exposure and aversive/anxiety-like behavioral dysfunction at 1-month post-exposure.

Conclusions

Our findings demonstrate a previously unreported role for the dynorphin/KOR system as a mediator of biochemical and behavioral dysfunction following repetitive blast exposure and highlight this system as a potential prophylactic/therapeutic treatment target.
Performing a shortened version of the Action Research Arm Test in immersive virtual reality to assess post-stroke upper limb activity
Authors: Burton Quentin , Lejeune Thierry , Dehem Stéphanie , Lebrun Noémie , Ajana Khawla , Edwards Martin Gareth , Everard Gauthier
Published: December 2022

Background

To plan treatment and measure post-stroke recovery, frequent and time-bounded functional assessments are recommended. With increasing needs for neurorehabilitation advances, new technology based methods, such as virtual reality (VR) have emerged. Here, we developed an immersive VR version of the Action Research Arm Test (ARAT-VR) to complement neurorehabilitation.

Objective

This study aimed to assess the validity, usability and test–retest reliability of the ARAT-VR among individuals with stroke, healthcare professionals and healthy control subjects (HCS).

Methods

Among the 19 items of the ARAT, 13 items were selected and developed in immersive VR. 11 healthcare professionals, 30 individuals with stroke, and 25 HCS were recruited. Content validity was assessed by asking healthcare professionals to rate the difficulty of performing each item of the ARAT-VR in comparison to the classical Action Research Arm Test (ARAT-19). Concurrent validity was first measured using correlation (Spearman tests) between the ARAT-VR and ARAT-19 scores for the individuals with stroke, and second through correlation and comparison between the scores of the ARAT-VR and the reduced version of the ARAT (ARAT-13) for both individuals with stroke and HCS (Wilcoxon signed rank tests and Bland–Altman plots). Usability was measured using the System Usability Scale. A part of individuals with stroke and HCS were re-tested following a convenient delay to measure test–retest reliability (Intra-class correlation and Wilcoxon tests).

Results

Regarding the content validity, median difficulty of the 13 ARAT-VR items (0[0 to − 1] to 0[0–1]) evaluated by healthcare professionals was rated as equivalent to the classical ARAT for all tasks except those involving the marbles. For these, the difficulty was rated as superior to the real tasks (1[0–1] when pinching with the thumb-index and thumb-middle fingers, and 1[0–2] when pinching with thumb-ring finger). Regarding the concurrent validity, for paretic hand scores, there were strong correlations between the ARAT-VR and ARAT-13 (r = 0.84), and between the ARAT-VR and ARAT-19 (r = 0.83). Usability (SUS = 82.5[75–90]) and test–retest reliability (ICC = 0.99; p < 0.001) were excellent.

Conclusion

The ARAT-VR is a valid, usable and reliable tool that can be used to assess upper limb activity among individuals with stroke, providing potential to increase assessment frequency, remote evaluation, and improve neurorehabilitation.

Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04694833; Unique identifier: NCT04694833, Date of registration: 11/24/2020.
Formulation enhanced the stability of Foot-and-mouth virus and prolonged vaccine storage
Authors: Li Jing , Chang Yanyan , Yang Shunli , Zhou Guangqing , Wei Yanming
Published: December 2022

Foot-and-mouth disease (FMD) is a highly contagious viral disease that affects cloven-hoofed animals. Vaccination is the most effective measure to control FMD. However, FMDV particles are prone to dissociation, leading to insufficient potency of vaccine. Based on this characteristic, a combination of twenty percentage trehalose, 500 mM NaCl and 3 mM CuSO4·5H2O was developed to increase viral stability. Heating-resistance test showed that FMDV infectivity was maintained when formulated with formulation. Additionally, the half-life of FMDV inactivation was prolonged remarkably. Sequencing analysis demonstrated that viral genome could not be altered in serial passages. Vaccine stability was monitored for up to 1 year at 4 °C, with a higher level of 146S content remained. This study suggested that the formulation could protect FMDV against massive structural breakdown and extend the shelf life of vaccine. Our findings could provide strategy to develop more solutions for the stabilization of viral vaccine.
Therapeutic and diagnostic applications of nanoparticles in the management of COVID-19: a comprehensive overview
Authors: Gholizadeh Omid , Yasamineh Saman , Amini Parya , Afkhami Hamed , Delarampour Abbasali , Akbarzadeh Sama , Karimi Matloub Rasool , Zahedi Mahlagha , Hosseini Parastoo , Hajiesmaeili Mehrnaz , Poortahmasebi Vahdat
Published: December 2022

In December 2019, Coronavirus Disease 2019 (COVID-19) was reported in Wuhan, China. Comprehensive strategies for quick identification, prevention, control, and remedy of COVID-19 have been implemented until today. Advances in various nanoparticle-based technologies, including organic and inorganic nanoparticles, have created new perspectives in this field. These materials were extensively used to control COVID-19 because of their specific attribution to preparing antiviral face masks, various safety sensors, etc. In this review, the most current nanoparticle-based technologies, applications, and achievements against the coronavirus were summarized and highlighted. This paper also offers nanoparticle preventive, diagnostic, and treatment options to combat this pandemic.

