bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review of cardiac surgery clinical prediction models that include intra-operative variables
Authors: Jones Ceri , Taylor Marcus , Sperrin Matthew , Grant Stuart W.
Published: April 2024

Background

Most cardiac surgery clinical prediction models (CPMs) are developed using pre-operative variables to predict post-operative outcomes. Some CPMs are developed with intra-operative variables, but none are widely used. The objective of this systematic review was to identify CPMs with intra-operative variables that predict short-term outcomes following adult cardiac surgery.

Methods

Ovid MEDLINE and EMBASE databases were searched from inception to December 2022, for studies developing a CPM with at least one intra-operative variable. Data were extracted using a critical appraisal framework and bias assessment tool. Model performance was analysed using discrimination and calibration measures.

Results

A total of 24 models were identified. Frequent predicted outcomes were acute kidney injury (9/24 studies) and peri-operative mortality (6/24 studies). Frequent pre-operative variables were age (18/24 studies) and creatinine/eGFR (18/24 studies). Common intra-operative variables were cardiopulmonary bypass time (16/24 studies) and transfusion (13/24 studies). Model discrimination was acceptable for all internally validated models (AUC 0.69-0.91). Calibration was poor (15/24 studies) or unreported (8/24 studies). Most CPMs were at a high or indeterminate risk of bias (23/24 models). The added value of intra-operative variables was assessed in six studies with statistically significantly improved discrimination demonstrated in two.

Conclusion

Weak reporting and methodological limitations may restrict wider applicability and adoption of existing CPMs that include intra-operative variables. There is some evidence that CPM discrimination is improved with the addition of intra-operative variables. Further work is required to understand the role of intra-operative CPMs in the management of cardiac surgery patients.
Assessment of Axial Resistance of Piles Considering Consolidation Setup and Aging Setup Using Direct Pile Cone Penetration Test Methods
Authors: Khasib Isam A. , Abu-Farsakh Murad Y.
Published: April 2024

This paper focuses on evaluating the increase in axial pile resistance subjected to both consolidation and aging setups. Consolidation and aging setup models were first developed to estimate the setup parameters based on databases collected from literature, which include 10 instrumented piles for consolidation setup and 26 test piles for long-term aging. The eight top-performing pile cone penetration test (CPT) methods that were evaluated in a previous study were used to estimate the side resistance of soil layers at 14 days after pile driving. The developed consolidation and aging setup models were then used to extrapolate the results to evaluate the side resistance of each soil layer at the end of consolidation and for long-term aging. The estimated side and total resistances were compared with the measurements from pile load tests considering both consolidation and aging setups. The resistances estimated before and after completion of excess pore water pressure dissipation indicates that significant aging takes place after consolidation setup. The value of consolidation setup parameter ( Ac) was 0.53, and, for aging, the setup parameter ( Ag) was 0.23 in clay and 0.16 in sand. The results show that all pile CPT methods with/without using a consolidation setup model tend to underestimate the unit side resistance of clay soil layers. The use of pile CPT methods in combination with an aging model improved the accuracy of pile CPT methods, and this was verified using load test results for five piles subjected to aging. The Philipponnat and University of Florida (UF) methods showed the best performance on estimating the total resistance of piles subjected to aging.
Exploring the Semantic-Inconsistency Effect in Scenes Using a Continuous Measure of Linguistic-Semantic Similarity
Authors: Damiano Claudia , Leemans Maarten , Wagemans Johan
Published: April 2024

Viewers use contextual information to visually explore complex scenes. Object recognition is facilitated by exploiting object–scene relations (which objects are expected in a given scene) and object–object relations (which objects are expected because of the occurrence of other objects). Semantically inconsistent objects deviate from these expectations, so they tend to capture viewers’ attention (the semantic-inconsistency effect). Some objects fit the identity of a scene more or less than others, yet semantic inconsistencies have hitherto been operationalized as binary (consistent vs. inconsistent). In an eye-tracking experiment ( N = 21 adults), we study the semantic-inconsistency effect in a continuous manner by using the linguistic-semantic similarity of an object to the scene category and to other objects in the scene. We found that both highly consistent and highly inconsistent objects are viewed more than other objects (U-shaped relationship), revealing that the (in)consistency effect is more than a simple binary classification.
Social Media Marketing Activities, Brand Community Engagement and Brand Loyalty: Modelling the Role  of Self-brand Congruency with Moderated Mediation Approach
Authors: Changani Shubhi , Kumar Rakesh
Published: April 2024

