bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond text: ChatGPT as an emotional resilience support tool for Gen Z – A sequential explanatory design exploration
Authors: Kavitha Krishnan , Joshith V. P , Sharma Sonal
Published: June 2024

In the digital era, Artificial Intelligence (AI) has arisen as a revolutionary influence with the potential to transform multiple spheres of human life. Chatbots, particularly OpenAI's Chat Generative Pre-trained Transformer (ChatGPT), are increasingly recognised as promising tools in diverse aspects, including mental health. This study delves into ChatGPT's effectiveness as an emotional resilience support tool specifically for Generation Z (Gen Z), a demographic deeply engaged in digital interactions. Employing a sequential explanatory design that integrates quantitative and qualitative analyses, the research investigates Gen Z users' perceptions of ChatGPT's effectiveness, barriers to its utilisation, and impact on emotional resilience. The findings reveal a significant acknowledgement of ChatGPT's role in enhancing emotional well-being and notable concerns regarding privacy and security. Further, qualitative insights underscore the significance of personalised interactions, nonjudgmental space, and active listening characteristics of ChatGPT in fostering emotional resilience. Moreover, the study identifies key areas for improvement, such as expanded topic coverage and cultural representation. Educational stakeholders and mental health professionals are encouraged to utilise these insights to integrate ChatGPT and other AI tools into tailored support frameworks for Gen Z.
Efficacy and safety of long-acting injectable versus oral antipsychotics in the treatment of patients with early-phase schizophrenia-spectrum disorders: a systematic review and meta-analysis
Authors: Vita Giovanni , Tavella Angelantonio , Ostuzzi Giovanni , Tedeschi Federico , De Prisco Michele , Segarra Rafael , Solmi Marco , Barbui Corrado , Correll Christoph U.
Published: June 2024

Background:

Long-acting injectable antipsychotics (LAIs) have advantages over oral antipsychotics (OAPs) in preventing relapse and hospitalization in chronically ill patients with schizophrenia-spectrum disorders (SSDs), but evidence in patients with first-episode/recent-onset, that is, early-phase-SSDs is less clear.

Objectives:

To assess the relative medium- and long-term efficacy and safety of LAIs versus OAPs in the maintenance treatment of patients with early-phase SSDs.

Method:

We searched major electronic databases for head-to-head randomized controlled trials (RCTs) comparing LAIs and OAPs for the maintenance treatment of patients with early-phase-SSDs.

Design:

Pairwise, random-effects meta-analysis. Relapse/hospitalization and acceptability (all-cause discontinuation) measured at study-endpoint were co-primary outcomes, calculating risk ratios (RRs) with their 95% confidence intervals (CIs). Subgroup analyses sought to identify factors moderating differences in efficacy or acceptability between LAIs and OAPs.

Results:

Across 11 head-to-head RCTs ( n = 2374, median age = 25.2 years, males = 68.4%, median illness duration = 45.8 weeks) lasting 13–104 (median = 78) weeks, no significant differences emerged between LAIs and OAPs for relapse/hospitalization prevention (RR = 0.79, 95%CI = 0.58–1.06, p = 0.13) and acceptability (RR = 0.92, 95%CI = 0.80–1.05, p = 0.20). The included trials were highly heterogeneous regarding methodology and patient populations. LAIs outperformed OAPs in preventing relapse/hospitalization in studies with stable patients (RR = 0.65, 95%CI = 0.45–0.92), pragmatic design (RR = 0.67, 95%CI = 0.54–0.82), and strict intent-to-treat approach (RR = 0.64, 95%CI = 0.52–0.80). Furthermore, LAIs were associated with better acceptability in studies with schizophrenia patients only (RR = 0.87, 95%CI = 0.79–0.95), longer illness duration (RR = 0.88, 95%CI = 0.80–0.97), unstable patients (RR = 0.89, 95%CI = 0.81–0.99) and allowed OAP supplementation of LAIs (RR = 0.90, 95%CI = 0.81–0.99).

Conclusion:

LAIs and OAPs did not differ significantly regarding relapse prevention/hospitalization and acceptability. However, in nine subgroup analyses, LAIs were superior to OAPs in patients with EP-SSDs with indicators of higher quality and/or pragmatic design regarding relapse/hospitalization prevention (four subgroup analyses) and/or reduced all-cause discontinuation (five subgroup analyses), without any instance of OAP superiority versus LAIs. More high-quality pragmatic trials comparing LAIs with OAPs in EP-SSDs are needed.

Trial registration:

CRD42023407120 (PROSPERO).
“Bringing Children in a Burning World?” The Role of Climate Anxiety and Threat Perceptions in Childbearing Motivations of Emerging Adults in Switzerland
Authors: Zimmermann Grégoire , Darwiche Joëlle , Messerli-Bürgy Nadine , Van Petegem Stijn , Mouton Bénédicte , Venard Gaëlle , Antonietti Jean-Philippe
Published: June 2024

