bluuebunny/crossref_metadata_2025 huggingface dataset:
Sirolimus experience in adult patients with vascular malformations
Authors: Akyildiz Arif , Ismayilov Rashad , Guven Deniz Can , Yildirim Hasan Cagri , Tatar Omer Denizhan , Kus Fatih , Chalabiyev Elvin , Turker Fatma Alev , Dizdar Omer , Yalcin Suayib , Gullu Halil Ibrahim
Published: March 2024

Aim

Sirolimus, a mammalian target of rapamycin inhibitor, inhibits cell growth and proliferation by controlling ribosome biogenesis and protein synthesis in vascular anomalies and cancers. However, most sirolimus studies on vascular anomalies were conducted in the pediatric population, with limited data in adults. In this study, we assessed the effectiveness and safety of sirolimus in adult patients with vascular malformation, a subtype of vascular anomaly.

Methods

We conducted a retrospective analysis of adult vascular malformation patients aged over 16, treated at Hacettepe University Cancer Institute from January 2013 to September 2022. Patient demographics and clinical characteristics were recorded. The primary outcome was the efficacy of sirolimus evaluated by response and disease control rates. The disease control rate was defined as the cumulative percentage of complete or partial responses, along with stable disease. The secondary endpoint was toxicity and safety.

Results

38 patients with a median age of 21 (IQR: 18–33) were recruited. Prior to sirolimus treatment, 57.9% of patients had undergone other therapeutic interventions, predominantly sclerotherapy and surgery. The median follow-up time during sirolimus treatment was 18.5 (IQR: 11.3–74.5) months. The disease control rate was 92.1% (35/38). Head-neck localization was associated with better response rates ( p = .001). Sirolimus was generally well tolerated and grade 1 or 2 oral mucositis ( n = 4) and skin rash ( n = 3) were the most common side effects.

Conclusion

In this study, we found sirolimus was efficacious and well tolerated in adult patients with vascular malformation.
An Analysis of Double Bass Vibrato
Authors: Mick James P.
Published: March 2024

The purpose of this study was to investigate the rates, widths, and pitches of university double bass players’ vibrato in relation to pitch height, fingers used, and tempo. Forty ( N = 40) undergraduate and graduate double bass players performed excerpts in first, fourth, and thumb positions. The overall mean vibrato rate and width was 5.17 Hz and 19 cents. Analyses indicated that university double bassists employed faster vibrato rates and increased width as they performed in progressively higher registers. The third and fourth fingers vibrated the fastest, but the second finger produced the largest width. Musical examples played with a fast tempo were both faster and wider (5.35 Hz, 20 cents) than musical examples played with a slow tempo (4.94 Hz, 19 cents). Participants vibrated almost equally above and below the in-tune pitch—overall mean pitches of vibrated and non-vibrated tones varied by 1 cent. Music educators may use these results to create more consistent descriptions of double bass vibrato and, potentially, more efficient methods for teaching vibrato.
Carotidynia: Overview of an uncommon identification for unilateral neck pain
Authors: Ari Buse Cagla , Baydar Baran , Elgezen Mehmet
Published: March 2024

Background

Carotidynia, also known as Fay Syndrome, manifests as an atypical facial neuralgia characterized by an unusual neck pain extending towards the head and associated with carotid artery tenderness. Diagnostic criteria include neck tenderness, elevated carotid pulse without anatomical abnormalities, and neck distension. It was initially classified as a vascular headache but later re-evaluated and reclassified as a nonentity—a general condition caused by nonvascular factors. The etiology has not been extensively elucidated.

Case Presentation

We present two cases characterized by dysphagia, intermittent discomfort, and numbness in the throat and cervical region. Although the neurological examinations yielded no abnormalities, the diagnosis of carotidynia was ultimately established among the differential diagnoses upon the identification of wall thickening and inflammatory alterations through neuroimaging.

Conclusions

Carotidynia is consistent with idiopathic vasculitis near the distal common carotid artery. Inflammatory processes trigger sympathetic plexus stimulation, causing discomfort in the head and neck. Neuroimaging resolves ambiguities in idiopathic unilateral neck pain, detecting soft tissue growth near the carotid artery. “Carotidynia” now refers to a diagnostic symptom and clinical entity encompassing a variety of disorders; therefore, approach to definition remains controversial. This report aims to raise healthcare awareness by highlighting two different cases of carotidynia.
Effect of blended learning on mathematical achievement and anxiety: A context-based technology integration for meaningful learning
Authors: Shishigu Aweke , Michael Kassa , Atnafu Mulugeta
Published: March 2024