All regions are experiencing a boom in social media adoption, and marketers are continuously seeking innovative approaches to grow their network of loyal customers through online brand communities. The present study aims to examine how social media marketing activities may lead to brand loyalty. In this connection, the study investigates the role of brand community engagement and self-brand congruency. The data were gathered using a survey based on a questionnaire from 245 social media users following certain brand community pages on various social media platforms. Analysis of data set was conducted using structural equation modelling via Amos 23.0 and SPSS 20.0. Additionally, moderated mediation was assessed using SPSS’s Process macro. The findings reveal that social media marketing activities significantly influence customer’s loyalty towards the brand. However, this effect was found to be mediated through brand community engagement. Additionally, the outcome of the moderated mediation analysis demonstrated that the indirect impact of social media marketing activities on brand loyalty through brand community engagement was moderated by self-brand congruency. The study produces novel insights into the intricate relationship between social media marketing activities, brand community engagement, brand loyalty and self-brand congruency, significantly providing a roadmap for managers, guiding them to strategically craft brand experiences, adapt to consumer trends and foster emotional attachments with the brand.
Effect of formalin-fixation and paraffin-embedded tissue storage times on RNAscope in situ hybridization signal amplification
Authors: Colburn Megan E. , Delaney Martha A. , Anchor Gretchen C. , Terio Karen A.
Published: April 2024

RNAscope in situ hybridization (ISH) detects target RNA in formalin-fixed, paraffin-embedded (FFPE) tissues. Protocols suggest that prolonged FFPE storage and formalin fixation may impact signal detection, potentially limiting the utility of RNAscope ISH in retrospective studies. To develop parameters for RNAscope use with archived specimens, we evaluated the effect of formalin-fixation time by measuring the signal of a reference gene ( 16srRNA) in selected tissues fixed in 10% neutral-buffered formalin for 1, 2, 3, 5, 7, 10, 14, 21, 28, 60, 90, 180, and 270 d. The signal intensity and percent area of signal decreased after 180 d. Tissues had detectable signal at 180 d but not at 270 d of formalin fixation. To assess target detection in paraffin blocks, we qualitatively compared the signal of canine distemper virus (CDV) antigen via immunohistochemistry and CDV RNA via RNAscope ISH in replicate sections from blocks stored at room temperature for 6 mo, 1, 3, 6, 8, 11, 13, and 15 y; RNA was detected in FFPE tissues stored for up to 15 y. Our results demonstrate that RNAscope ISH can detect targets in tissues with prolonged paraffin storage intervals and formalin-fixation times.
Interdependencies in Visiting Relatives Travel: Uncovering the Nature, Meanings, and Dynamics of Host–Guest Interactions
Authors: Wang Xi , Cave Jenny , Simpson Mary
Published: April 2024

This study examines the role of visiting relatives (VRs) travel in enabling the interdependencies between transnational sojourners and their stay-behind family members. VRs travel is found to facilitate cross-border support exchange while preserving geographically stretched family ties. This study contributes to the theory by demonstrating that the current understanding of social exchange theory does not adequately explain the dynamics of VRs host-guest interactions, because some previously unidentified factors (e.g., felt obligation and family life cycle) also shape visiting and hosting behaviors. At a practical level, the findings help both sides better understand each other’s needs and respective roles in VRs travel. This study contributes new knowledge to the field of tourism planning and management, by revealing motives and patterns that lie behind VRs travel, while suggesting that the VRs travel market is more diverse than it seems to be, as parent and non-parent visitors tend to have different expectations of hosting.
Influence of reduced pressure on arc and weld pool properties in TIG welding
Authors: Han Xiaohui , Cui Xuefei , Wu Yongshou , Chen Ji , Zhang Guangda , Wu Chuansong
Published: April 2024

In this article, transient transport phenomena in the arc and weld pool for different ambient pressures during tungsten inert gas welding were reported. Arc plasma and weld pool behaviour vary with ambient pressure because of changes in arc thermophysical properties. The maximum arc temperature decreases with decreasing ambient pressure because of reduced plasma electrical conductivity. Decreased arc mass density results in a lower maximum weld pool surface temperature and a decrease in maximum metal vapour content as ambient pressure decreases. Arc pressure decreases with decrease in ambient pressure, resulting in shallower penetration. Calculated arc temperature distribution and weld cross-section are compared with experiments to validate the modeling method for simulating heat and mass transfer phenomena in low ambient pressure welding.
An optical investigation on macro spray characteristics of convergent-divergent ducted fuel injection under high ambient pressures
Authors: An Yanzhao , Chen Tao , Shen Shicheng , Zhang Yuhan , Pei Yiqiang , Zhao Hua
Published: April 2024

The fuel-air mixing process can be improved via straight (ST) ducted fuel injection along with the risk of greater heat transfer loss due to prolonged spray tip penetration (STP) and spray impingement. We proposed the convergent-divergent (CD) duct spray in this study to produce acceptable STP and wider spray cone angle (SCA) for improving engine efficiency. STP and SCA are closely related to ambient pressure. This paper aims to explore the influence of ambient pressure on the macro spray characteristics of CD duct spray for better fuel-air mixing with the analysis of spray air entrainment (SAE). The Schlieren system was used to record the spray morphology of different duct sprays under ambient pressures of 20, 30, 40, and 50 bar. The results showed that compared with free spray, with the increase of ambient pressure, the application of CD duct can more effectively improve the SCA increase rate of free spray. With the ambient pressure changes from 20 to 50 bar, the SCA increase rate is up to 20.17% for free spray, and the SCA increase rate increased more than three times to 76.96% with ST3 duct and more than eight times to 173.06% with CD 4.5 duct compared with free spray respectively. The SAE of CD3 and ST3 duct sprays is higher than that of other sprays. CD4.5 and CD6 duct sprays reduce the probability of spray-wall impingement but along with a certain reduced amount of SAE.
Sonographic Evaluation of Doppler Parameters Within the Central Retinal Artery: A Cohort Study
Authors: Paulinus Samson Omini , Ijever Andrew Wueseter , Akwa Egom Erim , Archibong Bassey Eyo , Akintomide Akintunde Olusijibomi , Eru Eru Mba , Egbe Nneoyi Onen , Okoro Ulu Ulu
Published: April 2024

Objective:

The objective of this study was to assess the Doppler parameters, associated within the central retinal artery (CRA), based on a cohort of Nigerian participants.