This research investigates the relation between climate anxiety, threat perceptions for future generations, and childbearing motivations in childless emerging adults. Using a sample of 1211 Swiss college students aged 18–25, the study explores if threat perceptions mediate the relationship between climate anxiety and childbearing motivations. Results from structural equation modeling (SEM) indicated that climate anxiety significantly predicted greater perceptions of threat, which in turn related to less positive childbearing motivations and more negative childbearing motivations. Specifically, the relationship between climate anxiety and childbearing motivations was partly to fully explained by threat perceptions, suggesting that worries about the future environment could be an important factor in emerging adults’ complex reproductive considerations. No gender moderation was found. These findings underscore the need for policy interventions that provide psychological support and targeted educational resources to assist young adults in navigating the complex interplay between climate anxiety, threat perceptions, and their decisions regarding childbearing.
Decoding Nursing Job Demands: A Multicenter Cross-Sectional Descriptive Study Assessing Nursing Workload in Hospital Medical-Surgical Wards
Authors: Ivziku Dhurata , Gualandi Raffaella , Ferramosca Federica Maria Pia , Lommi Marzia , Tolentino Diaz Maria Ymelda , Raffaele Barbara , Montini Graziella , Porcelli Barbara , Stievano Alessandro , Rocco Gennaro , Notarnicola Ippolito , Latina Roberto , De Benedictis Anna , Tartaglini Daniela
Published: June 2024

Background

Nursing workload is largely studied but poorly explored under physical, mental, and emotional dimensions. Currently, only a limited number of variables have been linked to nursing workload and work contexts.

Purpose

The study aimed to investigate whether it is feasible to identify variables that consistently correlate with nursing workload and others that are specific to the context.

Methods

We employed a descriptive correlational analysis and a cross-sectional design. Data were collected through a survey distributed to registered nurses working across Italy, at the conclusion of randomly assigned morning or afternoon shifts.

Results

We received 456 surveys from 195 shifts, collected from nurses in four public and two private hospitals. Commonly associated variables with nursing workload dimensions included patient complexity of care, admission/discharge or transfer, informing patients/relatives, contacting physicians, and unscheduled activities. Variables categorized as setting-specific were patient isolation and specialties, nurse-to-patient ratio, adequacy of staff in the shift, peer collaboration, healthcare documentation, educating others, and medical urgency.

Conclusions

In summary, certain variables consistently correlate with nursing workload across settings, while others are specific to the context of care. It is imperative for nurses and nurse managers to measure the nursing workload in various dimensions, enabling the prompt implementation of improvement actions.
How Post-1965 Asian Migration Changed US Protestant Christianity
Authors: Hong Jane
Published: June 2024

The 1965 Immigration and Nationality Act (or the Hart-Celler Act) remade the racial and ethnic composition of the nation, opening the United States to large numbers of Asian migrants for the first time. The new immigration system, based on job skills and family reunification, flipped the racial demographics of US-bound migrants from majority European to majority Asian and Latin American. It is estimated that as many as 75 percent of Asians who migrated to the United States between 1965 and 2000 had some kind of Christian background. This article provides a brief overview of how post-1965 Asian migrants have changed a range of US Protestant institutions and organizations.
Alkalinization Using Sodium Bicarbonate for COVID-19 Treatment: A Systematic Review and Meta-Analysis
Authors: Shafiee Arman , Jafarabady Kyana , Moltazemi Hassan , Amini Mohammad Javad , Rafiei Mohammad Ali , Akhondi Amirhossein , Mozhgani Sayed-Hamidreza
Published: June 2024

Background

A systematic review and meta-analysis have been conducted to evaluate the efficacy of alkalinization for COVID-19 patients based on current evidence to determine the impact of alkalinization on COVID-19 outcomes.

Methods

We searched MEDLINE (Pubmed), Web of Science, Cochrane Library, and Clinicaltrials.gov for studies evaluating the efficacy of alkalinization up to 30 April 2023. Based on the PRISMA 2020 statement criteria a systematic review and meta-analysis of studies were performed.

Results

The results of our meta-analysis showed a significant reduction in mortality rate in the alkalinization group compared to controls (RR 0.73, 95% CI: 0.56-0.95; I2  =  0%). However, our subgroup analysis showed no significant improvement in RCT-only studies (RR 0.78, 95% CI: 0.59-1.05; I2  =  0%), the recovery rate was significantly higher in the alkalinization group (RR 2.13, 95% CI: 1.39-3.26; I2  =  0%), duration of recovery also has improved in alkalinization group (SMD 0.76, 95% CI: 0.33-1.18; I2  =  0%). The results of our meta-analysis showed a significant reduction in the duration of hospitalization in the alkalinization group compared to controls with very low certainty of evidence (SMD −0.66, 95% CI: −0.97 to −0.35; I2  =  36%).

Conclusion

With low certainty of evidence, alkalinization (by sodium bicarbonate) can be an efficient and safe adjuvant treatment for COVID-19 patients. Future randomized controlled trials are needed to strengthen the available evidence.
Development of a novel nanoformulation based on aloe vera-derived carbon quantum dot and chromium-doped alumina nanoparticle (Al2O3:Cr@Cdot NPs): evaluating the anticancer and antimicrobial activities of nanoparticles in photodynamic therapy
Authors: Karimi Merat , Homayoonfal Mina , Zahedifar Mostafa , Ostadian Amirreza , Adibi Reyhaneh , Mohammadzadeh Bahareh , Raisi Arash , Ravaei Fatemeh , Rashki Somaye , Khakbraghi Mahsa , Hamblin Michael , Kheirkhah Zahra , Sadeghi Ehsan , Nejati Majid , Mirzaei Hamed
Published: June 2024