Ethiopia has envisioned becoming a middle-income country in the year 2030. To achieve this vision, several initiatives including the ESDP (I-VI), GQIP, and the education development Roadmap have been undertaken to improve the quality of education at all levels. Apart from those initiatives, it is equally important to rethink of a pedagogical approach that suits the contemporary technological advancement and cultural contexts. Currently, our world is experiencing scientific and technological changes, but the customary methods are relatively unable to cope with these changes. It is no longer viable to rely on one-size-fits-all curriculum. So far, the impact of instructional technology on students learning is not consistent and lacks specific context of students’ environment. This indicates that there is a need for intensive investigation to make learning more meaningful and interactive. This study aimed to restructure the existing mathematics course in Ethiopian higher education so as to produce a pedagogically enhanced learning environment. To achieve the goal of the study, a pedagogical intervention with a time series design was made at Wolkite University, Ethiopia. The repeated measures ANOVA show significant difference between students’ mean scores of course achievement measured before, during and after the intervention (F (2.182, 52.358) = 8.354, p < .05, ƞ2 = 0.258). The multiple comparison test further shows a significant improvement of students’ mathematical achievement. It was also found that when technology was used as a tool to enhance students learning, it can overcome the math anxiety caused by the cognitive failure. Therefore, blended learning could be a good approach to enhance students’ mathematics achievement. This might also be extended at lower levels. Additional imperative implications for practice and future research are forwarded.
Selections From the ABC 2023 Annual Conference, Denver, Colorado USA: Mining Nuggets of Business Communication Pedagogy Gold
Authors: Whalen D. Joel , Drehmer Charles , Cavanaugh Andrew
Published: March 2024

This My Favorite Assignment (MFA) article features 11 teaching innovations first presented at the 2023 Association for Business Communication Annual International Conference held Denver, Colorado, USA. These assignments are designed to boost students’ writing, persuasion, crisis management skills, and personal and professional development.
ChatGPT Yields a Passing Score on a Pediatric Board Preparatory Exam but Raises Red Flags
Authors: Le Mindy , Davis Michael
Published: March 2024

Objectives

We aimed to evaluate the performance of a publicly-available online artificial intelligence program (OpenAI’s ChatGPT-3.5 and -4.0, August 3 versions) on a pediatric board preparatory examination, 2021 and 2022 PREP® Self-Assessment, American Academy of Pediatrics (AAP).

Methods

We entered 245 questions and answer choices from the Pediatrics 2021 PREP® Self-Assessment and 247 questions and answer choices from the Pediatrics 2022 PREP® Self-Assessment into OpenAI’s ChatGPT-3.5 and ChatGPT-4.0, August 3 versions, in September 2023. The ChatGPT-3.5 and 4.0 scores were compared with the advertised passing scores (70%+) for the PREP® exams and the average scores (74.09%) and (75.71%) for all 10 715 and 6825 first-time human test takers.

Results

For the AAP 2021 and 2022 PREP® Self-Assessments, ChatGPT-3.5 answered 143 of 243 (58.85%) and 137 of 247 (55.46%) questions correctly on a single attempt. ChatGPT-4.0 answered 193 of 243 (79.84%) and 208 of 247 (84.21%) questions correctly.

Conclusion

Using a publicly-available online chatbot to answer pediatric board preparatory examination questions yielded a passing score but demonstrated significant limitations in the chatbot’s ability to assess some complex medical situations in children, posing a potential risk to this vulnerable population.
A Dimensional Analysis of School Connectedness in Adolescents Newly Diagnosed With Cancer
Authors: Giugliano Debra
Published: March 2024

Background: Adolescents newly diagnosed with cancer must navigate medical, psychosocial, and educational issues when confronting this life-threatening illness. Frequent hospitalizations and intense therapy disrupt attendance at school and social events. Research supports that school connectedness is a protective factor associated with improved adolescent health, psychological, and academic outcomes. However, this phenomenon is understudied in adolescents newly diagnosed with cancer. Method: This qualitative inquiry used a dimensional analysis method to uncover the nature of school connectedness in adolescents newly diagnosed with cancer prior to school reentry. Semistructured interviews with 19 adolescents explored school relationships and experiences at the time of cancer diagnosis. Data collection and inductive analysis occurred simultaneously. Results: Analysis revealed four key dimensions: “School Days and Ways,” “The Boom,” “The Pause,” and “Connection Reconciliation: Me, You, and Learning.” Additionally, “Social Scenes,” “Shared Experiences,” and “Seeing and Being With” emerged as subdimensions of “School Days and Ways.” All adolescents in this study described being negatively impacted by the cancer experience with universal disruption in school relationships and diminished school connections. However, the desire to restore unraveled or broken relationships and reconcile connections with self, others from the school, and learning were highly salient. Discussion: This research uncovers the meaning and context of school connectedness prior to and following a cancer diagnosis, illuminating a deeper understanding of the impact of a cancer diagnosis on adolescents, school relationships, and learning. The findings provide direction in supporting adolescents as they confront the physical, psychosocial, and educational disruptions caused by their cancer.
HPV-associated cervicovaginal microbiome and host metabolome characteristics
Authors: Zhang Yao , Wu Xu , Li Dan , Huang Rong , Deng Xiangyu , Li Mingxing , Du Fukuan , Zhao Yueshui , Shen Jing , Chen Yu , Zhang Pingxiu , Hu Congcui , Xiao Zhangang , Wen Qinglian
Published: March 2024

Background

Cervicovaginal microbiome plays an important role in the persistence of HPV infection and subsequent disease development. However, cervicovaginal microbiota varied cross populations with different habits and regions. Identification of population-specific biomarkers from cervicovaginal microbiota and host metabolome axis may support early detection or surveillance of HPV-induced cervical disease at all sites. Therefore, in the present study, to identify HPV-specific biomarkers, cervicovaginal secretion and serum samples from HPV-infected patients (HPV group, n = 25) and normal controls (normal group, n = 17) in Xichang, China were collected for microbiome (16S rRNA gene sequencing) and metabolome (UHPLC-MS/MS) analysis, respectively.