Graphical Abstract
How midwives and nurses experience implementing ten steps to successful breastfeeding: a qualitative case study in an Indonesian maternity care facility
Authors: Pramono Andini , Smith Julie , Bourke Siobhan , Desborough Jane
Published: December 2022

Background

The in-hospital stay following childbirth is a critical time for education and support of new mothers to establish breastfeeding. The WHO/UNICEF ‘Ten Steps to Successful Breastfeeding (Ten Steps)’ was launched globally in 1989 to encourage maternity services to educate and support mothers to breastfeed. The strategy is effective, however its uptake within health systems and facilities has been disappointing. We aimed to understand midwives’ and nurses’ experiences of implementing the Ten Steps in an Indonesian hospital.

Methods

This qualitative study was conducted in an Indonesian hospital which has been implementing the Ten Steps since the hospital’s establishment in 2012. Fourteen midwives and nurses participated in a focus group in January 2020. Data were analyzed using thematic analysis.

Results

We identified five themes that represented midwives’ and nurses’ experiences of implementing the Ten Steps in this Indonesian maternity unit: 1) Human rights of child and mother, 2) Dependency on precarious leadership, 3) Lack of budget prioritization, 4) Fragmented and inconsistent implementation of the Ten Steps across the health system, and 5) Negotiating with family, community and culture. The results highlighted a dependency on local hospital champions and a lack of budget prioritization as barriers to implementation, as well as health system gaps which prevented the enablement of mothers and families to establish and maintain breastfeeding successfully in Indonesian maternity services.

Conclusions

As Indonesia has one of the largest populations in South East Asia, it is an important market for infant milk formula, and health services are commonly targeted for marketing these products. This makes it especially important that the government invest strongly in Ten Steps implementation. Continuity of care within and across the health system and leadership continuity are key factors in reinforcing its implementation. The study findings from this Indonesian maternity care facility re-emphasize WHO recommendations to integrate the Ten Steps into national health systems and increase pre-service education on breastfeeding for health care professionals.
Adverse childhood experiences, recent negative life events, and non-suicidal self-injury among Chinese college students: the protective role of self-efficacy
Authors: Chen Zixun , Li JinWen , Liu JinMeng , Liu Xia
Published: December 2022

Background

Non-suicidal self-injury (NSSI) is a severe health problem closely related to adverse childhood experiences (ACEs). However, the underlying mechanisms by which ACEs may affect NSSI are largely unknown. Self-efficacy (NSSI-SE) and recent negative life events (RNLEs) may play important roles in this relationship. This study aimed to clarify the relationship between ACEs and NSSI among college students by examining the role of self-efficacy (NSSI-SE) and RNLEs in this process.

Method

Relevant self-report questionnaires were used to evaluate ACEs, RNLEs, NSSI-SE, and NSSI. A questionnaire of 1036 Chinese undergraduates (Mage = 19.65, 28.9% males, 71.1% females) was collected in a cross-sectional manner. The associations between ACEs, RNLEs, NSSI-SE and NSSI were assessed using Pearson correlation analyses. Then, hierarchical multiple linear regressions were used to analyze the effects of ACEs and RNLEs on NSSI, as well as the protective effect of NSSI-SE on the above relations.

Results

NSSI was associated with both ACEs and RNLEs. ACEs and RNLEs could directly increase the risks of participating in NSSI, and the effects of ACEs and RNLEs on NSSI were independent without an interactive effect. NSSI-SE buffered the relationship between ACEs and NSSI, as well as between RNLEs and NSSI. Compared to individuals with a low level of NSSI-SE, ACEs and RNLEs were not significantly associated with NSSI in persons with a high level of NSSI-SE.

Conclusion

NSSI-SE may buffer the effect of ACEs and RNLEs on NSSI, indicating that future interventions can be enhanced by targeting NSSI-SE among college students with ACEs or RNLEs to prevent their engagement in NSSI.
Plumbagin rescues the granulosa cell’s pyroptosis by reducing WTAP-mediated N6-methylation in polycystic ovary syndrome
Authors: Cai Zhaowei , He Shaojuan , Liu Rongju , Zhou Liling , Zhao Li
Published: December 2022

The survival of ovary granulosa cells (GC) is critical in the initiation and progression of polycystic ovary syndrome (PCOS) in females. Here, we found that the PCOS process is accompanied by massive GC pyroptosis resulting from Caspase-1 inflammasome activation. Administration of plumbagin, an effective compound isolated from plant medicine, can prevent the pyroptosis of GC and the onset of PCOS. Mechanistic study indicates the over-activation of the inflammasome in GC is due to the upregulation of WTAP, a key regulator of the RNA N6-methylase complex. WTAP mediates the mRNA N6-methylation of NLRP3 inflammasome component ASC and enhances ASC RNA stability, which results in the overactivation of the inflammasome in GCs from the PCOS model. Plumbagin treatment suppresses the WTAP-mediated N6-methylation of ASC mRNA and reduces the pyroptosis of GCs. This study supports the profound potential of plumbagin in PCOS treatment.