The objective of this study was to synthesize a novel antibacterial and anticancer nanoformulation using aloe vera-derived carbon quantum dots (Cdot) and chromium-doped alumina nanoparticles (Al2O3:Cr/Cdot NPs) via a sol–gel method. X-ray diffraction (XRD) analysis confirmed crystalline NPs with a size range of 10–12 nm, while energy-dispersive X-ray spectroscopy (EDS) revealed their elemental composition without impurities. Fourier-transform infrared spectroscopy (FT-IR) indicated strong interactions between Cdot and Al2O3:Cr NPs, forming a robust heterostructure. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) images provided visual confirmation of monodisperse, spherical NPs, ensuring uniformity for further applications. Evaluation of reactive oxygen species (ROS) demonstrated superior generation of singlet oxygen and hydroxyl radicals by Al2O3:Cr/Cdot NPs, essential for photodynamic therapy. Minimum inhibitory concentration (MIC) tests revealed potent antibacterial activity against drug-resistant bacteria, inhibiting biofilm formation by 89% and 95% for MRSA and P. aeruginosa PAO1, respectively. Furthermore, the anticancer activity of Al2O3:Cr/Cdot NPs was assessed using C26 cells, demonstrating enhanced cytotoxicity upon UVA exposure. The NPs exhibited an inhibitory concentration (IC50) of 20 μg/mL without UVA exposure, decreasing to 10 μg/mL with UVA exposure, highlighting the synergistic effect of UVA light in enhancing cytotoxicity. Overall, these findings underscore the significant potential of Al2O3:Cr/Cdot NPs as multifunctional agents for addressing drug-resistant bacteria and advancing cancer therapy, offering promising avenues for nanomedicine research and development.
Characterization of the intestinal microbiota in MSM with HIV infection
Authors: Fu Yuansheng , Ke Susu , Tang Gan , Guo Qisheng , Guo Qian , Wang Ziwei , Leng Ruixue , Fan Yinguang
Published: June 2024

Background

HIV-infected persons demonstrate notable disturbances in their intestinal microbiota; however, the impact of intestinal microbiota on HIV susceptibility in men who have sex with men (MSM), as well as the effects of HIV and antiretroviral therapy (ART) on their gut microbiota, remains under active study. Thus, our research focuses on clarifying the distinctions in intestinal microbiota composition among uninfected MSM and non-MSM healthy controls, investigating the alterations in early-stage intestinal microbial communities following HIV infection, and assessing how ART affects the intestinal microbiota.

Methods

This study enrolled four participant groups: uninfected MSM, Recent HIV-1 infection (RHI) MSM, MSM on ART, and non-MSM healthy controls, with 30 individuals in each group. We utilized 16S ribosomal DNA (16S rDNA) amplicon sequencing to analyze fecal microbiota and employed Luminex multiplex assays to measure plasma markers for microbial translocation (LBP, sCD14) and the inflammatory marker CRP.

Findings

Comparing uninfected MSM to non-MSM healthy controls, no substantial variances were observed in α and β diversity. Uninfected MSM had higher average relative abundances of Bacteroidetes, Prevotella, and Alloprevotella, while Bacteroides, Firmicutes, and Faecalibacterium had lower average relative abundances. MSM on ART had lower intestinal microbiota diversity than RHI MSM and uninfected MSM. In MSM on ART, Megasphaera and Fusobacterium increased, while Faecalibacterium and Roseburia decreased at genus level. Additionally, treatment with a non-nucleoside reverse transcriptase inhibitor (NNRTI) led to significant alterations in intestinal microbiota diversity and composition compared to RHI MSM. The random forest model showed that HIV infection biomarkers effectively distinguished between newly diagnosed HIV-infected MSM and HIV-negative MSM, with an ROC AUC of 76.24% (95% CI: 61.17-91.31%).

Conclusions

MSM showed early intestinal microbiota imbalances after new HIV infection. MSM on ART experienced worsened dysbiosis, indicating a combined effect of HIV and ART. NNRTI-based treatment notably changed intestinal microbiota, suggesting a potential direct impact of NNRTI drugs on intestinal microbiota.
High-dimensional mediation analysis for continuous outcome with confounders using overlap weighting method in observational epigenetic study
Authors: Hu Weiwei , Chen Shiyu , Cai Jiaxin , Yang Yuhui , Yan Hong , Chen Fangyao
Published: June 2024

Background

Mediation analysis is a powerful tool to identify factors mediating the causal pathway of exposure to health outcomes. Mediation analysis has been extended to study a large number of potential mediators in high-dimensional data settings. The presence of confounding in observational studies is inevitable. Hence, it’s an essential part of high-dimensional mediation analysis (HDMA) to adjust for the potential confounders. Although the propensity score (PS) related method such as propensity score regression adjustment (PSR) and inverse probability weighting (IPW) has been proposed to tackle this problem, the characteristics with extreme propensity score distribution of the PS-based method would result in the biased estimation.

Methods

In this article, we integrated the overlapping weighting (OW) technique into HDMA workflow and proposed a concise and powerful high-dimensional mediation analysis procedure consisting of OW confounding adjustment, sure independence screening (SIS), de-biased Lasso penalization, and joint-significance testing underlying the mixture null distribution. We compared the proposed method with the existing method consisting of PS-based confounding adjustment, SIS, minimax concave penalty (MCP) variable selection, and classical joint-significance testing.