Materials and Methods:

A total of 66 participants were recruited and consented at a medical clinic in Calabar, Nigeria, and presented from August 2019 to December 2023. The diagnostic data points recorded on this cohort were their fasting blood glucose (FBG) (mmol/L), CRA peak systolic velocity (PSV), CRA end-diastolic velocity (EDV), the resistive index (RI), and pulsatility index (PI). The data analysis was completed to provide descriptive information, as well as correlations. The statistical significance was set at P < .05.

Results:

In this cohort, the women demonstrated a higher PSV and EDV, based on the vascular flow within the right CRA (Rt. PSV [20.8 ± 6.0 SD] and Rt. EDV [5.8 ±2.1 SD]), as well as the left CRA (Lt. PSV [20. 6 ± 4.4 SD] and Lt. EDV [6.2 ± 2.0 SD]). This was compared to the men’s data taken on the vascular flow within the right CRA (Rt. PSV [19.6 ± 5.3 SD] and Rt. EDV [5.2 ± 1.8 SD]), as well as their left CRA (Lt. PSV [19.2± 4.7 SD] and Lt. EDV [5.3 ± 1.3 SD]). The participants’ FBG levels did not correlate with their respective Doppler parameters. The Doppler parameters, based on the flow within the right CRA, showed moderate to weak positive correlations compared with the left CRA. The PSV recorded in the right CRA was varied across the specific participant age groups of 17 to 25 and 26 to 34 years.

Conclusion:

Potential sex and age-related variations in the Doppler velocities, recorded within the CRA, were specific to this cohort, and the sample size may have compromised the overall study’s statistical power. A replication of this research is needed, and data from a larger cohort of participants are needed.
Exertional heat stroke-induced changes in gut microbiota cause cognitive impairment in mice
Authors: Xie Jiangang , Wang Linxiao , Xu Yunyun , Ma Yuexiang , Zhang Lingqin , Yin Wen , Huang Yang
Published: April 2024

Background

The incidence of exertional heat stroke (EHS) escalates during periods of elevated temperatures, potentially leading to persistent cognitive impairment postrecovery. Currently, effective prophylactic or therapeutic measures against EHS are nonexistent.

Methods

The selection of days 14 and 23 postinduction for detailed examination was guided by TEM of neuronal cells and HE staining of intestinal villi and the hippocampal regions. Fecal specimens from the ileum and cecum at these designated times were analyzed for changes in gut microbiota and metabolic products. Bioinformatic analyses facilitated the identification of pivotal microbial species and metabolites. The influence of supplementing these identified microorganisms on behavioral outcomes and the expression of functional proteins within the hippocampus was subsequently assessed.

Results

TEM analyses of neurons, coupled with HE staining of intestinal villi and the hippocampal region, indicated substantial recovery in intestinal morphology and neuronal injury on Day 14, indicating this time point for subsequent microbial and metabolomic analyses. Notably, a reduction in the Lactobacillaceae family, particularly Lactobacillus murinus, was observed. Functional annotation of 16S rDNA sequences suggested diminished lipid metabolism and glycan biosynthesis and metabolism in EHS models. Mice receiving this intervention (EHS + probiotics group) exhibited markedly reduced cognitive impairment and increased expression of BDNF/TrKB pathway molecules in the hippocampus during behavioral assessment on Day 28.

Conclusion

Probiotic supplementation, specifically with Lactobacillus spp., appears to mitigate EHS-induced cognitive impairment, potentially through the modulation of the BDNF/TrKB signaling pathway within the hippocampus, illustrating the therapeutic potential of targeting the gut-brain axis.
A case report of ventricular fibrillation following Shockwave intravascular lithotripsy during percutaneous coronary intervention
Authors: Jakobsen Lars , Christiansen Evald Høj , Thim Troels
Published: April 2024

Background

Shockwave intravascular lithotripsy (S-IVL) is widely used during percutaneous coronary intervention (PCI) of calcified coronary arteries. Ventricular capture beats during S-IVL are common but arrhythmias are rare.

Case presentation

A 75-year-old woman was scheduled for PCI to a short, heavily calcified chronic total occlusion of the right coronary artery. After wiring of the occlusion, S-IVL was used to predilated the calcified stenosis. During S-IVL, the patient developed ventricular fibrillation twice.

