bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing Boolean networks with backward equivalence
Authors: Argyris Georgios A. , Lluch Lafuente Alberto , Tribastone Mirco , Tschaikowski Max , Vandin Andrea
Published: May 2023

Background

Boolean Networks (BNs) are a popular dynamical model in biology where the state of each component is represented by a variable taking binary values that express, for instance, activation/deactivation or high/low concentrations. Unfortunately, these models suffer from the state space explosion, i.e., there are exponentially many states in the number of BN variables, which hampers their analysis.

Results

We present Boolean Backward Equivalence (BBE), a novel reduction technique for BNs which collapses system variables that, if initialized with same value, maintain matching values in all states. A large-scale validation on 86 models from two online model repositories reveals that BBE is effective, since it is able to reduce more than 90% of the models. Furthermore, on such models we also show that BBE brings notable analysis speed-ups, both in terms of state space generation and steady-state analysis. In several cases, BBE allowed the analysis of models that were originally intractable due to the complexity. On two selected case studies, we show how one can tune the reduction power of BBE using model-specific information to preserve all dynamics of interest, and selectively exclude behavior that does not have biological relevance.

Conclusions

BBE complements existing reduction methods, preserving properties that other reduction methods fail to reproduce, and vice versa. BBE drops all and only the dynamics, including attractors, originating from states where BBE-equivalent variables have been initialized with different activation values The remaining part of the dynamics is preserved exactly, including the length of the preserved attractors, and their reachability from given initial conditions, without adding any spurious behaviours. Given that BBE is a model-to-model reduction technique, it can be combined with further reduction methods for BNs.
Empowering biologists to decode omics data: the Genekitr R package and web server
Authors: Liu Yunze , Li Gang
Published: May 2023

Background

A variety of high-throughput analyses, such as transcriptome, proteome, and metabolome analysis, have been developed, producing unprecedented amounts of omics data. These studies generate large gene lists, of which the biological significance shall be deeply understood. However, manually interpreting these lists is difficult, especially for non-bioinformatics-savvy scientists.

Results

We developed an R package and a corresponding web server—Genekitr, to assist biologists in exploring large gene sets. Genekitr comprises four modules: gene information retrieval, ID (identifier) conversion, enrichment analysis and publication-ready plotting. Currently, the information retrieval module can retrieve information on up to 23 attributes for genes of 317 organisms. The ID conversion module assists in ID-mapping of genes, probes, proteins, and aliases. The enrichment analysis module organizes 315 gene set libraries in different biological contexts by over-representation analysis and gene set enrichment analysis. The plotting module performs customizable and high-quality illustrations that can be used directly in presentations or publications.

Conclusions

This web server tool will make bioinformatics more accessible to scientists who might not have programming expertise, allowing them to perform bioinformatics tasks without coding.
Effect of body mass index on clinical outcomes after robotic cardiac surgery: is there an obesity paradox?
Authors: Wu Wenjun , Ding Renzhong , Chen Jianming , Yuan Ye , Song Yi , Yan Manrong , Hu Yijie
Published: May 2023

Background

To investigate the effect of body mass index (BMI) on clinical outcomes after robotic cardiac surgery, and to explore the postoperative obesity paradox.

Methods

The data of 146 patients who underwent robotic cardiac surgery under cardiopulmonary bypass (CPB) from July 2016 to June 2022 in Daping Hospital of Army Medical University were retrospectively analyzed, and their demographic data and related clinical data were statistically analyzed. The mean age was (42.88 ± 13.01) years, 55 (37.67%) were male and 91 (62.33%) were female. Patients were divided into 3 groups according to preoperative BMI: lean group (BMI < 18.5 kg/m2; n = 17; 11.64%), normal group (BMI 18.5 kg/m2 to 23.9 kg/m2; n = 81; 55.48%), and overweight and obese group (BMI ≥ 24 kg/m2; n = 48; 32.88%). Multivariate analysis was performed to compare clinical outcomes across BMI groups.