Results

Simulation studies demonstrate the proposed procedure has the best performance in mediator selection and estimation. The proposed procedure yielded the highest true positive rate, acceptable false discovery proportion level, and lower mean square error. In the empirical study based on the GSE117859 dataset in the Gene Expression Omnibus database using the proposed method, we found that smoking history may lead to the estimated natural killer (NK) cell level reduction through the mediation effect of some methylation markers, mainly including methylation sites cg13917614 in CNP gene and cg16893868 in LILRA2 gene.

Conclusions

The proposed method has higher power, sufficient false discovery rate control, and precise mediation effect estimation. Meanwhile, it is feasible to be implemented with the presence of confounders. Hence, our method is worth considering in HDMA studies.
Clinical characteristics and outcomes of patients with Herpes Simplex Encephalitis in Vietnam: a retrospective study
Authors: Ngan Ta Thi Dieu , Tuyet Nguyen Thi , Hung Dinh Trong , Cap Nguyen Trung , Nguyen Duy Manh , Dat Vu Quoc
Published: June 2024

Background

Herpes simplex encephalitis (HSE) is an important central nervous infection with severe neurological sequelae. The aim of this study was to describe clinical characteristic and outcomes of patients with HSE in Vietnam.

Methods

This was a retrospective study of 66 patients with herpes simplex encephalitis who admitted to the National Hospital for Tropical Diseases, Hanoi, Vietnam from 2018 to 2021. The detection of herpes simplex virus (HSV) in cerebrospinal fluid was made by the real-time PCR assay. We reported the clinical manifestation on admission and evaluated clinical outcomes at the hospital discharge by modified Rankin Scale (mRS). Multivariate logistic regression analysis was used to analyze the independent risk factors of severe outcomes.

Results

Of the 66 patients with laboratory confirmed HSE, the median age was 53 years (IQR 38–60) and 44 patients (69.7%) were male. The most common manifestations included fever (100%), followed by the consciousness disorder (95.5%). Other neurological manifestation were seizures (36.4%), memory disorders (31.8%), language disorders (19.7%) and behavioral disorders (13.6%). Conventional magnetic resonance imaging (MRI) showed 93.8% patients with temporal lobe lesions, followed by abnormalities in insula (50%), frontal lobe (34.4%) and 48.4% of patients had bilateral lesions. At discharge, 19 patients (28.8%) completely recovered, 15 patients (22.7%) had mild sequelae, 28 patients (42.4%) had moderate to severe sequelae. Severe neurological sequelae were memory disorders (55.8%), movement disorders (53.5%), language disorders (30.2%). Multivariate logistic regression analysis showed that Glasgow score decrement at admission, seizures, and time duration from onset of symptoms to the start of Acyclovir treatment > 4 days were independent factors associated with severe outcomes in HSE patients.

Conclusion

Glasgow score decrement, seizures and delay treatment with Acyclovir were associated with the poor outcome of patients with HSE.
Effects of perineal massage at different stages on perineal and postpartum pelvic floor function in primiparous women: a systematic review and meta-analysis
Authors: Yin Jinzhu , Chen Yun , Huang Meiling , Cao Zhongyan , Jiang Ziyan , Li Yao
Published: June 2024

Background

Perineal massage, as a preventive intervention, has been shown to reduce the risk of perineal injuries and may have a positive impact on pelvic floor function in the early postpartum period. However, there is still debate concerning the best period to apply perineal massage, which is either antenatal or in the second stage of labor, as well as its safety and effectiveness. Meta-analysis was used to evaluate the effect of implementing perineal massage in antenatal versus the second stage of labor on the prevention of perineal injuries during labor and early postpartum pelvic floor function in primiparous women.

Methods

We searched nine different electronic databases from inception to April 16, 2024. The randomized controlled trials (RCTs) we included assessed the effects of antenatal and second-stage labor perineal massage in primiparous women. All data were analyzed with Revman 5.3, Stata Statistical Software, and Risk of Bias 2 was used to assess the risk of bias. Subgroup analyses were performed based on the different periods of perineal massage. The primary outcomes were the incidence of perineal integrity and perineal injury. Secondary outcomes were perineal pain, duration of the second stage of labor, postpartum hemorrhage, urinary incontinence, fecal incontinence, and flatus incontinence.

Results

This review comprised a total of 10 studies that covered 1057 primigravid women. The results of the analysis showed that perineal massage during the second stage of labor reduced the perineal pain of primigravid women in the immediate postpartum period compared to the antenatal period, with a statistical value of (MD = -2.29, 95% CI [-2.53, -2.05], P < 0.001). Additionally, only the antenatal stage reported that perineal massage reduced fecal incontinence (P = 0.04) and flatus incontinence (P = 0.01) in primiparous women at three months postpartum, but had no significant effect on urinary incontinence in primiparous women at three months postpartum (P = 0.80).

Conclusions

Reducing perineal injuries in primiparous women can be achieved by providing perineal massage both antenatally and during the second stage of labor. Pelvic floor function is improved in the postnatal phase by perineal massage during the antenatal stage.