Results

The results showed that key altered metabolites of 9,10-DiHOME, α-linolenic acid, ethylparaben, glycocholic acid, pipecolic acid, and 9,12,13-trihydroxy-10(E),15(Z)-octadecadienoic acid, correlating with Sneathia (Sneathia_amnii), Lactobacillus (Lactobacillus_iners), Atopobium, Mycoplasma, and Gardnerella, may be potential biomarkers of HPV infection.

Conclusion

The results of current study would help to reveal the association of changes in cervicovaginal microbiota and serum metabolome with HPV infections.
Long-term organogenic callus cultivation of Ranunculus illyricus L.: a blueprint for sustainable ex situ conservation of the species in urban greenery
Authors: Kocot Dawid , Nowak Barbara , Sitek Ewa
Published: March 2024

The growing trend of introducing wild plant species into urban environments necessitates the identification of novel species adapted to prevailing conditions. A promising reservoir of such species may be xerothermic communities where Ranunculus illyricus occurs. This study aimed to establish a micropropagation protocol for R. illyricus using indirect organogenesis. The protocol includes initiation of culture from various explants, callus proliferation, shoot regeneration, multiplication, and concurrent rooting. Callus appeared on most types of vegetative explants tested, but stolons were considered the best due to their good availability, high disinfection (85%), and robust callus production (maximum increase − 363.1%). The growth rate of the callus fresh matter (CFM) obtained from stolons was calculated. Greater CFM was obtained on the medium with the supplemented picloram 8.0 mg L− 1 with kinetin 5.0 mg L− 1 and in second part of experiment on medium with the addition of 2,4-D (2,4-dichlorophenoxyacetic acid) 2.0 mg L− 1 alone or picloram 6.0 mg L− 1 with kinetin 8.0 mg L− 1. Shoot organogenesis was observed on macronutrients B5 (Gamborg medium), micronutrients MS (Murashige and Skoog) medium with the addition of 2.0 mg L− 1 IBA (indole-3-butyric acid) and 4.0 mg L− 1 BAP (6-benzylaminopurine). To document the process of callus differentiation, microscopic preparations were prepared. Subsequently, the regenerated plants underwent acclimatisation and their growth in an ex situ collection was monitored over three growing seasons. In particular, in vitro-origin plants exhibited developmental patterns similar to those of their seed-origin counterparts. The incorporation of R. illyricus into urban landscapes not only increases aesthetic appeal, but also ensures the preservation of valuable genetic resources for this rare species, potentially contributing to effective ex situ conservation in the future. This marks the first scientific report on in vitro cultures of R. illyricus.
Reproductive factors and subsequent pregnancy outcomes in patients with prior pregnancy loss
Authors: Yang Xin , Mu Fangxiang , Zhang Jian , Yuan Liwei , Zhang Wei , Yang Yanting , Wang Fang
Published: March 2024

Background

At present, individualized interventions can be given to patients with a clear etiology of pregnancy loss to improve the subsequent pregnancy outcomes, but the current reproductive status of the patient cannot be changed. The aim of this study was to investigate the association between female reproductive status and subsequence pregnancy outcome in patients with prior pregnancy loss (PL).

Methods

A prospective, dynamic population cohort study was carried out at the Second Hospital of Lanzhou University. From September 2019 to February 2022, a total of 1955 women with at least one previous PL were enrolled. Maternal reproductive status and subsequent reproductive outcomes were recorded through an electronic medical record system and follow-up. Logistic regression was used to evaluate the association between reproductive status and the risk of subsequent reproductive outcomes.

Results

Among all patients, the rates of subsequent infertility, early PL, late PL, and live birth were 20.82%, 24.33%, 1.69% and 50.77% respectively. In logistic regression, we found that age (OR 1.08, 95% CI 1.04–1.13) and previous cesarean delivery history (OR 2.46, 95% CI 1.27–4.76) were risk factors for subsequent infertility in patients with PL. Age (OR 1.06, 95% CI 1.03–1.10), age at first pregnancy (OR 1.06, 95% CI 1.03–1.10), BMI (OR 1.06, 95% CI 1.02–1.11), previous PL numbers (OR 1.18, 95% CI 1.04–1.57) and without pre-pregnancy intervention (OR 1.77, 95% CI 1.35–2.24) were risk factors for non-live birth. Age (OR 1.06, 95% CI 1.03–1.09), age at first pregnancy (OR 1.06, 95% CI 1.02–1.09), BMI (OR 1.07, 95% CI 1.02–1.11), previous PL numbers (OR 1.15, 95% CI 1.02–1.31) and without pre-pregnancy intervention (OR 2.16, 95% CI 1.65–2.84) were risk factors for PL.