Conclusion

To our knowledge, this is only the second reported case of VF during S-IVL. Although very rare, it is important to be aware of this potential and serious complication.
An important issue of burnout among pre-hospital emergency medical personnel in Chengdu: a cross-sectional study
Authors: Liu ZhiJiang , Luo Li , Dai Hang , Zhang Bihua , Ma Lin , Xiang Tao
Published: April 2024

Objective

This survey aims to comprehensively understand occupational burnout among pre-hospital emergency medical personnel and explore associated risk factors.

Methods

A cross-sectional online survey using a census method was conducted between 15 July, 2023, and ends on 14 August, 2023, in Chengdu, SiChuan province, China. The questionnaire included general demographic information, the Maslach Burnout Inventory-General Survey (MBI-GS) with 15 items, and the Fatigue Scale-14 (FS-14) with 14 items. Univariate analysis was conducted on all variables, followed by multivariate logistic regression models to examine the associations between occupational burnout and the risk factors.

Results

A total of 2,299 participants,99.57% completed the survey effectively The participants were from 166 medical institutions in Chengdu, comprising 1,420 nurses (61.50%) and 889 clinical doctors (38.50%). A total of 33.36% participants experienced burnout, predominantly mild (30.27%), followed by moderate (2.78%) and severe (0.3%). Physicians, higher fatigue scores, age, work experience appeared to be related to burnout. Logistic regression models revealed that individuals aged over 50 were less prone to experience burnout compared to medical staff aged 18–30 (OR: 0.269, 95% CI: 0.115–0.627, p = 0.002). Physicians were more prone to experience burnout compared to nursing staff (OR: 0.690, 95% CI: 0.531–0.898, p = 0.006). Those with 0–5 years of experience were more prone to experience burnout compared to those with 6–10 years or over 15 years of experience (OR: 0.734, 95% CI: 0.547–0.986, p = 0.040; OR: 0.559, 95% CI: 0.339–0.924, p = 0.023). Additionally, for each 1-point increase in the fatigue score, the likelihood of burnout in medical staff increased by 1.367 times (OR: 1.367, 95% CI: 1.323–1.412, p < 0.0001).

Conclusion

Pre-hospital emergency medical personnel demonstrate a notable prevalence of mild job burnout. These results provide a groundwork for future focus on the various stages of job burnout within pre-hospital emergency staff, alerting hospital and departmental managers to promptly address the mental well-being of their personnel and intervene as needed.
Realization path and connotation of the Healthy China strategy: macroscopic perspective of dietary structure and the entry of individual health consciousness
Authors: Zhu Xiaohua , Zhang Yan , Zhu Yuanyuan , Guo Youhua , Zhang Yunjin , Wen Bin
Published: April 2024

Background

Dietary rationality and health concept have certain influence on individual health level. This study aims to explore the characteristics and existing problems of Chinese residents’ health behaviors from both macro and micro perspectives, and explore the feasibility and realization path of Healthy China strategy.

Methods

We utilized regression models to evaluate the correlation between diet and the risk of disease causes of death. By use of the linear regression analysis model, we distinguished the impact of each dimension on health literacy index at the individual level. Then, we explored the influential factors of the diet health index using the binary logit regression model.

Results

Increased consumption of animal-derived foods in China has contributed to the burden of non-communicable diseases. The individuals’ health awareness is still weak, and the health literacy index is greatly affected by the diet, while the individual gender and age are positively correlated with the diet health index, and the individual body mass index (BMI) level is negatively correlated with the diet health index.

Conclusions

This study provided a comprehensive understanding of existing problems of Chinese residents’ health behaviors. We have proposed a path model for the implementation of the Healthy China strategy from the perspectives of “diet health, physical health, conceptual health and environmental health,” which is also a great contribution to the world.
The mediating role of depressive symptoms among Turkish population related to gender and low back pain: evidence from a national health survey
Authors: Yıldız Nadire Gülçin , Aydin Halide Z. , Sambo Grace , Aydın Kemal , Yıldız Hatice , Santri Ichtiarini Nurullita , Wardani Yuniar , Mwamulima Bwanalori , Isni Khoiriyah , Phiri Yohane V. A.
Published: April 2024

Background

Low back pain (LBP), though non-life-threatening, burdens healthcare with treatment expenses and work hours lost. Globally, 70–84% experience it, with risk factors tied to societal structure, income, and living conditions, making it a leading cause of disability.

Methods

This study utilized data from the 2019 Türkiye Health Survey, which consisted of 17,084 individuals aged 15 and above. Our study focused on investigating the factors related to low back pain through a cross-sectional analysis. To analyze these factors, we employed binary multivariate logistic regression. Additionally, we conducted post-hoc analyses to assess the potential mediating effect of depressive symptoms on the relationship between low back pain and gender.