Trial registration

CRD42023415996 (PROSPERO).
‘It’s not me, it’s them’ – a report describing the weight-related attitudes towards obesity in pregnancy among maternal healthcare providers
Authors: Nagpal Taniya S. , Angrish Kirina , Bonisteel Emily , Puhl Rebecca M. , Ferraro Zachary M. , Malkani Niyati M. , LeJour Caroline , Adamo Kristi B.
Published: June 2024

Background

Occurrences of weight stigma have been documented in prenatal clinical settings from the perspective of pregnant patients, however little is known from the viewpoint of healthcare providers themselves. Reported experiences of weight stigma caused by maternal healthcare providers may be due to negative attitudes towards obesity in pregnancy and a lack of obesity specific education. The objective of this study was to assess weight-related attitudes and assumptions towards obesity in pregnancy among maternal healthcare providers in order to inform future interventions to mitigate weight stigma in prenatal clinical settings.

Methods

A cross-sectional survey was administered online for maternal healthcare providers in Canada that assessed weight-related attitudes and assumptions towards lifestyle behaviours in pregnancy for patients who have obesity. Participants indicated their level of agreement on a 5-point likert scale, and mean scores were calculated with higher scores indicating poorer attitudes. Participants reported whether they had observed weight stigma occur in clinical settings. Finally, participants were asked whether or not they had received obesity-specific training, and attitude scores were compared between the two groups.

Results

Seventy-two maternal healthcare providers (midwives, OBGYNs, residents, perinatal nurses, and family physicians) completed the survey, and 79.2% indicated that they had observed pregnant patients with obesity experience weight stigma in a clinical setting. Those who had obesity training perceived that their peers had poorer attitudes (3.7 ± 0.9) than those without training (3.1 ± 0.7; t(70) = 2.23, p = 0.029, Cohen’s d = 0.86).

Conclusions

Weight stigma occurs in prenatal clinical environments, and this was confirmed by maternal healthcare providers themselves. These findings support advocacy efforts to integrate weight stigma related content and mitigation strategies in medical education for health professionals, including maternal healthcare providers. Future work should include prospective examination of weight related attitudes among maternal healthcare providers and implications of obesity specific education, including strategies on mitigating weight stigma in the delivery of prenatal care.
Risk factors associated with oral Human Papillomavirus (HPV) prevalence within a young adult population
Authors: Whitton Aimee F. , Knight Gillian L. , Marsh Elizabeth K.
Published: June 2024

Background

The prevalence of, and risk factors for, genital Human Papillomavirus (HPV) infections within the young adult population are well-established; the same is not known for oral HPV. This observational study aimed to determine oral HPV prevalence and abundance within a UK young adult population, and examine if sexual practices and established risk factors of oropharyngeal squamous cell carcinomas (OPSCCs) (such as smoking and alcohol consumption) influenced HPV prevalence.

Methods

Convenience sampling was used to recruit a small sample of 452 UK-based young adults studying at a higher education (HE) institution to the study; the study was not powered. A highly sensitive real-time PCR HPV screening method was developed for the detection of multiple HPV subtypes from oral swabs. HPV-positive samples were subsequently screened by qPCR for viral subtypes HPV-6, HPV-11, HPV-16, HPV-18. Results were analysed by univariate and multivariate methods and stratified for gender, with lifestyle behaviour data collected via questionnaire. Socio-economic status was not captured within the questionnaire.

Results

We found a high oral HPV prevalence of 22.79%, with a dominance of high-risk viral type HPV-16 (prevalence 19.12%; abundance average 1.08 × 105 copies/million cells) detected within healthy young adults. Frequent smoking (p = .05), masturbation (p = .029), and engagement in multiple sexual activities (p = .057), were found to be associated with oral HPV prevalence, and HPV-16 prevalence, whilst behaviours traditionally associated with genital HPV were not.

Conclusions

Our results strengthen the link between sexual practices and oral HPV transmission. We suggest that young adults should be considered high-risk for the contraction of oral HPV, although acknowledge that this sample of HE students may not be representative of the wider population. We show that high-risk HPV-16 is prevalent in the healthy population, as well as dominating within OPSCC; this study is one of the first to determine the dominance of oral HPV-16 prevalence and abundance within this population, presenting a clear need for greater awareness of oral HPV infections, and the risk factors for HPV-positive OPSCC within young adults.
Fear of COVID-19 associated with burnout syndrome in dentists of the Health Directorate of the National Police of Peru: a cross-sectional study at national level under multivariable regression model
Authors: Verástegui-Sandoval Arturo , Aquiles-Barzola Flor , Machco-Pasmiño Heriberto , Ladera-Castañeda Marysela , Briceño-Vergel Gissela , Castro-Rojas Miriam , Cornejo-Pinto Alberto , Cervantes-Ganoza Luis , Cayo-Rojas César
Published: June 2024

Background

During the pandemic, many police dentists had the crucial responsibility of ensuring law and order while providing dental care by taking government-approved health measures to stop the spread of the coronavirus. The aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the National Police of Peru (PNP), taking into account possible confounding variables.

Methods

This cross-sectional and analytical study included 182 PNP dentists. The Fear COVID-19 Scale assessed fear of COVID-19 and the Maslach Burnout Inventory Test assessed burnout syndrome. The association between the fear of COVID-19 and Burnout syndrome (self-fulfilment) was analyzed using Spearman's Rho. A multivariable Poisson regression model with a robust variance estimation method was employed to evaluate the impact of fear of COVID-19 on the various dimensions of Burnout syndrome, considering possible confounding variables. The statistical significance level was set at p < 0.05.