Graphical Abstract
Synthesis, spectral characterization, and theoretical investigation of the photovoltaic properties of (E)-6-(4-(dimethylamino)phenyl)diazenyl)-2-octyl-benzoisoquinoline-1, 3-dione
Authors: Ofem Mbang I. , Louis Hitler , Agwupuye John A. , Ameuru Umar S. , Apebende Gloria C. , Gber Terkumbur E. , Odey Joseph O. , Musa Neksumi , Ayi Ayi A.
Published: December 2022

This research work focuses on the synthesis, characterization through spectra (FT-IR, UV–vis, and 1H-NMR) investigations, and the use of density functional theory (DFT) along with time-dependent density functional theory (TD-DFT) to investigate the electronic, structural, reactivity, photophysical properties, and the photovoltaic properties of a novel (E)-6-(4-(dimethylamino)phenyl)diazenyl)-2-octyl-benzoisoquinoline-1,3-dione. The structure of the synthesized compound was modeled using the Gaussian09W and GaussView6.0.16 softwares employing B3LYP and 6–31 + G(d) basis set. The DFT studies was performed in order to investigate the Frontier Molecular Orbital (FMO), Natural Bond Orbital (NBO), charge distribution, Nonlinear Optics (NLO), and stability of the titled molecule. The HOMO–LUMO energy gap which corresponds to the difference between HOMO and LUMO energies of the studied compound was found to be 2.806 eV indicating stiff and smooth nature of the titled molecule. This accounts for the less stability and high chemical reactivity of the compound. The photovoltaic properties were conducted to evaluate the light harvesting efficiency (LHE), short circuit current density (JSC), Gibbs free energy of injection ($$\Delta {G}_{inj}$$

Δ

G

inj

), open cycled voltage (VOC) and Gibbs free energy regeneration ($$\Delta {G}_{reg}$$

Δ

G

reg

) and solar cell conversion efficiency. Interestingly, the results obtained were found to be in good agreement with other experimental and computational findings.
Altitudinal distribution and species richness of triatomines (Hemiptera:Reduviidae) in Colombia
Authors: Méndez-Cardona Sergio , Ortiz Mario I. , Carrasquilla María Cristina , Fuya Patricia , Guhl Felipe , González Camila
Published: December 2022

Background

Chagas disease is considered to be endemic in up to 40% of the territory of Colombia, and to date 27 triatomine species have been reported the country. The purpose of this study was to update the geographical distribution of triatomine species in Colombia and assess the species richness patterns and their altitudinal distribution.

Methods

Occurrence data were compiled between 2007 and 2020, including from reports of entomological surveillance from the Instituto Nacional de Salud (INS), the Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT) at Universidad de Los Andes and a review of the literature. Geographic Information Systems (GIS) were used to describe general species richness patterns of the Triatominae subfamily. To establish the altitudinal distribution of the triatomine species, ranges were obtained from reports with unique elevation values. A generalized linear model was fitted, based on a Poisson distribution, to test the relation between triatomine species richness and Chagas disease cases (2012–2019).

Results

An updated geographical and altitudinal distribution for triatomine species in Colombia was established, with 507 municipalities added to the previously known distributions. The greatest triatomine richness in Colombia was found to be concentrated in the northeastern region of the country, extending towards the center to the departments of Arauca, Casanare and Meta. Regarding the altitudinal distribution, the study revealed that the species Rhodnius prolixus and Triatoma dimidiata have the greatest altitudinal ranges. The data also suggest a positive relation between species richness and number of Chagas disease cases reported per department.

Conclusions

Altitudinal ranges for 17 triatomine species found in Colombia are presented. Species richness and species composition patterns are also described, and areas with a higher risk of transmission based on the relation found with Chagas disease cases are highlighted. This updated distribution reveals that Panstrongylus geniculatus is the triatomine with the largest presence by municipalities in Colombia, being reported in 284 municipalities, followed by Rhodnius prolixus in 277 municipalities.