Results

We found that 31.9% of the population experienced low back pain, with women being 58% more likely [aOR = 1.58; 95% CI (1.45–1.73)] than men to report symptoms. Individuals aged 55 + years old had a 90% [aOR = 1.90; 95% CI (1.61–2.23)] chance of experiencing low back pain, indicating an age-related increase. In the general population, having depressive symptoms was 2.49 [95% CI (2.23–2.78)] times more likely associated with low back pain. Our mediation analysis showed that gender (i.e., women vs. men), indicated by direct effects with β-estimates e = 0.78, predicted the likelihood of low back pain. Additionally, the relationship between gender and low back pain, mediated through a history of depressive symptoms, had a significant total indirect effect (i.e., β-estimate given as e = 0.49). Specifically, a history of depressive symptoms accounted for 17.86% [95% CI (9.67–20.10)] of the association between women having a higher likelihood of low back pain compared to men.

Conclusion

We observed that a higher likelihood of low back pain associated with gender and aging. Additionally, BMI served as a significant predictor, particularly in adults. Depression mediated the association between gender and low back pain. Acknowledging these associations may help identify and address contributing factors to LBP, potentially increasing awareness and alleviating the burden. Policymakers and healthcare professionals may consider these findings when developing prevention and treatment programs for low back pain.
Association between area-level walkability and glycated haemoglobin: a Portuguese population-based study
Authors: Sá Regina , Roquette Rita , Rebecchi Andrea , Matias Judite , Rocha Jorge , Buffoli Maddalena , Capolongo Stefano , Ribeiro Ana Isabel , Nunes Baltazar , Dias Carlos , Sousa Uva Mafalda
Published: April 2024

Diabetes poses a substantial disease burden, prompting preventive interventions. Physical inactivity, a major risk factor for type 2 diabetes, can potentially be mitigated by enhancing area-level walkability. Despite this, limited population-based studies have investigated the link between walkability and objective diabetes measures. Our study aims to estimate the association between area-level walkability and individual glycated haemoglobin levels in the Portuguese adult population without the diagnosis of diabetes. Data from the 2011 census and an updated street map were obtained to construct a walkability index based on residential density, land-use mix, and street connectivity. Individual health data were sourced from The National Health Examination Survey (INSEF) 2015, a representative survey of the Portuguese adult population. Gamma regression was employed for estimation of the main associations, revealing that residing in moderately walkable areas significantly reduced average glycated haemoglobin levels (Exp(β) = 0.906; 95% CI: 0.821, 0.999) compared to the least walkable areas. The association was less pronounced and not statistically significant for the third tertile of walkability (Exp(β) = 0.919; 95% CI: 0.822, 1.028). Our findings highlight a nonlinear protective association between walkability and glycated haemoglobin, emphasizing the potential policy implications for urban planning, diabetes prevention, and health promotion.
Investigating and analyzing the current situation and factors influencing chronic neck, shoulder, and lumbar back pain among medical personnel after the epidemic
Authors: Wang Ansu , Zhou Yufeng , Li Xuyan , Wang Weiqun , Zhao Xu , Chen Ping , Liao Wenbo
Published: April 2024

Background

Chronic shoulder and neck pain is one of the most common chronic occupational disorders, with an average incidence rate of 48.5%, severely affecting patients’ quality of life and ability to work. According to epidemiological research, the prevalence of chronic neck, shoulder, and low back pain in adults over the age of 45 ranges from 40 to 80%. According to reports, medical staff have a higher incidence rate than other populations, and there is a positive correlation between the grade of the medical institution and the incidence rate, making medical staff a priority group for the prevention of chronic neck, shoulder, and low back pain. By the end of 2022, China has been fully opened to epidemic prevention and control, the total number of patients in domestic hospitals has increased significantly, and resulting in medical personnel shoulting great pressure, which seriously affects the physical and mental health of medical personnel. The aim of this study was to explore the risk factors of chronic neck, shoulder and lumbar back pain in medical staff. To provide guidelines for medical staff to improve cervical and lumbar subacute pain and reduce the emergence of spinal lesions.

Methods

From January to February 2023, 602 staff members of a third-grade hospital in Zunyi City were studied by Questionnaire star. Univariate and multivariate Logistic regression were used to analyze the independent risk factors of chronic neck, shoulder and lumbar back pain in medical staff, with stepwise regression utilized to choose the optimum model. The model was selected using Akaike’s information criterion (AIC) and the Hosmer-Lemeshow goodness-of-fit test.

Results

A total of 602 medical staff were polled, and the findings revealed that 588 cases of chronic neck, shoulder, and low back pain of varied severity had occurred in the previous 1 to 2 years, with a 97.7% incidence rate; logistic regression analysis revealed that anxiety level, frequency of bending over in the previous 1 to 2 years, whether related preventive measures were taken at work, gender, positive senior title, daily ambulation time, and whether the department they worked in organized independent influencing factors.

Conclusion

The incidence of chronic neck, shoulder, and lumbar back pain among medical staff is high; its influencing factors are different and have not been systematically identified. Hospitals should take effective measures tailored to local conditions to improve the physical and mental health of medical staff.
The effectiveness of instrument-assisted soft tissue mobilization on range of motion: a meta-analysis
Authors: Tang Sien , Sheng Li , Xia Jinming , Xu Bing , Jin Peiyong
Published: April 2024

Background

To evaluate the effectiveness of instrument-assisted soft tissue mobilization (IASTM) on range of motion (ROM).