Results

Under bivariate analysis, fear of COVID-19 was significantly linked with low direct intensity toward emotional exhaustion (Rho = 0.325, p < 0.001), very low direct intensity toward depersonalization (Rho = 0.180, p = 0.015), and very low inverse intensity toward self-fulfilment (Rho =—0.186, p = 0.012). Under multivariable analysis, it was observed that dentists who exhibited fear of COVID-19 were 3.4 and 3.7 times more likely to experience emotional exhaustion and depersonalization, respectively (APR = 3.40, 95% CI: 1.74—6.63 and APR = 3.68, 95% CI: 1.31—10.37), as compared to those who did not display fear of COVID-19. Moreover, none of the potential confounding factors were found to have a significant impact on emotional exhaustion (p > 0.05), depersonalization (p > 0.05), and self-fulfilment (p > 0.05).

Conclusion

Fear of COVID-19 was significantly associated with emotional exhaustion and depersonalization, and inversely associated with self-fulfilment. PNP dentists who exhibited fear of COVID-19 were at greater risk for emotional exhaustion and depersonalization. In developing Burnout syndrome, no significant impact was observed from factors such as age, gender, marital status, children, hierarchy, years of service, work area, private practice, work over 40 h per week, type of service, work performed, sport practice and daily exercise time.
Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis
Authors: Boonsirikamchai Win , Wilartratsami Sirichai , Ruangchainikom Monchai , Korwutthikulrangsri Ekkapoj , Tongsai Sasima , Luksanapruksa Panya
Published: June 2024

This study presents a systematic literature review and meta-analysis of pseudarthrosis risk factors following lumbar fusion procedures. The odds ratio (OR) and 95% confidence interval (95% CI) were used for outcome measurements. The objective of this study was to identify the independent risk factors for pseudarthrosis after lumbar spinal fusion, which is crucial for mitigating morbidity and reoperation. Systematic searches in PubMed, Embase, and Scopus (1990–July 2021) were conducted using specific terms. The inclusion criteria included prospective and retrospective cohorts and case‒control series reporting ORs with 95% CIs from multivariate analysis. The quality assessment utilized the Newcastle–Ottawa scale. Meta-analysis, employing OR and 95% CI, assessed pseudarthrosis risk factors in lumbar fusion surgery, depicted in a forest plot. Of the 568 abstracts identified, 12 met the inclusion criteria (9 retrospective, 2006–2021). The 17 risk factors were categorized into clinical, radiographic, surgical, and bone turnover marker factors. The meta-analysis highlighted two significant clinical risk factors: age (95% CI 1.02–1.11; p = 0.005) and smoking (95% CI 1.68–5.44; p = 0.0002). The sole significant surgical risk factor was the number of fused levels (pooled OR 1.35; 95% CI 1.17–1.55; p < 0.0001). This study identified 17 risk factors for pseudarthrosis after lumbar fusion surgery, emphasizing age, smoking status, and the number of fusion levels. Prospective studies are warranted to explore additional risk factors and assess the impact of surgery and graft type.
Can conservative treatment be effective for thoracolumbar injuries patients with TLICS scores of 4 or 5? An analysis of initial radiological findings and clinical risk factors for treatment failure
Authors: Khil Eun Kyung , Choi Il , Lee Kyoung Yeon , Kim Young Woo
Published: June 2024

Background

This study aimed to assess the outcomes of conservative management in patients with thoracolumbar fractures classified with a Thoracolumbar Injury Classification and Severity (TLICS) score of 4 or 5, and to analyze initial imaging findings and clinical risk factors associated with treatment failure.

Methods

In this retrospective analysis, patients with thoracolumbar fractures and a TLICS score of 4 or 5, determined through MRI from January 2017 to December 2020, were included. Patients undergoing conservative treatment were categorized into two groups: Group 1 (treatment success) and Group 2 (treatment failure), based on initial and 6-month follow-up outcomes. Clinical data were compared between the two groups. Initial radiological assessments included three kyphosis measurements (Cobb angle, Gardner angle, and sagittal index [SI]), anterior and posterior wall height, and central canal compromise (CC). Additionally, risk factors contributing to treatment failure were analyzed.

Results

The conservative treatment group comprised 84 patients (mean age, 60.25 ± 15.53; range 22–85; 42 men), with 57 in Group 1 and 27 in Group 2. Group 2 exhibited a higher proportion of women, older age, and lower bone mass density (p = 0.001–0.005). Initial imaging findings in Group 2 revealed significantly greater values for Cobb angle, SI, and CC (p = 0.001–0.045 or < 0.001; with cutoff values of 18.2, 12.8, and 7.8%, respectively), and lower anterior wall height (p = 0.001), demonstrating good to excellent interobserver agreement (0.72–0.99, p < 0.001). Furthermore, osteoporosis was identified as a significant risk factor (odds ratio = 5.64, p = 0.008).

Conclusion

Among patients with TLICS scores of 4 or 5, those experiencing conservative treatment failure exhibited unfavorable initial radiological findings, a higher proportion of women, advanced age, and osteoporosis. Additionally, osteoporosis emerged as a significant risk factor for treatment failure.
Knowledge, usability and challenges of e-learning platforms for continuing Professional Development of healthcare professionals at University Teaching Hospital of Kigali
Authors: Mukamana Agnes , Byungura Jean Claude , Manirakiza Felix , Rushingabigwi Gerard
Published: June 2024

Background

Healthcare professionals constitute a critical component of clinical care services. To provide the expected service, they must continuously develop their profession through continuous learning. This kind of learning is recognized as continuing professional development (CPD). Traditionally, CPD is offered onsite. Onsite training is associated with some barriers that prevent healthcare professionals from attending such educational activities, including financial difficulties and long distance. This is why online learning is proposed to overcome these barriers.