Results

Preoperative data in different BMI groups showed that there were statistically significant differences in age, height, weight, body surface area (BSA), diabetes, left atrial anteroposterior diameter (LAD), triglyceride (TG), and high-density lipoprotein (HDL) (all P < 0.05). Postoperative clinical outcomes showed that there was no statistical difference between the lean group and the normal group; the intensive care unit stay and postoperative hospital stay in the overweight and obese group were significantly higher than those in the normal group (P < 0.05), and the risk of postoperative cardiac surgery-related acute kidney injury (CSA-AKI) was significantly increased (P = 0.021); further Multiple Binary Logistic Regression Analysis suggested that preoperative TG (OR = 1.772, 95% CI 1.068–2.942, P = 0.027) and operation time ≥ 300 min (OR = 3.823, 95% CI 1.098–13.308, P = 0.035) were independent risk factors for postoperative CSA-AKI.

Conclusions

Overweight and obese patients had significantly prolonged intensive care unit stay and postoperative hospital stay after robotic cardiac surgery, and significantly increased incidence of postoperative CSA-AKI, which did not support the obesity paradox; preoperative TG and operation time ≥ 300 min were independent risk factors for postoperative CSA-AKI.
Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort study
Authors: Lin Ming-Shyan , Wang Po-Chang , Lin Meng-Hung , Kuo Ting-Yu , Lin Yu-Sheng , Chen Tien-Hsing , Tsai Ming-Horng , Yang Yao-Hsu , Lin Chun-Liang , Chung Chang-Min , Chu Pao-Hsien
Published: May 2023

Background

Little research has been done on ischemic outcomes related to left ventricular ejection fraction (EF) in acute decompensated heart failure (ADHF).

Methods

A retrospective cohort study was conducted between 2001 and 2021 using the Chang Gung Research Database. ADHF Patients discharged from hospitals between January 1, 2005, and December 31, 2019. Cardiovascular (CV) mortality and heart failure (HF) rehospitalization are the primary outcome components, along with all-cause mortality, acute myocardial infarction (AMI) and stroke.

Results

A total of 12,852 ADHF patients were identified, of whom 2,222 (17.3%) had HFmrEF, the mean (SD) age was 68.5 (14.6) years, and 1,327 (59.7%) were males. In comparison with HFrEF and HFpEF patients, HFmrEF patients had a significant phenotype comorbid with diabetes, dyslipidemia, and ischemic heart disease. Patients with HFmrEF were more likely to experience renal failure, dialysis, and replacement. Both HFmrEF and HFrEF had similar rates of cardioversion and coronary interventions. There was an intermediate clinical outcome between HFpEF and HFrEF, but HFmrEF had the highest rate of AMI (HFpEF, 9.3%; HFmrEF, 13.6%; HFrEF, 9.9%). The AMI rates in HFmrEF were higher than those in HFpEF (AHR, 1.15; 95% Confidence Interval, 0.99 to 1.32) but not in HFrEF (AHR, 0.99; 95% Confidence Interval, 0.87 to 1.13).

Conclusion

Acute decompression in patients with HFmrEF increases the risk of myocardial infarction. The relationship between HFmrEF and ischemic cardiomyopathy, as well as optimal anti-ischemic treatment, requires further research on a large scale.
Reporting quality of randomized controlled trials of angina pectoris with integrated traditional Chinese and western medicine interventions: a cross-sectional study
Authors: Deng Jiashuai , He Juan , Wang Juan , Cheng Chung Wah , Jiao Yalin , Wang Nana , Li Ji , Wang Ping , Han Fei , Lyu Aiping , Bian Zhaoxiang , Zhang Xuan
Published: May 2023

Background and objective

Integrated traditional Chinese and western medicine (ITCWM), as a representative type of complex intervention, is commonly used for the treatment of angina pectoris (AP) in clinical practice. However, it is unclear whether the details of ITCWM interventions, such as rationale for selection and design, implementation and potential interactions for different therapies, were adequately reported. Therefore, this study aimed to describe the reporting characteristics and quality in randomized controlled trials (RCTs) of AP with ITCWM interventions.