Graphical Abstract
The effect of type-2 diabetes conditions on neutrophil rolling adhesion
Authors: Taverner Keith , Murad Yousif , Yasunaga Adam B. , Furrer Christine , Little Jonathan , Li Isaac T. S.
Published: December 2022

Objective

Type 2 diabetes mellitus (T2D) is the result of a dysregulation of insulin production and signalling, leading to an increase in both glucose concentration and pro-inflammatory cytokines such as interleukin (IL)-6 and tumour necrosis factor (TNF)-α. Previous work showed that T2D patients exhibited immune dysfunction associated with increased adhesion molecule expression on endothelial cell surfaces, accompanied by decreased neutrophil rolling velocity on the endothelial cell surface. Changes in cell rolling adhesion have direct vascular and immune complications such as atherosclerosis and reduced healing time in T2D patients. While previous studies focused primarily on how endothelial cells affect neutrophil rolling under T2D conditions, little is known about changes to neutrophils that affect their rolling. In this study, we aim to show how the rolling behaviour of neutrophils is affected by T2D conditions on a controlled substrate.

Results

We found that neutrophils cultured in T2D-serum mimicking media increased cell rolling velocity compared to neutrophils under normal conditions. Specifically, glucose alone is responsible for higher rolling velocity. While cytokines further increase the rolling velocity, they also reduce the cell size. Both glucose and cytokines likely reduce the function of P-selectin Glycoprotein Ligand-1 (PSGL-1) on neutrophils.
Novel blood-based FUT7 DNA methylation is associated with lung cancer: especially for lung squamous cell carcinoma
Authors: Fang Yifei , Qu Yunhui , Ji Longtao , Sun Hao , Li Jiaqi , Zhao Yutong , Liang Feifei , Wang Zhi , Su Jiao , Liu Jingjing , Dai Liping , Ouyang Songyun
Published: December 2022

Background

The death rate of lung cancer (LC) ranks first in the world. Changes of DNA methylation in peripheral blood may be related to malignant tumors. It is necessary to explore blood-based biomarkers of methylation to detect LC.

Methods

Mass spectrometry assays were conducted to measure DNA methylation levels of seven CpG sites withinFUT7gene in the peripheral blood of 428 patients with LC, 233 patients with benign pulmonary nodule (BPN) and 862 normal controls (NC). The odds ratios (ORs) of all CpG sites were evaluated for their risk to LC using per SD change and tertiles analyses by logistic regression. The predictive ability of the sevenFUT7CpG sites and risk factors were evaluated by receiver operating characteristic curve (ROC).

Results

The methylation levels of seven CpG sites ofFUT7in LC were significantly lower than that in NC (P < 0.05). The per SD decrement of methylation level in CpG_1-7 was significantly associated with 65%, 38%, 59%, 46%, 23%, 20% and 68% higher risk for LC versus NC, respectively, and the adjusted ORs (95% CI) were 2.92 (2.17–3.96), 1.76 (1.29–2.38), 2.83 (2.09–3.82), 3.00 (2.17–4.16), 1.81 (1.35–2.43), 1.48 (1.11–1.97) and 3.04 (2.23–4.16) for the lowest tertiles of methylation level in CpG_1-7 compared with the top tertiles, respectively. The area under the curve (AUC) of FUT7_CpG_1-7 was 0.659 (CI 0.626–0.693), 0.792 (CI 0.736–0.848) and 0.729 (CI 0.665–0.792) in distinguishing LC versus NC, LUSC versus NC and LUSC versus BPN.

Conclusions

Our study revealed an association betweenFUT7hypomethylation and LC, especially for LUSC, which provides novel support for the blood-based methylation signatures as potential marker for assessing lung cancer risk.
Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials
Authors: Yang Guo-Yan , Hunter Jennifer , Bu Fan-Long , Hao Wen-Li , Zhang Han , Wayne Peter M. , Liu Jian-Ping
Published: December 2022

Background

This overview summarizes the best available systematic review (SR) evidence on the health effects of Tai Chi.

Methods

Nine databases (PubMed, Cochrane Library, EMBASE, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Sino-Med, and Wanfang Database) were searched for SRs of controlled clinical trials of Tai Chi interventions published between Jan 2010 and Dec 2020 in any language. Effect estimates were extracted from the most recent, comprehensive, highest-quality SR for each population, condition, and outcome. SR quality was appraised with AMSTAR 2 and overall certainty of effect estimates with the GRADE method.

Results

Of the 210 included SRs, 193 only included randomized controlled trials, one only included non-randomized studies of interventions, and 16 included both. Common conditions were neurological (18.6%), falls/balance (14.7%), cardiovascular (14.7%), musculoskeletal (11.0%), cancer (7.1%), and diabetes mellitus (6.7%). Except for stroke, no evidence for disease prevention was found; however, multiple proxy-outcomes/risks factors were evaluated. One hundred and fourteen effect estimates were extracted from 37 SRs (2 high, 6 moderate, 18 low, and 11 critically low quality), representing 59,306 adults. Compared to active and/or inactive controls, 66 of the 114 effect estimates reported clinically important benefits from Tai Chi, 53 reported an equivalent or marginal benefit, and 6 an equivalent risk of adverse events. Eight of the 114 effect estimates (7.0%) were rated as high, 43 (37.7%) moderate, 36 (31.6%) low, and 27 (23.7%) very low certainty evidence due to concerns with risk of bias (92/114, 80.7%), imprecision (43/114, 37.7%), inconsistency (37/114, 32.5%), and publication bias (3/114, 2.6%). SR quality was often limited by the search strategies, language bias, inadequate consideration of clinical, methodological, and statistical heterogeneity, poor reporting standards, and/or no registered SR protocol.