Methods

We performed a literature search of the PubMed, Embase, Web of Science, and Cochrane Library databases from inception to December 23, 2023. Randomized controlled trials that compared treatment groups receiving IASTM to controls or IASTM plus another treatment(s) to other treatment(s) among healthy individuals with or without ROM deficits, or patients with musculoskeletal disorders were included. The Cochrane risk of bias tool was used to assess the risk of bias.

Results

Nine trials including 450 participants were included in the quantitative analysis. The IASTM was effective in improving ROM in degree in healthy individuals with ROM deficits and patients with musculoskeletal disorders (n=4) (MD = 4.94, 95% CI: 3.29 to 6.60), and in healthy individuals without ROM deficits (n=4) (MD = 2.32, 95% CI: 1.30 to 3.34), but failed to improve ROM in centimeter in healthy individuals with ROM deficits (n=1) (MD = 0.39, 95% CI: -1.34 to 2.11, p=0.66, I2 = 88%).

Conclusions

IASTM can improve ROM in degree in healthy individuals with or without ROM deficits, or in patients with musculoskeletal disorders (with very low to low certainty).

Trial registration

The PROSPERO registration ID is CRD42023425200.
Serum gonadal hormones levels and hypogonadism in ART naïve newly diagnosed HIV infected adult males in Mwanza, Tanzania
Authors: Iddi Shabani , Dika Haruna , Kidenya Benson R. , Kalluvya Samuel
Published: April 2024

Background

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is an endemic chronic disease which is characterized with progressive depletion of CD4 T cells and increased susceptibility to opportunistic infections. Previous studies have associated HIV infection with increased hypogonadism. However, the prevalence of hypogonadism remained poorly defined and widely ranging in various studies. This study aims to evaluate the serum gonadal hormonal levels and hypogonadism in antiretroviral therapy (ART) naïve newly diagnosed HIV infected-males in Mwanza, Tanzania.

Methods

This was a comparison study involving 81 ART naïve newly diagnosed HIV-infected adult males as study group and 81 apparently healthy HIV-negative males as comparison group. The participants in the study group and comparison group were matched by body mass index and age. Serum hormones [Total testosterone (TT), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E) were estimated. Serum testosterone < 300 ng/dl, or testosterone > 300 ng/dl with high LH and FSH (compensatory hypogonadism) were taken as markers of hypogonadism. Data were analyzed using STATA version 15.

Results

The median serum testosterone level among ART naïve newly diagnosed HIV-infected adult males was significantly lower as compared to their comparison group (447 [259–534] versus 517 [396–605]; p = 0.0074) and shown to decrease with decreasing CD4 level. The median [IQR] serum FSH level among ART naïve newly diagnosed HIV-infected adult males was significantly higher than among their comparison group (3.8 [2.1–6.5] versus 2.6 [1.8–4.2]; p = 0.0086). The differences in serum LH and Estradiol were not statistically significant. Furthermore, the proportion of hypogonadism was significantly higher among ART naïve newly diagnosed HIV-infected adult males than in their comparison group (37.0% [30/81] versus 14.8% [12/81]; p = 0.0006). Out of these 30, 24 HIV-infected males had secondary hypogonadism, one had primary, and the remaining five had compensatory hypogonadism.

Conclusion

Serum testosterone was lower and follicle stimulating hormone was higher among ART naïve HIV-infected males as compared to the HIV negative controls. Hypogonadism, mainly secondary, is common endocrine abnormality among ART naïve HIV-infected male patients in this study. HIV is associated with variations in gonadal hormones which may lead to sexual dysfunction in infected individuals.
Alarm fatigue and perceived stress among critical care nurses in the intensive care units: Palestinian perspectives
Authors: Salameh Basma , Abdallah Jihad , Alkubati Sameer A , ALBashtawy Mohammed
Published: April 2024

Objective

The frequency of alarms generated by monitors and other electro-medical devices is undeniably valuable but can simultaneously escalate the workload for healthcare professionals, potentially subjecting intensive care unit nurses to alarm fatigue. The aim of this study is to investigate alarm fatigue and stress levels among critical care nursing personnel. Additionally, the study aims to assess predictors for both alarm fatigue and perceived stress.

Methodology

: A descriptive cross-sectional study recruited 187 Intensive Care Unit (ICU) nurses from hospitals located in the northern and central regions of the West Bank, Palestine. Data were gathered through online surveys due to logistic concerns using the Alarm Fatigue Scale and the Perceived Stress Scale. The research was conducted between November 2023 and January 2024.

Results

The mean overall alarm fatigue score was 23.36 (SD = 5.57) out of 44. The study showed that 62.6% of the participating ICU nurses experience average to high degree of alarm fatigue, while 69.5% experience average to high levels of perceived stress. A significant positive Pearson correlation was found between stress and alarm fatigue (0.40,P < 0.01). Important predictors of alarm fatigue include perceived stress, nurse-to-patient ratio, gender, and years of experience, while important predictors of perceived stress include alarm fatigue, type of working shift and hospital unit.