Conclusions

The reproductive status of people with PL is strongly correlated with the outcome of subsequent pregnancies. Active pre-pregnancy intervention can improve the subsequent pregnancy outcome.

Trial registration

This study was registered in the Chinese Clinical Trial Registry with the registration number of ChiCTR2000039414 (27/10/2020).
Exploring the medical decision-making patterns and influencing factors among the general Chinese public: a binary logistic regression analysis
Authors: Lyu Yuwen , Xu Qian , Liu Junrong
Published: March 2024

Objective

With the ongoing evolution of the healthcare system and shifts in cultural paradigms, there is a pressing need to delve into the medical decision-making behaviors of general Chinese public and understand their underlying motivations. This research seeks to elucidate the prevailing tendencies in these decision-making processes and to empirically validate the pivotal factors that shape their choices, offering valuable insights for healthcare policymakers and institutions.

Method

A comprehensive survey was administered to 2,696 Chinese residents to examine their medical decision-making patterns. These patterns were classified into two primary categories: Unilateral Decision-making (Doctor-dominant, Family-centric, and Patient-driven subtypes) and Collaborative Decision-making (Doctor-led, Doctor-Patient, Patient-Family, and Doctor-Patient-Family subtypes). Binary logistic regression analysis was employed to empirically pinpoint the significant factors influencing these decision-making frameworks.

Results

The study's analysis reveals distinct preferences in medical decision-making among Chinese residents. In the Collaborative Decision-making category, chosen by 70.81% of participants, the subtypes are as follows: Doctor-led (29.90%), Doctor-Patient (13.54%), Patient-Family (2.93%), and Doctor-Patient-Family (24.44%). The Unilateral Decision-making, preferred by 29.19%, includes Doctor-dominant (23.22%), Family-centric (1.74%), and Patient-driven (4.23%) models. The preference for Collaborative Decision-making is associated with higher educational levels, specific marital statuses (particularly married but childless), and choices of rural residents' basic medical insurance or occupational basic medical insurance. In contrast, Unilateral Decision-making correlates with males, individuals with religious beliefs, certain occupational roles (like civil servants), and holders of commercial or publicly funded medical insurance.

Conclusion

This study elucidates the complex interplay of socio-cultural and individual determinants shaping medical decision-making in China. The findings reveal a marked inclination towards collaborative models, closely linked to educational level, marital status, and specific insurance types, reflecting an evolving trend towards participatory healthcare. Simultaneously, the persistence of unilateral models, influenced by gender, religious beliefs, and occupational roles, highlights the heterogeneity within Chinese healthcare preferences. These insights are crucial for policymakers and healthcare practitioners, underscoring the need for adaptable, culturally attuned healthcare frameworks that cater to this diversity, thereby enhancing patient engagement and healthcare efficacy.
Neighborhood-level factors associated with COVID-19 vaccination rates: a case study in Chicago
Authors: Keegan Grace , Zhu Mengqi , Paz Maria , Kang Hyojung , Patel Ajanta , Baig Arshiya A.
Published: March 2024

Introduction

Chicago’s deeply-rooted racial and socioeconomic residential segregation is a pattern mirrored in other major cities, making it a prototype for studying the uptake of public health interventions across the US. Residential segregation is related to availability of primary care, sense of community, and trust in the healthcare system, components which are essential in the response to crises like Covid-19 in which vaccine rollout was primarily community-based. We aimed to evaluate the association between rates of access to primary care and community-belonging with Covid-19 vaccination within Chicago’s neighborhoods.

Methods

Data from Chicago Department of Public Health (12/2020-6/2022) on Covid-19 vaccination rates, race/ethnicity (% Black and % Hispanic/Latinx residents), age (% >65), gender (% female), socioeconomic status (% below the federal poverty line), access to needed care rate, and rate of self-reported sense of community-belonging on the neighborhood level were analyzed. Linear mixed models (LMMs) were used to study the impact of variables on vaccination; each neighborhood was added as a random effect to account for with-community association.

Results

The average Covid-19 vaccination rates across Chicago’s neighborhoods was 79%, ranging from 37 to 100%, with median 81%. We found that Covid-19 vaccination rates were positively correlated with access to needed care (p < 0.001) and community-belonging (p < 0.001). Community areas that had lower vaccination rates had greater percentage of Black residents (p < 0.0001) and greater poverty rates (p < 0.0001). After adjusting for poverty, race, gender and age in the models, the association between vaccination rates and access to care or community-belonging were no longer significant, but % Black residents and poverty remained significant.

Conclusions

Though access to needed primary care and community-belonging are correlated with vaccination rates, this association was not significant when controlling for demographic factors. The association between poverty, race and vaccination status remained significant, indicating that socioeconomic and racial disparities across Chicago drive Covid-19 vaccine recommendation adherence regardless of care access. Understanding how poverty, and its intersectional relation to race and primary care access, affects vaccination should be a priority for public health efforts broadly.
Barriers and enabling factors for utilizing physical rehabilitation services by Afghan immigrants and refugees with disabilities in Iran: a qualitative study
Authors: Amini Elaheh , Etemadi Manal , Shahabi Saeed , Barth Cornelia Anne , Honarmandi Farzaneh , Karami Rad Marzieh , Lankarani Kamran Bagheri
Published: March 2024

Introduction

Individuals with a migrant background often underutilize physical rehabilitation services (PRS) compared to the host population. This disparity is attributed to various barriers, including limited access to information, language barriers, illiteracy, and cultural factors. To improve PRS utilization by Afghan immigrants and refugees in Iran, it is crucial to identify these barriers and enabling factors. In response, this study explored the barriers and enabling factors for utilizing PRS among Afghan immigrants and refugees with disabilities in Iran.