Methods

Through a search of 7 electronic databases, we identified RCTs of AP with ITCWM interventions published in both English and Chinese from 1st Jan 2017 to 6th Aug 2022. The general characteristics of included studies were summarized, further, the quality of reporting was assessed based on three Checklists, including the CONSORT with 36 items (except for one item 1b about abstract), the CONSORT for abstracts (17 items), and a self-designed ITCWM-related checklist (21 items covering rationale and details of interventions, outcome assessment and analysis). The quality of RCTs published in English and Chinese, as well as journals and dissertations were also compared.

Results

A total of 451 eligible RCTs were included. For the reporting compliance, the mean score (95% Confidence Interval) of the CONSORT (72 scores in total), CONSORT for abstract (34 scores in total), and ITCWM-related (42 scores in total) checklists was 27.82 (27.44–28.19), 14.17 (13.98–14.37) and 21.06 (20.69–21.43), respectively. More than half items were evaluated as poor quality (reporting rate < 50%) among each Checklist. Moreover, the reporting quality of publications in English journals was higher than that in Chinese journals in terms of the CONSORT items. The reporting of published dissertations was better than that in journal publications regarding both the CONSORT and ITCWM-specific items.

Conclusion

Although the CONSORT appears to have enhanced the reporting of RCTs in AP, the quality of ITCWM specifics is variable and in need of improvement. Reporting guideline of the ITCWM recommendations should be developed thus to improve their quality.
Prognosis prediction in esophageal signet-ring-cell carcinoma: a competing risk analysis
Authors: Chen Chen , Wang Zehua , Qin Yanru
Published: May 2023

Objective

This study aims to construct and validate a competing risk nomogram model to predict 1-year, 3-year, and 5-year cancer-specific survival (CSS) for patients with esophageal signet-ring-cell carcinoma.

Methods

Patients diagnosed with esophageal signet-ring-cell carcinoma (ESRCC) between 2010 and 2015 were abstracted from the Surveillance, Epidemiology, and End Results (SEER) database. We performed the competing risk model to select significant variables to build a competing risk nomogram, which was used to estimate 1-year, 3-year, and 5-year CSS probability. The C-index, receiver operating characteristic (ROC) curve, calibration plot, Brier score, and decision curve analysis were performed in the internal validation.

Results

A total of 564 patients with esophageal signet-ring-cell carcinoma fulfilled the eligibility criteria. The competing risk nomogram identified 4 prognostic variables, involving the gender, lung metastases, liver metastases, and receiving surgery. The C indexes of nomogram were 0.61, 0.75, and 0.70, respectively for 5-year, 3-year, and 1-year CSS prediction. The calibration plots displayed high consistency. The Brier scores and decision curve analysis respectively favored good prediction ability and clinical utility of the nomogram.

Conclusions

A competing risk nomogram for esophageal signet-ring-cell carcinoma was successfully constructed and internally validated. This model is expected to predict 1-year, 3-year, and 5-year CSS, and help oncologists and pathologists in clinical decision making and health care management for esophageal signet-ring-cell carcinoma patients.
Confocal endomicroscopy diagnostic criteria for early signet-ring cell carcinoma in hereditary diffuse gastric cancer
Authors: Pilonis Nastazja D. , O’Donovan Maria , Richardson Susan , Fitzgerald Rebecca C. , di Pietro Massimiliano
Published: May 2023

Background

Recognition of early signet-ring cell carcinoma (SRCC) in patients with hereditary diffuse gastric cancer (HDGC) undergoing endoscopic surveillance is challenging. We hypothesized that probe-based confocal laser endomicroscopy (pCLE) might help diagnose early cancerous lesions in the context of HDGC. The aim of this study was to identify pCLE diagnostic criteria for early SRCC.