Objective

The main purpose was to evaluate usability, knowledge and challenges of e-learning platforms for CPD of healthcare professionals at University Teaching Hospital of Kigali (CHUK).

Methods

The cross-sectional quantitative study approach was utilized; the data was collected at the workplace of nurses, midwives, and allied health professionals by using a pre-designed questionnaire. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25 and presented as frequencies.

Results

A significant majority was aware of CPD e-learning platforms. For example, 95.7% of the participants were familiar with these platforms, indicating that they had some degree of knowledge about their existence and purpose. Regarding the mode of accessing CPD courses, 82.1% of participants preferred online platforms, demonstrating a strong will to use e-learning platforms.

Conclusion

This study highlighted a high level of awareness and utilization of CPD e-learning platforms among healthcare professionals at CHUK, additionally, participants expressed confidence in using the platforms but emphasized the need for further support and training.
3D exploration of gene expression in chicken embryos through combined RNA fluorescence in situ hybridization, immunofluorescence, and clearing
Authors: André Maëlys , Dinvaut Sarah , Castellani Valérie , Falk Julien
Published: June 2024

Background

Fine characterization of gene expression patterns is crucial to understand many aspects of embryonic development. The chicken embryo is a well-established and valuable animal model for developmental biology. The period spanning from the third to sixth embryonic days (E3 to E6) is critical for many organ developments. Hybridization chain reaction RNA fluorescent in situ hybridization (HCR RNA-FISH) enables multiplex RNA detection in thick samples including embryos of various animal models. However, its use is limited by tissue opacity.

Results

We optimized HCR RNA-FISH protocol to efficiently label RNAs in whole mount chicken embryos from E3.5 to E5.5 and adapted it to ethyl cinnamate (ECi) tissue clearing. We show that light sheet imaging of HCR RNA-FISH after ECi clearing allows RNA expression analysis within embryonic tissues with good sensitivity and spatial resolution. Finally, whole mount immunofluorescence can be performed after HCR RNA-FISH enabling as exemplified to assay complex spatial relationships between axons and their environment or to monitor GFP electroporated neurons.

Conclusions

We could extend the use of HCR RNA-FISH to older chick embryos by optimizing HCR RNA-FISH and combining it with tissue clearing and 3D imaging. The integration of immunostaining makes possible to combine gene expression with classical cell markers, to correlate expressions with morphological differentiation and to depict gene expressions in gain or loss of function contexts. Altogether, this combined procedure further extends the potential of HCR RNA-FISH technique for chicken embryology.
Hepatic steatosis, metabolic dysfunction and risk of mortality: findings from a multinational prospective cohort study
Authors: Mayén Ana-Lucia , Sabra Mirna , Aglago Elom K. , Perlemuter Gabriel , Voican Cosmin , Ramos Ines , Debras Charlotte , Blanco Jessica , Viallon Vivian , Ferrari Pietro , Olsen Anja , Tjønneland Anne , Langmann Fie , Dahm Christina C. , Rothwell Joseph , Laouali Nasser , Marques Chloé , Schulze Matthias B. , Katzke Verena , Kaaks Rudolf , Palli Domenico , Macciotta Alessandra , Panico Salvatore , Tumino Rosario , Agnoli Claudia , Farràs Marta , Molina-Montes Esther , Amiano Pilar , Chirlaque María-Dolores , Castilla Jesús , Werner Mårten , Bodén Stina , Heath Alicia K. , Tsilidis Kostas , Aune Dagfinn , Weiderpass Elisabete , Freisling Heinz , Gunter Marc J. , Jenab Mazda
Published: June 2024

Background

Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) are implicated in the aetiology of non-communicable diseases. Our study aimed to evaluate associations between NAFLD and MetS with overall and cause-specific mortality.

Methods

We used dietary, lifestyle, anthropometric and metabolic biomarker data from a random subsample of 15,784 EPIC cohort participants. NAFLD was assessed using the fatty liver index (FLI) and MetS using the revised definition. Indices for metabolic dysfunction–associated fatty liver disease (MAFLD) were calculated. The individual associations of these indices with overall and cause-specific mortality were assessed using multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs). As a subobjective, risk associations with adaptations of new classifications of metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic and alcohol-related liver disease (MetALD) were also assessed.

Results

Among the 15,784 sub-cohort participants, a total of 1997 deaths occurred (835 due to cancer, 520 to CVD, 642 to other causes) over a median 15.6 (IQR, 12.3–17.1) years of follow-up. Compared to an FLI < 30, FLI ≥ 60 was associated with increased risks of overall mortality (HR = 1.44, 95%CI = 1.27–1.63), and deaths from cancer (HR = 1.32, 95%CI = 1.09–1.60), CVD (HR = 2.06, 95% CI = 1.61–2.63) or other causes (HR = 1.21, 95%CI = 0.97–1.51). Mortality risk associations were also elevated for individuals with MAFLD compared to those without. Individuals with MetS were at increased risk of all mortality endpoints, except cancer-specific mortality. MASLD and MetALD were associated with higher risk of overall mortality.