Methods

This qualitative study was conducted in Iran between January and March 2023. Participants were selected through convenient and snowball sampling. Individual, semi-structured interviews were carried out both in face-to-face and online formats. Data analysis occurred concurrently with data collection, using the directed content analysis approach.

Results

Findings from our research indicate that common barriers to PRS utilization among Afghan immigrants and refugees include insufficient insurance coverage, high service costs, expensive transportation and accommodation, limited knowledge about Iran’s health system, inadequate awareness of available supports, restricted access to PRS in remote areas, impatience among PRS providers, fear of arrest and deportation, a lack of trust in modern treatments, stringent immigration rules, high inflation rates limiting the ability to pay for PRS, and limited social support. On the other hand, several enabling factors were identified, such as strengthening insurance coverage, utilizing the capacities of charities and NGOs, providing information about available services, promoting respectful behavior by healthcare providers towards patients, facilitating cultural integration, and increasing immigrants’ awareness of available services and eligibility criteria.

Conclusion

The barriers and enabling factors uncovered in this study offer valuable insights into the complexities surrounding PRS utilization by Afghan immigrants and refugees with disabilities in Iran. Understanding and addressing these factors is essential for developing targeted interventions and policies that can improve access and utilization, ultimately leading to enhanced health outcomes for this vulnerable population.
Association between dental age and malocclusions: a systematic review
Authors: Fonseca-Souza Gabriela , Renostro-Souza Amanda , Alves-Souza Lhorrany , Junior Geraldo Thedei , de Menezes-Oliveira Maria Angélica Hueb , Antunes Lívia Azeredo Alves , Beisel-Memmert Svenja , Kirschneck Christian , Feltrin-Souza Juliana , Küchler Erika Calvano
Published: March 2024

Background

The evidence in the literature suggests that some skeletal or dental malocclusions are involved with dental development, resulting in advanced or delayed dental age (DA). The purpose of this systematic review was to investigate the association between DA and different types of malocclusions.

Methods

The search was carried out on PubMed, Scopus, Web of Science, Virtual Health Library, and in the gray literature. Observational studies that evaluated the association between DA and sagittal, vertical, or transversal malocclusions were included. The quality assessment was performed using the Newcastle–Ottawa Scale (NOS). The data from primary studies were narratively synthesized. The certainty of evidence was evaluated using the GRADE approach. The study was conducted from August 2023 to October 2023.

Results

One Thousand Nine Hundred Ninety-One records were identified in the initial search. Twenty (n= 20) studies were included. Most of the studies (n=15) presented a moderate quality according to NOS. Twelve studies evaluated the association between DA and sagittal discrepancies; eight studies evaluated vertical discrepancies, and only one study analyzed a transversal discrepancy. Demirjian’s method for DA assessment was the most used among the studies. The primary studies observed that patients of both sexes presenting a vertical growth pattern and males with skeletal Class III malocclusion tend to have advanced DA. The study that investigated transversal malocclusion found that unilateral posterior cross-bite is associated with delayed DA. The certainty of evidence was very low for all outcomes evaluated.

Conclusion

DA may be associated with the type of malocclusion. It is suggested that DA can be used as an initial diagnostic tool in orthodontics. Future well-designed studies should be performed in order to investigate the association between DA and different types of malocclusions in more detail.

Trial registration

This study was registered in the PROSPERO database (CRD42023454207).
Care complexity, perceptions of complexity and preferences for interprofessional collaboration: an analysis of relationships and social networks in paediatrics
Authors: van Klaveren Lisa-Maria , Geukers Vincent , de Vos Rien
Published: March 2024

Background

In the context of increasingly intricate healthcare systems, professionals are compelled to collaborate within dynamically changing interprofessional teams. Moreover, they must adapt these collaborative processes to effectively and efficiently manage the evolving complexity of care needs. It remains unclear how professionals determine care complexity and relate this complexity to their preferences for interprofessional collaboration (IPC). This study investigated the relationships between care complexity, professionals’ perceived complexity and IPC preferences, and examined the variation in individual and team characteristics of IPC-practices across different levels of complexity in paediatric care.

Methods

In an online questionnaire, 123 healthcare professionals working at an academic tertiary children’s hospital scored their perceptions of complexity and preferences for IPC. They also selected family and various professions as members of the interprofessional (IP-) team based on thirteen patient cases. We employed conjoint analysis to systematically model the complexity of case descriptions across the five domains of the International Classification of Functioning, Disability and Health (ICF). Additionally, we applied social network analysis to identify important professions, crucial connectors and influential professions in the IP-team, and to describe the cohesiveness of IP-teams.