Methods

Patients with HDGC syndrome were prospectively recruited and pCLE assessment was performed on areas suspicious for early SRCC and control regions during an endoscopic surveillance procedure. Targeted biopsies were taken for gold standard histologic assessment. In Phase I two investigators assessed video sequences off-line to identify pCLE features related to SRCC. In Phase II pCLE diagnostic criteria were evaluated in an independent video set by the investigators blinded to the histologic diagnosis. Sensitivity, specificity, accuracy, and interobserver agreement were calculated.

Results

Forty-two video sequences from 16 HDGC patients were included in Phase I. Four pCLE patterns associated to SRCC histologic features were identified: (A) glands with attenuated margins, (B) glands with spiculated or irregular shape, (C) heterogenous granular stroma with sparse glands, (D) enlarged vessels with tortuous shape. In Phase II, 38 video sequences from 15 patients were assessed. Criteria A and B and C had the highest diagnostic accuracy, with a κ for interobserver agreement ranging from 0.153 to 0.565. A panel comprising these 3 criteria with a cut-off of at least one positive criterion had a sensitivity of 80.9% (95%CI:58.1—94.5%) and a specificity of 70.6% (95%CI:44.0—89.7%) for a diagnosis of SRCC.

Conclusions

We have generated and validated off-line pCLE criteria for early SRCC. Future real-time validation of these criteria is required.
Electroencephalography in young onset dementia
Authors: Brown Casey W , Chen Huei-Yang , Panegyres Peter K
Published: May 2023

Background

Young onset dementia (YOD) is a major diagnostic and management problem.

Methods

We set out to explore if electroencephalography (EEG) might be useful in the diagnosis of young onset Alzheimer’s disease (YOAD) and young onset frontotemporal dementia (YOFTD). The ARTEMIS project is a 25-year prospective study of YOD based in Perth, Western Australia. 231 participants were included: YOAD: n = 103, YOFTD: n = 28, controls: n = 100. EEGs were performed prospectively, with 30-minute recording time for each subject, without knowledge of diagnosis or other diagnostic data.

Results

80.9% of patients with YOD had abnormal EEGs (P < 0.00001). Slow wave changes were more frequent in YOAD that YOFTD (P < 0.00001), but no difference in the frequency of epileptiform activity (P = 0.32), with 38.8% of YOAD and 28.6% of YOFTD patients having epileptiform activity. Slow wave changes were more generalized in YOAD (P = 0.001). Slow wave changes and epileptiform activity were not sensitive to the diagnosis of YOD, but highly specific (97–99%). The absence of slow wave changes and epileptiform activity had a 100% negative predictive value and likelihood radio 0.14 and 0.62 respectively, meaning that those without slow wave changes or epileptiform activity had low probability of having YOD. No relationship was established between EEG findings and the patient’s presenting problem. Eleven patients with YOAD developed seizures during the study, and only one with YOFTD.

Conclusions

The EEG is highly specific for the diagnosis of YOD with the absence of slow wave changes and epileptiform phenomena making the diagnosis unlikely, with 100% negative predictive value and with low probability for the dementia diagnosis.
Vitamin A supplementation coverage and its associated factors among children aged 6–59 months in West Azernet Berbere Woreda, South West Ethiopia
Authors: Berihun Bihon , Chemir Fantaye , Gebru Mehari , GebreEyesus Fisha Alebel
Published: May 2023

abstract

Background

Vitamin A deficiency is one of the major public health problems in low and middle-income countries including Ethiopia. Despite this fact, little attention was given to routine vitamin A supplementation in hard-to-reach rural areas and districts. Therefore, this study aimed to assess vitamin A supplementation coverage and its associated factors among children aged 6–59 months in West Azernet Berbere woreda, southern Ethiopia, 2021.

Methods

A community-based cross-sectional study was conducted from April to May 2021. A total sample size of 471 study participants was involved in the study area. A simple random sampling technique was used to recruit the study subject. A pretested structured interviewer-administered questionnaire was used. Bivariable and multivariable logistic regression analyses were done to identify variables having a significant association with vitamin A supplementation. The variables having a p-value ≤ 0.05 with 95% CI were used to declare an association between factors and a dependent variable.