Conclusions

The findings suggest Tai Chi has multidimensional effects, including physical, psychological and quality of life benefits for a wide range of conditions, as well as multimorbidity. Clinically important benefits were most consistently reported for Parkinson’s disease, falls risk, knee osteoarthritis, low back pain, cerebrovascular, and cardiovascular diseases including hypertension. For most conditions, higher-quality SRs with rigorous primary studies are required.

Systematic review registration

PROSPERO CRD42021225708.
Economic evaluation of healthcare-associated infection prevention and control in long-term care: a systematic review protocol
Authors: Tchouaket Eric Nguemeleu , Kruglova Katya , Beogo Idrissa , Sia Drissa , Robins Stephanie , Bélanger Emilie , Jubinville Maripier , Séguin Catherine , Kilpatrick Kelley , Boivin Sandra , Létourneau Josiane
Published: December 2022

Background

Given the high risk of contracting a healthcare-associated infection in long-term care facilities, infection prevention and control are essential for the quality of care and safety of residents and staff. To develop more effective infection prevention and control interventions in long-term care facilities, it is important to assess the cost-effectiveness and cost-benefit of existing interventions. There are only a few reviews on this subject, but these are not recent and most do not perform an economic evaluation. Moreover, none uses a discounting approach which limits inter-study comparison. To address these gaps, we will conduct a systematic review of economic evaluations related to healthcare-associated infection prevention and control in long-term care facilities using a discounting approach.

Methods

We will query MEDLINE, Embase, Web of Science, Cochrane, CINAHL, EconLit, JSTOR, and Scopus, as well as the gray literature databases CORDIS and ProQuest. We will include quantitative studies that evaluate four clinical best practices associated with infection prevention and control (hand hygiene, hygiene and sanitation, screening, basic, and additional precautions) and use at least one of five economic analyses (cost-effectiveness, cost-benefit, cost-minimization, cost-utility, cost-consequences). Primary outcomes will include net cost savings, incremental cost-effectiveness ratio, incremental cost per quality-adjusted life year, and incremental cost per disability-adjusted life year. Two co-authors will independently screen and select articles, extract data, and assess the quality of selected articles using the Scottish Intercollegiate Guidelines Network criteria, the Economic Evaluation criteria, and the Cochrane criteria for economic evaluation. Extracted data will be synthesized, and values will be adjusted to 2022 Canadian dollars using the discount rates of 3%, 5%, and 8%.

Discussion

Information obtained through this systematic review may help researchers and policy makers make more efficient use of limited healthcare resources to ensure the safety and quality of long-term care.

Systematic review registration

Research registry ID: reviewregistry1210.
RETRACTED ARTICLE: Improving cloud efficiency through optimized resource allocation technique for load balancing using LSTM machine learning algorithm
Authors: Ashawa Moses , Douglas Oyakhire , Osamor Jude , Jackie Riley
Published: December 2022

Allocating resources is crucial in large-scale distributed computing, as networks of computers tackle difficult optimization problems. Within the scope of this discussion, the objective of resource allocation is to achieve maximum overall computing efficiency or throughput. Cloud computing is not the same as grid computing, which is a version of distributed computing in which physically separate clusters are networked and made accessible to the public. Because of the wide variety of application workloads, allocating multiple virtualized information and communication technology resources within a cloud computing paradigm can be a problematic challenge. This research focused on the implementation of an application of the LSTM algorithm which provided an intuitive dynamic resource allocation system that analyses the heuristics application resource utilization to ascertain the best extra resource to provide for that application. The software solution was simulated in near real-time, and the resources allocated by the trained LSTM model. There was a discussion on the benefits of integrating these with dynamic routing algorithms, designed specifically for cloud data centre traffic. Both Long-Short Term Memory and Monte Carlo Tree Search have been investigated, and their various efficiencies have been compared with one another. Consistent traffic patterns throughout the simulation were shown to improve MCTS performance. A situation like this is usually impossible to put into practice due to the rapidity with which traffic patterns can shift. On the other hand, it was verified that by employing LSTM, this problem could be solved, and an acceptable SLA was achieved. The proposed model is compared with other load balancing techniques for the optimization of resource allocation. Based on the result, the proposed model shows the accuracy rate is enhanced by approximately 10–15% as compared with other models. The result of the proposed model reduces the error percent rate of the traffic load average request blocking probability by approximately 9.5–10.2% as compared to other different models. This means that the proposed technique improves network usage by taking less amount of time due, to memory, and central processing unit due to a good predictive approach compared to other models. In future research, we implement cloud data centre employing various heuristics and machine learning approaches for load balancing of energy cloud using firefly algorithms.
Task partitioning and offloading in IoT cloud-edge collaborative computing framework: a survey
Authors: Chen Haiming , Qin Wei , Wang Lei
Published: December 2022