Results

Modelled case complexity, professionals’ perceived complexity and IPC preferences were positively associated. We found large inter-individual variations in the degree of these associations. Social network analysis revealed that the importance and influence of professions was more equally distributed when case complexity increased. Depending on the context and complexity of the case, different professions (e.g. medical doctors, social professionals, extramural professionals) were considered to be more crucial connectors within the IP-team. Furthermore, team cohesion was positively associated with modelled and perceived care complexity.

Conclusions

In conclusion, our study contributes to the existing knowledge by integrating task-specific insights and broadening the use of conjoint and social network analysis in the context of IPC. The findings substantiate the contingency theory that relates characteristics of IPC to care complexity, offering quantified insights into how IP-teams adapt to situational needs. This understanding of relationships and variations within IPC holds crucial implications for designing targeted interventions in both clinical and health profession education contexts. Consequently, it contributes to advancements in healthcare systems.
Development of an interdisciplinary training program about chronic pain management with a cognitive behavioural approach for healthcare professionals: part of a hybrid effectiveness-implementation study
Authors: Munneke Wouter , Demoulin Christophe , Nijs Jo , Morin Carine , Kool Emy , Berquin Anne , Meeus Mira , De Kooning Margot
Published: March 2024

Background

Many applied postgraduate pain training programs are monodisciplinary, whereas interdisciplinary training programs potentially improve interdisciplinary collaboration, which is favourable for managing patients with chronic pain. However, limited research exists on the development and impact of interdisciplinary training programs, particularly in the context of chronic pain.

Methods

This study aimed to describe the development and implementation of an interdisciplinary training program regarding the management of patients with chronic pain, which is part of a type 1 hybrid effectiveness-implementation study. The targeted groups included medical doctors, nurses, psychologists, physiotherapists, occupational therapists, dentists and pharmacists. An interdisciplinary expert panel was organised to provide its perception of the importance of formulated competencies for integrating biopsychosocial pain management with a cognitive behavioural approach into clinical practice. They were also asked to provide their perception of the extent to which healthcare professionals already possess the competencies in their clinical practice. Additionally, the expert panel was asked to formulate the barriers and needs relating to training content and the implementation of biopsychosocial chronic pain management with a cognitive behavioural approach in clinical practice, which was complemented with a literature search. This was used to develop and adapt the training program to the barriers and needs of stakeholders.

Results

The interdisciplinary expert panel considered the competencies as very important. Additionally, they perceived a relatively low level of healthcare professionals’ possession of the competencies in their clinical practice. A wide variety of barriers and needs for stakeholders were formulated and organized within the Theoretical Domain Framework linked to the COM-B domains; ‘capability’, ‘opportunity’, and ‘motivation’. The developed interdisciplinary training program, including two workshops of seven hours each and two e-learning modules, aimed to improve HCP’s competencies for integrating biopsychosocial chronic pain management with a cognitive behavioural approach into clinical practice.

Conclusion

We designed an interdisciplinary training program, based on formulated barriers regarding the management of patients with chronic pain that can be used as a foundation for developing and enhancing the quality of future training programs.
Application of machine learning methods for predicting under-five mortality: analysis of Nigerian demographic health survey 2018 dataset
Authors: Samuel Oduse , Zewotir Temesgen , North Delia
Published: March 2024

Background

Under-five mortality remains a significant public health issue in developing countries. This study aimed to assess the effectiveness of various machine learning algorithms in predicting under-five mortality in Nigeria and identify the most relevant predictors.

Methods

The study used nationally representative data from the 2018 Nigeria Demographic and Health Survey. The study evaluated the performance of the machine learning models such as the artificial neural network, k-nearest neighbourhood, Support Vector Machine, Naïve Bayes, Random Forest, and Logistic Regression using the true positive rate, false positive rate, accuracy, precision, F-measure, Matthew’s correlation coefficient, and the Area Under the Receiver Operating Characteristics.

Results

The study found that machine learning models can accurately predict under-five mortality, with the Random Forest and Artificial Neural Network algorithms emerging as the best models, both achieving an accuracy of 89.47% and an AUROC of 96%. The results show that under-five mortality rates vary significantly across different characteristics, with wealth index, maternal education, antenatal visits, place of delivery, employment status of the woman, number of children ever born, and region found to be the top determinants of under-five mortality in Nigeria.

Conclusions

The findings suggest that machine learning models can be useful in predicting U5M in Nigeria with high accuracy. The study emphasizes the importance of addressing social, economic, and demographic disparities among the population in Nigeria. The study’s findings can inform policymakers and health workers about developing targeted interventions to reduce under-five mortality in Nigeria.
Outcomes of professional misconduct by nurses: a qualitative study
Authors: Varaei Shokoh , Nayeri Nahid Dehghan , Sayadi Leila , Shahmari Mehraban , Ghobadi Akram
Published: March 2024

Background

Professional misconduct by nurses is a critical challenge in providing safe quality care, which can lead to devastating and extensive outcomes. Explaining the experiences of clinical nurses and nursing managers in this regard using an in-depth qualitative method can be beneficial. This study was conducted with the aim of explaining the experiences of nurses regarding the outcomes of professional misconduct.