Conclusions

Our findings based on a prospective cohort suggest that individuals with hepatic steatosis or metabolic dysfunction have a higher overall and cause-specific mortality risk.
Evaluation the kill rate and mutant selection window of danofloxacin against Actinobacillus pleuropneumoniae in a peristaltic pump model
Authors: Wang Hongjuan , Liao Chengshui , Ding Ke , Zhang Longfei , Wang Lei
Published: June 2024

Background

Actinobacillus pleuropneumoniae is a serious pathogen in pigs. The abundant application of antibiotics has resulted in the gradual emergence of drugresistant bacteria, which has seriously affected treatment of disease. To aid measures to prevent the emergence and spread of drug-resistant bacteria, herein, the kill rate and mutant selection window (MSW) of danofloxacin (DAN) against A. pleuropneumoniae were evaluated.

Methods

For the kill rate study, the minimum inhibitory concentration (MIC) was tested using the micro dilution broth method and time-killing curves of DAN against A. pleuropneumoniae grown in tryptic soy broth (TSB) at a series drug concentrations (from 0 to 64 MIC) were constructed. The relationships between the kill rate and drug concentrations were analyzed using a Sigmoid Emax model during different time periods. For the MSW study, the MIC99 (the lowest concentration that inhibited the growth of the bacteria by ≥ 99%) and mutant prevention concentration (MPC) of DAN against A. pleuropneumoniae were measured using the agar plate method. Then, a peristaltic pump infection model was established to simulate the dynamic changes of DAN concentrations in pig lungs. The changes in number and sensitivity of A. pleuropneumoniae were measured. The relationships between pharmacokinetic/pharmacodynamic parameters and the antibacterial effect were analyzed using the Sigmoid Emax model.

Results

In kill rate study, the MIC of DAN against A. pleuropneumoniae was 0.016 µg/mL. According to the kill rate, DAN exhibited concentration-dependent antibacterial activity against A. pleuropneumoniae. A bactericidal effect was observed when the DAN concentration reached 4–8 MIC. The kill rate increased constantly with the increase in DAN concentration, with a maximum value of 3.23 Log10 colony forming units (CFU)/mL/h during the 0–1 h period. When the drug concentration was in the middle part of the MSW, drugresistant bacteria might be induced. Therefore, the dosage should be avoided to produce a mean value of AUC24h/MIC99 (between 31.29 and 62.59 h. The values of AUC24h/MIC99 to achieve bacteriostatic, bactericidal, and eradication effects were 9.46, 25.14, and > 62.59 h, respectively.

Conclusion

These kill rate and MSW results will provide valuable guidance for the use of DAN to treat A. pleuropneumoniae infections.
From “Husky” to “Bulldog”– behavioural correlates between castration and breed groups in the domestic dog (Canis lupus familiaris)
Authors: Kolkmeyer C.A. , Baum J. , Warlich-Zach N. , Gansloßer U.
Published: June 2024

Neutering dogs is a widespread method and is carried out for various behavioural and husbandry reasons. This study’s main objective is to investigate the behavioural correlations between neutering and the breed of male dogs. In order to possibly find breed-dependent differences in the behaviour of intact and castrated dogs, a differentiation between two clades - the “Huskies“(chow chow, shar pei, akita/shiba inu, alaskan malamute, siberian/alaskan husky) and the “Bulldogs” (german boxer, english/french bulldog, old english mastiff, boston terrier, english bull terrier, staffordshire bull terrier, american staffordshire terrier), based on Parker et al. [1], was made.

Using an online questionnaire,, 31 neutered and 37 intact male dogs from the clade “Huskies“ and 30 neutered and 38 intact male dogs from the clade “Bulldogs”, participated in the study (N = 136).The survey included detailed questions on the dogs’ personality and any associated issues as well as a behavioural anamnesis. Further questions relating to four of the “big five” personality dimensions based on the “Budapest questionnaire” by Turcsán et al. from 2011 [2] were also added.

The results show, that neutered males from both breed clades more frequently displayed aggression toward humans than intact males (multinomial logistic regression, p = 0.002). When it came to aggression towards other dogs, it was the “Huskies” that differed significantly from the “Bulldogs“(multinomial logistic regression, p = 0.04) with being more aggressive. There were also significant differences in stress-related behaviour depending on castration status and breed (multinomial logistic regression, p < 0.001; Cramer’s V = 0.33) and only the castration status had an impact on the significance (multinomial logistic regression, p < 0.001). The analysis also revealed significance for stress-indicating behaviour with dependence on neutering status (multinomial logistic regression, p < 0.001) and showed that stress as well as uncertainty are significantly more common in neutered dogs depending on breed and neutering status (multinomial logistic regression, p < 0.001; Cramer’s V = 0.42), in that only neutered “Bulldogs“ were stressed, but more “Huskies“ overall.

According to the Budapest questionnaire data, the “Bulldog” clade had considerably greater extraversion scores overall (ordinal regression, p < 0.001) than the “Huskies“.

Our findings highlight the risks and potential negative effects of neutering. Gonadectomy in no way substitutes for the dog receiving the necessary socialization, training, or bonding. Although in some circumstances it might have a favourable impact on the dog’s behaviour, it should not be seen as a panacea for unwanted behaviour. Given that not all behaviours are influenced by sex hormones, every castration decision must be weighed up individually.