Results

In this study, a total of 471 respondents were successfully interviewed with a response rate of 97.3%. The coverage of vitamin A supplementation was found to be 58.0%. Family monthly income [AOR = 2.565, 95% CI(1.631,4.032)], having PNC visit [AOR = 1.801, 95% CI (1.158, 2.801)], husbands disapproval about vitamin A supplementation [AOR = 0.324, 95% CI (0.129, 0.813)], information about vitamin A supplementation [AOR = 2.932, 95% CI (1.893, 4,542)] and ANC follow-up [AOR = 1.882, 95% CI (1.084, 3.266)] were factors significantly associated to vitamin A supplementation.

Conclusion

Vitamin A supplementation was found to be low and it is strongly associated with family monthly income, postnatal care, husband's disapproval of vitamin A supplementation, antenatal care follow-up, and information about vitamin A supplementation. Based on our findings, it is recommended to improve the monthly income of the household by actively engaging in various income-generating activities, enhance health information dissemination among mothers, particularly those who are underprivileged by using different strategies like local health campaigns, and mass media, advocacy of antenatal, and postnatal follow-up and promote the involvement of males/husband in childhood immunization service.
Evaluation of maternal performance about food security in dietary diversity for children aged 12-24 months and its relationship with anthropometric measurements
Authors: Yeganeh Sedigheh , Motamed Niloofar , Najafpour Boushehri Saeid , Bagherzadeh Razieh , Ravanipour Maryam
Published: May 2023

Background

Despite growing awareness of the problem of food security, some areas of Iran continue to experience food insecurity. The aim of the present study was to evaluate maternal performance about food security in dietary diversity for children aged between 12-24 months and its relationship with anthropometric measurements in Bushehr.

Methods

A cross-sectional study was carried out using 400 mothers of children aged from 12 to 24 months in Bushehr selected via quota sampling. Data were collected using a reliable localized version of a 32-item food frequency questionnaire, consisting of six subscales, with a Cronbach's α: 0.81. The anthropometric measurements of height and weight were also calculated. Data analysis was performed using median, Mean±SD and multinomial logistic regression test, and odds ratio in SPSS, version 18.

Results

According to standard servings, only 24% of the mothers fed their infants cereals, whereas 54.8%, 36.3%, 39.8%, and 20.3% of the mothers used meat, fruits, vegetables, and dairy products, respectively. The strongest associations were between attendance at educational classes and vegetable consumption (OR=2.09, CI=1.03-4.21), age at the onset of complementary feeding and the consumption of meat (OR=1.30, CI=1.02-1.66) and fruits (OR=1.44, CI=1.03-2.03), and the mothers’ level of education and use of dairy products (OR=0.29, CI=0.09-0.90). No evidence of a significant association was found between consumption of any food groups and the anthropometric measurements.

Conclusions

Mothers in Bushehr performed poorly in providing their infants with the required nutrition with regard to dietary diversity and amount of food. However, their performance can be improved by enhancing their basic nutrition knowledge, holding practical classes on food preparation for them, and focusing on mothers with infants in high-risk groups, e.g. infants suffering from excessive weight gain, obesity, and malnutrition.
The repetitive transcranial magnetic stimulation in Alzheimer's disease patients with behavioral and psychological symptoms of dementia: a case report
Authors: Yang Zhen , Zhou Ying
Published: May 2023

Background

Repetitive transcranial magnetic stimulation is a noninvasive intervention, can significantly reduce behavioral and psychological symptoms and cognitive impairment in AD patients. Only few cases have been reported the adverse reactions after the treatment. This report described the different adverse reactions after repetitive transcranial magnetic stimulation with different parameters.