Methods

The present study used a qualitative descriptive with a conventional content analysis approach. A total of 22 clinical nurses and nursing managers were selected through purposive sampling until data saturation was reached. Data were collected using semi-structured in-depth interviews and analyzed using Graneheim and Lundman’s approach.

Results

Analyzed data were categorized into four main themes and 11 subthemes: (1) Physical outcomes: critical threat and weakening patients’ safety; (2) Psychological outcomes: psycho-emotional responses of patients and their families, moral distress, and cautionary tale of nurses; (3) Financial outcomes: imposing costs on the patient and financial loss of the nurse; (4) Organizational outcomes: the normalization of misconduct, chaos in the organization, waste of the organization’s resources, and reputational damage to the organization.

Conclusion

Professional misconduct by nurses can have adverse outcomes for patients in physical, mental, and financial dimensions, their families, nurses, and healthcare organizations. Therefore, it is indispensable to adopt management strategies to reduce the rate of professional misconduct.
Putting the cart before the horse: mixed-methods participatory investigation of working equid harnessing practices in three selected towns of the Oromia national regional state in Ethiopia
Authors: Merridale-Punter Mathilde S. , Elias Belay , Wodajo Abel L. , El-Hage Charles M. , Zewdu Hanna , Tesfaye Reta , Hailegebreal Gizachew , Sori Teshale , Wiethoelter Anke K. , Hitchens Peta L.
Published: March 2024

Background

Millions of working equids provide socio-economic support for many low-income communities worldwide. With the prevalence of harness-related wounds reported as higher than 60%, this study aims to describe the equipment used by working equids in three locations of the Ethiopian national regional state of Oromia (Fiche, Bishoftu and Shashamene), and the attitudes and practices of equid owners, users and harness makers regarding work equipment. This mixed-methods study consists of cross-sectional surveying of working equids used for taxi or transport of goods or water, as well as cart-driver questionnaires and focus groups (FG) with working equid stakeholders. Activities conducted with FG included participatory ranking of equipment attributes and equipment drawing exercises. Indicators of equipment design and assembly, as well as cart-driver attitudes and practices were described quantitatively. Associations between equipment characteristics and species, work-type and cart-driver indicators were investigated through univariable logistic regression models, whereas focus group discussions were transcribed and analysed thematically.

Results

In total, 368 working equid surveys and cart-driver questionnaires were completed and 87 participants took part in nine FG. Equipment composition and characteristics differed considerably from ideal animal draught and harnessing principles described in the literature, with none of the observed harnesses adhering to all principles and thus not considered fully adequate. Various harness compositions were used, with only saddles and breast collars present in all. Donkey equipment had fewer components than that of horses, such as swingle trees (OR 0.02; 95% CI 0.01–0.06;p < 0.001) or girths (OR 0.09; 95%CI 0.02–0.4;p = 0.002). Horse equipment was more likely to have functional elements such as breeching (OR 7.8; 95% CI 2.9–20.9;p < 0.001). Of all equipment attributes, FG participants ranked cost, design and impact on animal wellbeing as having the highest importance. Thematic analysis identified motivations and priorities regarding equipment; awareness and knowledge of design and function; barriers to using ideal equipment; and consequences of equipment design and practices as key themes.

Conclusions

Various weaknesses of design, assembly and use of equid work equipment were identified. Promoting behavioural change through awareness and training could lead to a sustainable improvement of work equipment quality, access, and prevention of equipment-related problems.
Domperidone inhibits cell proliferation via targeting MEK and CDK4 in esophageal squamous cell carcinoma
Authors: Yuan Qiang , Shi Yunshu , Zhang Yuhan , Shi Yaqian , Hussain Zubair , Zhao Jimin , jiang Yanan , Qiao Yan , Guo Yaping , Lu Jing , Dong Ziming , Dong Zigang , Wang Junyong , Liu Kangdong
Published: March 2024

Background

Esophageal squamous cell carcinoma (ESCC) is one of the leading causes of digestive system tumor related death in the world. Unfortunately, effective chemopreventive agent is lack for patients with ESCC in clinical practice, which leads to the extremely high mortality rate.

Methods

A library of prescribed drugs was screened for finding critical anti-tumor properties in ESCC cells. The phosphoproteomics, kinase array, pulldown assay and drug affinity responsive target stabilization assay (DARTS) were applied to explore mechanisms and searched for synergistic targets. Established models of PDX in mice were used to determine the therapeutic effect of domperidone.

Results

After screening a library of prescribed drugs, we discovered that domperidone has anti-tumor properties. Domperidone, acting as a gastroprokinetic agent, has been widely used in clinic for gastrointestinal motility disorders. Despite limited research, there are indications that domperidone may have anti-tumor properties. In this study, we determined that domperidone significantly inhibited ESCC proliferation in vitro and in vivo. We employed phosphoproteomics to reveal p-ERK, and p-SMAD3 down-regulation upon domperidone treatment. Then, the results of kinase assay and pulldown assay further validated that domperidone directly combined with MEK1/2 and CDK4, leading to the inhibition of their kinase activity. Furthermore, our results revealed that MEK/ERK and CDK4/SMAD3 signal pathway were major pathways in domperidone against ESCC.