Internet of Things (IoT) is made up with growing number of facilities, which are digitalized to have sensing, networking and computing capabilities. Traditionally, the large volume of data generated by the IoT devices are processed in a centralized cloud computing model. However, it is no longer able to meet the computational demands of large-scale and geographically distributed IoT devices for executing tasks of high performance, low latency, and low energy consumption. Therefore, edge computing has emerged as a complement of cloud computing. To improve system performance, it is necessary to partition and offload some tasks generated by local devices to the remote cloud or edge nodes. However, most of the current research work focuses on designing efficient offloading strategies and service orchestration. Little attention has been paid to the problem of jointly optimizing task partitioning and offloading for different application types. In this paper, we make a comprehensive overview on the existing task partitioning and offloading frameworks, focusing on the input and core of decision engine of the framework for task partitioning and offloading. We also propose comprehensive taxonomy metrics for comparing task partitioning and offloading approaches in the IoT cloud-edge collaborative computing framework. Finally, we discuss the problems and challenges that may be encountered in the future.
Implementing an outpatient clinical trial on COVID-19 treatment in an emergency epidemic context: a mixed methods study among operational and research stakeholders within the Coverage trial, Bordeaux (France)
Authors: Grenier Carine , Loniewski Macha , Plazy Mélanie , Onaisi Racha , Doucet Marie-Hélène , Joseph Jean-Philippe , Duvignaud Alexandre , Malvy Denis , Anglaret Xavier , Orne-Gliemann Joanna ,   the Coverage study group
Published: December 2022

Background

The emergency set-up and implementation of outpatient clinical trials on epidemic emerging infectious diseases such as COVID-19 raise many issues in terms of research structuration, regulations, and health systems organization. We aimed to describe the experience and points of view of different stakeholders involved in a French home-based outpatient trial on COVID-19 and to identify the early barriers and facilitators to the trial implementation.

Methods

We conducted a mixed-methods study in July 2020. A self-administered questionnaire was emailed to 213 clinical, operational and research stakeholders involved in the Coverage trial; individual semi-directed interviews were conducted among 14 stakeholders. Questionnaire data and written interview notes are presented together by key theme.

Results

One hundred fifty six stakeholders responded to the questionnaire. 53.4% did not have prior experience in clinical research. The motivation of most stakeholders to participate in the Coverage trial was to feel useful during the pandemic. 87.9% agreed that the trial had an unusual set-up timeframe, and many regretted a certain lack of regulatory flexibility. Mobile medical teams and specific professional skills were perceived as instrumental for outpatient research.

Conclusions

The implementation of a home-based outpatient clinical trial on COVID-19 was perceived as relevant and innovative although requiring important adaptations of usual professional responsibilities and standard research procedures. Lessons learned from the Coverage trial underline the need for improved networks between hospital and community medicine, and call for a dedicated and reactive outpatient research platform on emerging or threatening infectious diseases.
Inhibitors and facilitators to the utilization of postpartum care in China: an integrative review
Authors: Zhang Xiaoqian , Matheï Catharina , Vermandere Mieke , Zuo Xiaoli , Wang Qian , Leng Hui , Li Tang , Buntinx Frank
Published: December 2022

Background

Postpartum care is an expanding concept in China, and it is gaining vast attention in Chinese society. However, due to some Chinese traditions and rituals during the postpartum period, the utilization of modern postpartum care should be improved on both individual and community levels from different aspects. This integrative review outlined the inhibitors and facilitators of postpartum care utilization in China.

Methods

Writing an integrative review, a literature search was conducted in Chinese and English databases including Wan Fang, China National Knowledge infrastructure, Medline, Web of Science, and Embase till 31 October 2021 to capture citations covering ‘postpartum care’, ‘utilization’ and ‘China’. Titles and abstracts were screened independently by three reviewers. Included studies were critically appraised using tools and checklists independently for both qualitative and quantitative studies by two different reviewers who also performed thematic synthesis.

Results

Of the 4359 citations screened, 41 studies (450,788 patients) were selected. Categorization of the factors influencing postpartum care utilization revealed five components: sociocultural (25 studies); educational (24 studies); organizational (12 studies); economic (19 studies); and physical (6 studies). Factors influencing postpartum care utilization both on individual and community levels were identified. They included facilitated factors such as higher mother’s and partner’s education level, higher socioeconomic status, lower parity, better insurance coverage, urban geographical location, Han ethnicity, and better transportation. Inhibitory factors such as under-managed policy regulation, migrants without domicile, and lower quality of care were also reported.