Patient presentation

This article reports a patient with dementia complicated with mental behavior disorder who was treated with repetitive transcranial magnetic stimulation (rTMS) in spite of poor drug response. First, 1 Hz rTMS was initiated. After 1 month, the patient showed improved symptoms of mental behavior, decreased cognitive function and prolonged sleep duration. After switched to 10 Hz rTMS, the patient’s cognitive function and mental behavior abnormalities improved, and the sleep time returned to normal. However, epilepsy occurred after one session and was changed to 0.8 Hz rTMS treatment. The patient’s symptoms improved and did not have seizure.

Conclusion

Repetitive transcranial magnetic stimulation has a positive effect on cognitive function and Behavioral And Psychological Symptoms Of Dementia, and adverse reactions are inevitable. Playing personalized treatment according to the patients can reduce occurrence of adverse reactions.
Chronic disease management program applied to type 2 diabetes patients and prevention of diabetic complications: a retrospective cohort study using nationwide data
Authors: Hyun Min Kyung , Lee Jang Won , Ko Seung-Hyun
Published: May 2023

Background

The outcomes of education and counseling by medical professionals for patients with type 2 diabetes mellitus (T2DM) are unclear. This study examined the effects of the Chronic Disease Management Program (CDMP), a health insurance fee-for-service benefit, on the incidence of diabetic complications in patients newly diagnosed with T2DM using the National Health Insurance data.

Methods

Patients newly diagnosed with T2DM aged ≥ 20 years from 2010 to 2014 were followed up until 2015. Selection bias was minimized using propensity score matching. A stratified Cox proportional hazards model was used to analyze the association between the CDMP and the risk of incident diabetic complications. Subgroup analysis was performed for patients with high medication adherence, which was indicated by a medication possession ratio (MPR) ≥ 80.

Results

Among the 11,915 patients with T2DM in the cohort, 4,617 were assigned to the CDMP and non-CDMP group each. The CDMP helped reduce the overall and microvascular risks of complications compared to the non-CDMP group; however, the protective effect against macrovascular complications was only observed in those aged ≥ 40 years. Subgroup analysis of the group aged ≥ 40 years with high adherence (an MPR ≥ 80) showed that the CDMP effectively reduced the incidence of micro- and macrovascular complications.

Conclusions

Effective management of T2DM is crucial in preventing complications in patients with the condition, and includes regular monitoring and adjustment of treatment by qualified physicians. Nevertheless, long-term prospective studies on the effects of CDMP are required to confirm this finding.
Housing instability and cardiometabolic health in the United States: a narrative review of the literature
Authors: Gu Kristine D. , Faulkner Katherine C. , Thorndike Anne N.
Published: May 2023

Housing instability is variably defined but generally encompasses difficulty paying rent, living in poor or overcrowded conditions, moving frequently, or spending the majority of household income on housing costs. While there is strong evidence that people experiencing homelessness (i.e., lack of regular housing) are at increased risk for cardiovascular disease, obesity, and diabetes, less is known about housing instability and health. We synthesized evidence from 42 original research studies conducted in the United States examining the association of housing instability and cardiometabolic health conditions of overweight/obesity, hypertension, diabetes, and cardiovascular disease. The included studies varied widely in their definitions and methods of measuring housing instability, but all exposure variables were related to housing cost burden, frequency of moves, living in poor or overcrowded conditions, or experiencing eviction or foreclosure, measured at either the individual household level or at a population level. We also included studies examining the impact of receipt of government rental assistance, which serves as a marker of housing instability given that its purpose is to provide affordable housing for low-income households. Overall, we found mixed but generally adverse associations between housing instability and cardiometabolic health, including higher prevalence of overweight/obesity, hypertension, diabetes, and cardiovascular disease; worse hypertension and diabetes control; and higher acute health care utilization among those with diabetes and cardiovascular disease. We propose a conceptual framework for pathways linking housing instability and cardiometabolic disease that could be targeted in future research and housing policies or programs.
Oral health-related quality of life and oral manifestations of Syrian children with congenital heart disease: a case-control study
Authors: Bsesa Shouq Sharar , Srour Samir , Dashash Mayssoon
Published: May 2023

Background

There was an immense need for studies evaluating the oral health status of Syrian children with congenital heart disease (CHD) and its impact on their quality of life. No contemporary data are available. The objective of this study was to investigate oral manifestations and oral health-related quality of life (OHRQoL) of children with CHD and compare them with healthy controls aged 4–12 years.