Conclusion

Alarm fatigue can compromise the timely intervention required to prevent adverse outcomes by causing delayed responses or missed critical alarm, which can have major ramifications for patient safety. Addressing stress is crucial for mitigating alarm fatigue and fostering a supportive work environment to ensure optimal patient care. Consequently, exploring strategies to alleviate the negative impacts of alarm fatigue on critical care nurses’ stress merits further investigation in future research studies.
Analysis of the mediating effect between ehealth literacy and health self-management of undergraduate nursing students’ mental health literacy
Authors: Zhang Shuang , Wang WeiWei , Wu Shan , Ye Hong , Dong LiXiao , Wang JingRu , Ning XiaoTong , Cui HuiXia
Published: April 2024

Background

Good health self-management positively affects the health of healthcare providers and their ability to manage their patients’ health. This study explored the relationship between ehealth literacy, health self-management skills, and mental health literacy among undergraduate nursing students. Some studies have confirmed the correlation between e-health literacy and health self-management skills, while mental health literacy may be correlated with both, and this study aims to explore the relationship between the three.

Methods

A descriptive cross-sectional survey was conducted at a medical university in northwestern China among 385 Chinese undergraduate nursing students. Participants completed the General Information Questionnaire, the Adult Health Self-Management Skills Rating Scale, the Mental Health Literacy Rating Scale, and the eHealth Literacy Scale, and provided valid responses. The IBM SPSS 27.0 statistical software was used for data entry and descriptive analysis, t-test, ANOVA, and Pearson correlation analysis. The IBM Amos 26.0 was used to construct the mediation effect model, and the Bootstrap method was employed to test mediating effects.

Results

Mental health literacy, ehealth literacy, and health self-management skills of undergraduate nursing students were at a moderate to high level. Mental health literacy, ehealth literacy, and health self-management were positively correlated. Mental health literacy, particularly, played a partial mediating role of 31.1% ( 95% CI [0.307–1.418] ) between ehealth literacy and health self-management.

Conclusions

Undergraduate nursing students’ mental health literacy partially mediates the link between eHealth literacy and health self-management skills. Schools should emphasize the development of nursing students’ e-health literacy and mental health literacy in order to improve their health self-management skills, which will not only bring about a better health outcome for the students, but will also benefit the health of the social population.
Meta-analysis of the human upper respiratory tract microbiome reveals robust taxonomic associations with health and disease
Authors: Quinn-Bohmann Nick , Freixas-Coutin Jose A. , Seo Jin , Simmons Ruth , Diener Christian , Gibbons Sean M.
Published: April 2024

Background

The human upper respiratory tract (URT) microbiome, like the gut microbiome, varies across individuals and between health and disease states. However, study-to-study heterogeneity in reported case–control results has made the identification of consistent and generalizable URT-disease associations difficult.

Results

In order to address this issue, we assembled 26 independent 16S rRNA gene amplicon sequencing data sets from case–control URT studies, with approximately 2–3 studies per respiratory condition and ten distinct conditions covering common chronic and acute respiratory diseases. We leveraged the healthy control data across studies to investigate URT associations with age, sex, and geographic location, in order to isolate these associations from health and disease states.

Conclusions

We found several robust genus-level associations, across multiple independent studies, with either health or disease status. We identified disease associations specific to a particular respiratory condition and associations general to all conditions. Ultimately, we reveal robust associations between the URT microbiome, health, and disease, which hold across multiple studies and can help guide follow-up work on potential URT microbiome diagnostics and therapeutics.
Impact of perioperative low-molecular-weight heparin therapy on clinical events of elderly patients with prior coronary stents implanted > 12 months undergoing non-cardiac surgery: a randomized, placebo-controlled trial
Authors: Wang Bin , Su Yanhui , Ma Cong , Xu Lining , Mao Qunxia , Cheng Wenjia , Lu Qingming , Zhang Ying , Wang Rong , Lu Yan , He Jing , Chen Shihao , Chen Lei , Li Tianzhi , Gao Linggen
Published: April 2024

Background

Little is known about the safety and efficacy of discontinuing antiplatelet therapy via LMWH bridging therapy in elderly patients with coronary stents implanted for > 12 months undergoing non-cardiac surgery. This randomized trial was designed to compare the clinical benefits and risks of antiplatelet drug discontinuation via LMWH bridging therapy.

Methods

Patients were randomized 1:1 to receive subcutaneous injections of either dalteparin sodium or placebo. The primary efficacy endpoint was cardiac or cerebrovascular events. The primary safety endpoint was major bleeding.

Results

Among 2476 randomized patients, the variables (sex, age, body mass index, comorbidities, medications, and procedural characteristics) and percutaneous coronary intervention information were not significantly different between the bridging and non-bridging groups. During the follow-up period, the rate of the combined endpoint in the bridging group was significantly lower than in the non-bridging group (5.79% vs. 8.42%, p = 0.012). The incidence of myocardial injury in the bridging group was significantly lower than in the non-bridging group (3.14% vs. 5.19%, p = 0.011). Deep vein thrombosis occurred more frequently in the non-bridging group (1.21% vs. 0.4%, p = 0.024), and there was a trend toward a higher rate of pulmonary embolism (0.32% vs. 0.08%, p = 0.177). There was no significant difference between the groups in the rates of acute myocardial infarction (0.81% vs. 1.38%), cardiac death (0.24% vs. 0.41%), stroke (0.16% vs. 0.24%), or major bleeding (1.22% vs. 1.45%). Multivariable analysis showed that LMWH bridging, creatinine clearance < 30 mL/min, preoperative hemoglobin < 10 g/dL, and diabetes mellitus were independent predictors of ischemic events. LMWH bridging and a preoperative platelet count of < 70 × 109/L were independent predictors of minor bleeding events.