Conclusion

Collectively, these findings suggest that domperidone serves as an effective “multi-target” inhibitor of MEK1/2 and CDK4, offering potential benefits for the chemoprevention of ESCC.
LncRNA RASAL2-AS1 promotes METTL14-mediated m6A methylation in the proliferation and progression of head and neck squamous cell carcinoma
Authors: Rong Meiting , Zhang Ming , Dong Feihong , Wu Ke , Cai Bingkun , Niu Jinrui , Yang Le , Li Zhongyan , Lu Hui-yi
Published: March 2024

Background

Long non-coding RNAs (lncRNAs) are key regulators of the 6-methyladenosine (m6A) epigenetic modification, playing a role in the initiation and progression of tumors. However, the regulatory mechanisms in head and neck squamous cell carcinoma (HNSCC) remain elusive. In this study, we investigated the molecular regulatory mechanisms of the lncRNA RASAL2-AS1 in the occurrence and development of HNSCC tumors.

Methods

A bioinformatics analysis was conducted to analyze the expression level of RASAL2-AS1 in HNSCC and normal tissues. RASAL2-AS1 mRNA and protein levels were detected using RT-PCR and Western blotting. Wound healing, transwell assays, flow cytometry, M6A dot blot, and RNA immunoprecipitation experiments were conducted to explore the regulatory role of the RASAL2-AS1 and downstream targets METTL14/LIS1 signaling pathway in HNSCC. Immunohistochemical examination was conducted to evaluate the expression of METTL14 and LIS1 in HNSCC and normal tissues. A tumor xenograft model of BALB/c nude mice was established to assess the impact of RASAL2-AS1 on cell proliferation and growth.

Results

RASAL2-AS1 high expression in HNSCC and cells deteriorated with survival rates of HNSCC. RASAL2-AS1 overexpression in HNSCC accelerated cell migration, colony formation, cell proliferation, cell cycle in S stage, while RASAL2-AS1 knockdown in HNSC cells inhibited cell cycle in G1 stage. After silencing METTL14, the above effects induced by overexpression of the RASAL2-AS1 were reversed. RASAL2-AS1 overexpression prompted LIS1 expression, whereas RASAL2-AS1 silencing reduced LIS1 levels in HNSCC cells, which was confirmed by immunohistological staining. Results demonstrated elevated expression of METTL14 or LIS1 in tongue cancer tissues. Overexpression of RASAL2-AS1 promoted tumor weight and tumor volume, which was counteracted by pcDNA3.1 RASAL2-AS1 plus silencing METTL14 and METTL14 and LIS1 were significantly decreased.

Conclusion

Our study highlights the functional importance of the LncRNA RASAL2-AS1 in HNSCC and might assist in the development of a prognostic stratification and therapeutic approach. Which regulates HNSCC with the dependence of m6a manner.
Long-acting injectable depot buprenorphine from a harm reduction perspective in patients with ongoing substance use and multiple psychiatric comorbidities: a qualitative interview study
Authors: Johnson Björn , Monwell Bodil , Capusan Andrea Johansson
Published: March 2024

Background

Long-acting injectable depot buprenorphine may increase access to opioid agonist treatment (OAT) for patients with opioid use disorder in different treatment phases. The aim of this study was to explore the experiences of depot buprenorphine among Swedish patients with ongoing substance use and multiple psychiatric comorbidities.

Method

Semi-structured qualitative interviews were conducted with OAT patients with experience of depot buprenorphine. Recruitment took place at two OAT clinics with a harm reduction focus, specializing in the treatment of patients with ongoing substance use and multiple comorbidities. Nineteen participants were included, 12 men and seven women, with a mean age of 41 years (range 24–56 years), and a mean of 21 years (5–35 years) of experience with illicit substance use. All participants had ongoing substance use and psychiatric comorbidities such as ADHD, anxiety, mood, psychotic and eating disorders. Interviews were transcribed verbatim. Thematic content analysis was conducted both manually and using qualitative data analysis software.

Results

Participants reported social benefits and positive changes in self-perception and identity. In particular, depot buprenorphine contributed to a realization that it was possible to make life changes and engage in activities not related to substance use. Another positive aspect that emerged from the interviews was a noticeable relief from perceived pressure to divert OAT medication, while some expressed the lack of income from diverted oral/sublingual OAT medication as a negative, but still acceptable, consequence of the depot buprenorphine. Many participants considered that the information provided prior to starting depot buprenorphine was insufficient. Also, not all patients found depot buprenorphine suitable, and those who experienced coercion exhibited particularly negative attitudes towards the medication.

Conclusions

OAT patients with ongoing substance use and multiple psychiatric comorbidities reported clear benefits of depot buprenorphine, including changes in self-perception which has been theorized to play an important role in recovery. Clinicians should consider the specific information needs of this population and the extensive diversion of traditional OAT medications in this population to improve the treatment experience and outcomes. Overall, depot buprenorphine is a valuable treatment option for a population in need of harm reduction and may also contribute to psychological changes that may facilitate recovery in those with the greatest need.