Methods

A case-control study was undertaken. A total of 200 patients with CHD and 100 healthy children belonging to the same patient’s family were included. Decayed, missed, and filled permanent teeth index (DMFT) and decayed, missed, and filled primary teeth index (dmft), Oral Hygiene Index (OHI), Papillary Marginal Gingivitis Index (PMGI), and dental abnormalities were recorded. The Arabic version of the Child Oral Health-Related Quality of Life Questionnaire (COHRQoL, 36-item) which was divided into 4 different domains (Oral Symptoms, Functional Limitations, Emotional Well-Being, Social Well-Being) were studied. Chi-square test and independent- t-test were used to perform statistical analysis.

Results

CHD patients experienced more periodontitis, dental caries, poor oral health, and enamel defects. The dmft mean was significantly higher in CHD patients than in healthy children (5.245 vs. 2.660, P < 0.05). No significant difference was found between patients and controls in the DMFT Mean (P = 0.731). There was a significant difference between CHD patients and healthy children in the mean of the OHI (5.954 vs. 1.871, P < 0.05), and PMGI (1.689 vs. 1.170, P < 0.05). CHD patients have significantly higher enamel opacities (8% vs. 2%) and hypocalcification (10.5% vs. 2%) than controls. Also, the 4 COHRQoL domains, showed significant differences between CHD children and controls.

Conclusions

Evidence about the oral health and COHRQoL of children with CHD was provided. Further preventive measures are still required to improve the health and quality of life of this vulnerable group of children.
Structural empowerment of midwifery students following simulation-based training of management of obstetric emergencies
Authors: Janighorban Mojgan , yousefi hojatollah , yamani Nikoo
Published: May 2023

Background

Having the ability of managing obstetric emergencies is the necessary capability for providing care during labor and delivery.Simulation is considered to be a valuable strategy for empowering midwifery students in managing emergencies. So, this study was conducted to determine the structural empowerment of midwifery students following the simulation-based training of management of midwifery emergencies.

Methods

This semi-experimental research was conducted from August 2017 to June 2019 in the Faculty of Nursing and Midwifery, Isfahan, Iran. 42 subjects of the third-year midwifery students were included in the study through convenience sampling method (n = 22 in the intervention group, n = 20 in the control group). Six simulation-based educational sessions were considered for the intervention group. Conditions for Learning Effectiveness Questionnaire, was used at the beginning of the study, one week after it and one year later. Repeated measures ANOVA was used to analyze the data.

Results

In the intervention group, the significant difference was observed between the mean score of the students’ structural empowerment before and after the intervention (MD=-28.41, SD = 3.25) (p < 0.001), before and one year after the study (MD=-12.45, SD = 3.47) (p = 0.003), and immediately after and one year after the study (MD = 15.95,SD = 3.67) (p < 0.001). In the control group, no significant difference was observed. Before the intervention, there was no significant difference between the mean score of the students’ structural empowerment in the control and intervention groups (MD = 2.89, SD = 3.50) (p = 0.415); but, immediately after the intervention, the mean score of structural empowerment in the students of the intervention group was significantly higher than those of the control group (MD = 25.40, SD = 4.94 ) (p < 0.001). One year after the study, there was no significant difference between the two groups in terms of the mean score of the structural empowerment (MD = 6.89, SD = 3.58 ) (p = 0.061).