Conclusion

This review has identified the inhibitors and facilitators of postpartum care utilization in China. Five major aspects including sociocultural, educational, organizational, economic, and physical components have been analysed. Results can be used to improve the utilization of modern postpartum care on both individual and community levels in Chinese society.
Prevalence and determinants of intention to use modern contraceptives among grand-multiparous women in sub-Saharan Africa
Authors: Alawode Oluwatobi Abel , Okeke Sylvester Reuben , Sah Rajeeb Kumar , Bolarinwa Obasanjo Afolabi
Published: December 2022

Background

Sub-Saharan Africa, characterised by high fertility and low contraceptive use prevalence, remains one of the settings with the poorest maternal and child health indices globally. Studies have established that grand-multiparous women are at increased risk of these adverse maternal health outcomes, and contraceptive use is important to averting these adverse outcomes. Thus, this study examines the prevalence and determinants of intention to use modern contraceptives among grand-multiparous women in 10 sub-Saharan African countries with high fertility rates.

Materials and methods

The study utilized data from the last installments of the Demographic and Health Survey from the 10 leading countries with the highest total fertility rates in sub-Saharan Africa. These countries include: Angola, Benin, Burundi, Chad, Cote d’Ivoire, the Republic of the Congo, Democratic Republic of Congo, Mali, Niger, and Nigeria. Data analysis of 23,500 grand-multiparous women was done at three univariate levels involving a frequency table and bar chart. We employed bivariate logit and multivariate logit regression at the bivariate and multivariate levels to achieve the study objectives. A significant level was determined at p < 0.05.

Results

Our study found that less than 40% of grand-multiparous women in these high fertility countries in sub-Saharan Africa, have the intention to use modern contraceptives (39%), but country variations exist with as low as 32.8% in Angola to as high as 71.2% in the Republic of the Congo. The study found that modern contraceptives use intention among grand-multiparous women in these high fertility countries was predicted by a history of contraceptive use and pregnancy termination, exposure to family planning messages on social media, and knowledge of family planning methods. Others were women’s fertility planning status, ideal family size, number of marriages (remarriage), couple’s fertility desire, current age, and level of education.

Conclusion

In the high fertility context of sub-Saharan Africa, characterized by low contraceptive use, improving contraceptive use intention among grand-multiparous women is vital for preventing adverse maternal and child health outcomes, including mortality, resulting from a high-risk pregnancy. Hence, interventions should be more innovative in targeting this group of women to increase the contraceptive prevalence rate in line with Family Planning 2030 goals, and ultimately reduce high fertility rates in the region.
Prediction of distant metastasis in esophageal cancer using a radiomics–clinical model
Authors: Zhu Chao , Mu Fengchun , Wang Songping , Qiu Qingtao , Wang Shuai , Wang Linlin
Published: December 2022

Background

Distant metastasis, which occurs at a rate of 25% in patients with esophageal cancer (EC), has a poor prognosis, with previous studies reporting an overall survival of only 3–10 months. However, few studies have been conducted to predict distant metastasis in EC, owing to a dearth of reliable biomarkers. The purpose of this study was to develop and validate an accurate model for predicting distant metastasis in patients with EC.

Methods

A total of 299 EC patients were enrolled and randomly assigned to a training cohort (n = 207) and a validation cohort (n = 92). Logistic univariate and multivariate regression analyses were used to identify clinical independent predictors and create a clinical nomogram. Radiomic features were extracted from contrast-enhanced computed tomography (CT) images taken prior to treatment, and least absolute shrinkage and selection operator (Lasso) regression was used to screen the associated features, which were then used to develop a radiomic signature. Based on the screened features, four machine learning algorithms were used to build radiomics models. The joint nomogram with radiomic signature and clinically independent risk factors was developed using the logical regression algorithm. All models were validated and compared by discrimination, calibration, reclassification, and clinical benefit.

Results

Multivariable analyses revealed that age, N stage, and degree of pathological differentiation were independent predictors of distant metastasis, and a clinical nomogram incorporating these factors was established. A radiomic signature was developed by a set of sixteen features chosen from 851 radiomic features. The joint nomogram incorporating clinical factors and radiomic signature performed better [AUC(95% CI) 0.827(0.742–0.912)] than the clinical nomogram [AUC(95% CI) 0.731(0.626–0.836)] and radiomics predictive models [AUC(95% CI) 0.754(0.652–0.855), LR algorithms]. Calibration and decision curve analyses revealed that the radiomics–clinical nomogram outperformed the other models. In comparison with the clinical nomogram, the joint nomogram's NRI was 0.114 (95% CI 0.075–0.345), and its IDI was 0.071 (95% CI 0.030–0.112), P = 0.001.