Conclusions

This study showed the safety and efficacy of perioperative LMWH bridging therapy in elderly patients with coronary stents implanted > 12 months undergoing non-cardiac surgery. An alternative approach might be the use of bridging therapy with half-dose LMWH.

Trial registration

ISRCTN65203415.
Associations between long-term exposure to air pollution and kidney function utilizing electronic healthcare records: a cross-sectional study
Authors: Dillon David , Ward-Caviness Cavin , Kshirsagar Abhijit V. , Moyer Joshua , Schwartz Joel , Di Qian , Weaver Anne
Published: April 2024

Background

Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex, recent research suggests associations with environmental exposures.

Methods

Our primary objective is to examine creatinine-based estimated glomerular filtration rate (eGFRcr) and diagnosis of CKD and potential associations with fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) using a random sample of North Carolina electronic healthcare records (EHRs) from 2004 to 2016. We estimated eGFRcr using the serum creatinine-based 2021 CKD-EPI equation. PM2.5 and NO2 data come from a hybrid model using 1 km2 grids and O3 data from 12 km2 CMAQ grids. Exposure concentrations were 1-year averages. We used linear mixed models to estimate eGFRcr per IQR increase of pollutants. We used multiple logistic regression to estimate associations between pollutants and first appearance of CKD. We adjusted for patient sex, race, age, comorbidities, temporality, and 2010 census block group variables.

Results

We found 44,872 serum creatinine measurements among 7,722 patients. An IQR increase in PM2.5 was associated with a 1.63 mL/min/1.73m2 (95% CI: -1.96, -1.31) reduction in eGFRcr, with O3 and NO2 showing positive associations. There were 1,015 patients identified with CKD through e-phenotyping and ICD codes. None of the environmental exposures were positively associated with a first-time measure of eGFRcr < 60 mL/min/1.73m2. NO2 was inversely associated with a first-time diagnosis of CKD with aOR of 0.77 (95% CI: 0.66, 0.90).

Conclusions

One-year average PM2.5 was associated with reduced eGFRcr, while O3 and NO2 were inversely associated. Neither PM2.5 or O3 were associated with a first-time identification of CKD, NO2 was inversely associated. We recommend future research examining the relationship between air pollution and impaired renal function.
Integrating spatial transcriptomics and single-cell RNA-sequencing reveals the alterations in epithelial cells during nodular formation in benign prostatic hyperplasia
Authors: Fei Xiawei , Liu Jican , Xu Junyan , Jing Hongyan , Cai Zhonglin , Yan Jiasheng , Wu Zhenqi , Li Huifeng , Wang Zhong , Shen Yanting
Published: April 2024

Objective

Proliferative nodular formation represents a characteristic pathological feature of benign prostatic hyperplasia (BPH) and serves as the primary cause for prostate volume enlargement and consequent lower urinary tract symptoms (LUTS). Its specific mechanism is largely unknown, although several cellular processes have been reported to be involved in BPH initiation and development and highlighted the crucial role of epithelial cells in proliferative nodular formation. However, the technological limitations hinder the in vivo investigation of BPH patients.

Methods

The robust cell type decomposition (RCTD) method was employed to integrate spatial transcriptomics and single cell RNA sequencing profiles, enabling the elucidation of epithelial cell alterations during nodular formation. Immunofluorescent and immunohistochemical staining was performed for verification.

Results

The alterations of epithelial cells during the formation of nodules in BPH was observed, and a distinct subgroup of basal epithelial (BE) cells, referred to as BE5, was identified to play a crucial role in driving this progression through the hypoxia-induced epithelial-mesenchymal transition (EMT) signaling pathway. BE5 served as both the initiating cell during nodular formation and the transitional cell during the transformation from luminal epithelial (LE) to BE cells. A distinguishing characteristic of the BE5 cell subgroup in patients with BPH was its heightened hypoxia and upregulated expression of FOS. Histological verification results confirmed a significant association between c-Fos expression and key biological processes such as hypoxia and cell proliferation, as well as the close relationship between hypoxia and EMT in BPH tissues. Furthermore, a strong link between c-Fos expression and the progression of BPH was also been validated. Additionally, notable functional differences were observed in glandular and stromal nodules regarding BE5 cells, with BE5 in glandular nodules exhibiting enhanced capacities for EMT and cell proliferation characterized by club-like cell markers.

Conclusions

This study elucidated the comprehensive landscape of epithelial cells during in vivo nodular formation in patients, thereby offering novel insights into the initiation and progression of BPH.