Conclusions

We developed and validated the first radiomics–clinical nomogram for distant metastasis in EC which may aid clinicians in identifying patients at high risk of distant metastasis.
Regimen comprising GLP-1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre-mixed insulin regimen
Authors: Lin Yi-Hsuan , Lin Chia-Hung , Huang Yu-Yao , Chen Hsin-Yun , Tai An-Shun , Fu Shih-Chen , Hsieh Sheng-Hwu , Sun Jui-Hung , Chen Szu-Tah , Lin Sheng-Hsuan
Published: December 2022

Background

Increasing evidence suggests that glucagon-like peptide 1 (GLP-1) receptor agonists (RA) can stabilize glycemic variability (GV) and interfere with eating behavior. This study compared the impact of insulin, GLP-1 RA, and dietary components on GV using professional continuous glucose monitoring (CGM).

Methods

Patients with type 2 diabetes underwent CGM before and after switching from a twice-daily pre-mixed insulin treatment regimen to a GLP-1 RA (liraglutide) plus basal insulin regimen. The dietary components were recorded and analyzed by a certified dietitian. The interactions between the medical regimen, GV indices, and nutrient components were analyzed.

Results

Sixteen patients with type 2 diabetes were enrolled in this study. No significant differences in the diet components and total calorie intake between the two regimens were found. Under the pre-mixed insulin regimen, for increase in carbohydrate intake ratio, mean amplitude of glucose excursion (MAGE) and standard deviation (SD) increased; in contrast, under the new regimen, for increase in fat intake ratio, MAGE and SD decreased, while when the protein intake ratio increased, the coefficient of variation (CV) decreased. The impact of the food intake ratio on GV indices disappeared under the GLP-1 RA regimen. After switching to the GLP-1 RA regimen, the median MAGE, SD, and CV values decreased significantly. However, the significant difference in GV between the two regimens decreased during the daytime.

Conclusion

A GLP-1 RA plus basal insulin regimen can stabilize GV better than a regimen of twice-daily pre-mixed insulin, especially in the daytime, and can diminish the effect of food components on GV.
Transosseous suture versus suture anchor fixation for inferior pole fractures of the patella in osteoporotic bone: a biomechanical study
Authors: Seggewiss Jana , Nicolini Luis Fernando , Lichte Philipp , Greven Johannes , Ribeiro Marx , Prescher Andreas , Michalik Roman , Herren Christian , Kobbe Philipp , Hildebrand Frank , Pishnamaz Miguel
Published: December 2022

Background

The surgical treatment of inferior patellar pole fractures can be a challenge, especially in geriatric patients, who are particularly frequently affected by osteoporosis. The objective of this biomechanical study was to compare the performance of suture anchor and transosseous suture fixation in fractures of the inferior patellar pole in context of bone mineral density.

Methods

Twelve fresh-frozen human cadaveric knees received a transverse osteotomy, simulating an AO/OTA 34C1.3 inferior pole fracture of the patella. These fractures were fixated with either suture anchors (SA; Corkscrew®FT 4.5 mm) or transosseous suture (TS; #2 FiberWire®). Cyclic loading tests were performed by pulling the quadriceps tendon against gravity from 90° flexion to almost full extension (5°) for 1000 cycles. Motion and fracture gap displacement were tracked until failure occurred. Subsequently, loading to failure tests followed. Differences between groups were compared using unpairedt-tests, and correlations were calculated with Pearson’s correlation coefficient.

Results

The suture anchor group showed significantly fewer cycles to failure than the transosseous suture group (SA: 539.0 ± 465.6 cycles, TS: 1000 ± 0 cycles,P = 0.04). Bone mineral density correlated positively with cycles to failure in the suture anchor group (Pearson’sr = 0.60,P = 0.02). No differences in fracture gap displacement could be proven after 100 cycles (SA: 4.1 ± 2.6 mm, TS: 6.5 ± 2.6 mm,P = 0.19); 500 cycles (SA: 6.4 ± 6.1 mm, TS: 9.6 ± 3.8 mm,P = 0.39); and 1000 cycles (SA: 4.0 ± 0.4 mm, TS: 11.0 ± 4.5 mm,P = 0.08). Furthermore, the mean destructive load to failure in the suture anchor group was also significantly lower than in the transosseous suture group (SA: 422.4 ± 212.2 N, TS: 825.7 ± 189.3 N,P = 0.04).

Conclusions

Suture anchors may be a viable alternative to transosseous suture in younger patients for clinical advantages, but in osteoporotic bone, the more stable osteosynthesis with transosseous suture continues to prove superior. Therefore, trauma surgeons might consider the use of transosseous suture in elderly patients, especially in those presenting with low bone mineral density values.