Conclusion

Simulation contributed to the structural empowerment of midwifery students by providing the opportunity for personal and professional growth and strengthening of the formal and informal power in the area of midwifery emergency management but these benefits were not seen at one year.
The genetic landscape and possible therapeutics of neurofibromatosis type 2
Authors: Ghalavand Mohammad Amin , Asghari Alimohamad , Farhadi Mohammad , Taghizadeh-Hesary Farzad , Garshasbi Masoud , Falah Masoumeh
Published: May 2023

Neurofibromatosis type 2 (NF2) is a genetic condition marked by the development of multiple benign tumors in the nervous system. The most common tumors associated with NF2 are bilateral vestibular schwannoma, meningioma, and ependymoma. The clinical manifestations of NF2 depend on the site of involvement. Vestibular schwannoma can present with hearing loss, dizziness, and tinnitus, while spinal tumor leads to debilitating pain, muscle weakness, or paresthesias. Clinical diagnosis of NF2 is based on the Manchester criteria, which have been updated in the last decade. NF2 is caused by loss-of-function mutations in the NF2 gene on chromosome 22, leading the merlin protein to malfunction. Over half of NF2 patients have de novo mutations, and half of this group are mosaic. NF2 can be managed by surgery, stereotactic radiosurgery, monoclonal antibody bevacizumab, and close observation. However, the nature of multiple tumors and the necessity of multiple surgeries over the lifetime, inoperable tumors like meningiomatosis with infiltration of the sinus or in the area of the lower cranial nerves, the complications caused by the operation, the malignancies induced by radiotherapy, and inefficiency of cytotoxic chemotherapy due to the benign nature of NF-related tumors have led a march toward exploring targeted therapies. Recent advances in genetics and molecular biology have allowed identifying and targeting of underlying pathways in the pathogenesis of NF2. In this review, we explain the clinicopathological characteristics of NF2, its genetic and molecular background, and the current knowledge and challenges of implementing genetics to develop efficient therapies.
Changes of equality of medical service utilization in China between 1993 and 2018: findings from six waves of nationwide household interview survey
Authors: Wu Ming , Huang Ju , Fu Hongqiao , Xie Xueqin , Wu Shiyong
Published: May 2023

Background

Changes in China’s health care system in the last three decades was remarkable. The current study aims on examine the change of equality of health care utilization in mainland China based on a nationwide household interview survey.

Methods

We used household interview data extracted from six waves of National Health Service Survey between 1993 and 2018. Changes of health care utilization were descripted. Equality of the utilization were examined with univariate meta-regression across urban and rural areas, socioeconomic development regions and income groups.

Results

The proportion of outpatient visits within last two weeks experienced a decrease from 17.0% in 1993 to 13.0% in 2013 and bounced back to 24.0% in 2018. The age-standardized trend remained unchanged. Hospitalization in the last 12 month increased from 2.6% in 1998 to 13.8% in 2018. The perceived unmet need of hospital admission fell from 35.9% in 1998 to 21.5% in 2018. The gaps in health care utilization between urban and rural areas, across regions and by income groups have been narrowed, implying improved equality of using medical services in the last two and a half decades.

Conclusion

China has experienced significant increases in health care utilization over the past 25 years. Meanwhile, the unmet needs for health care decreased remarkably and the equality of health care utilization improved significantly. These results imply significant achievements in health service accessibility in China.
Assessment of equity and efficiency of magnetic resonance imaging services in Henan Province, China
Authors: Huang Xiaoling , Wei Yan , Sun Hui , Huang Jiaqi , Chen Yingyao , Cheng Jingliang
Published: May 2023

Background

By evaluating equity and effectiveness, this study provides evidence-based knowledge for scientific decision-making and the optimization of magnetic resonance imaging (MRI) configuration and utilization at the provincial level.

Methods

Using data from 2017, we applied a Gini coefficient to analyze the equity of MRI services in 11 sample cities in Henan province. An agglomeration degree was then applied to measure equity from the perspective of population and geography, and a data envelopment analysis was used to evaluate MRI efficiency.

Results

The overall Gini coefficient of MRI allocation by population in the 11 sample cities is 0.117; however, equity varies considerably among the sample cities. The sample’s comprehensive efficiency is only 0.732, indicating the overall ineffectiveness of provincial MRI utilization. The pure technical and scale efficiencies of four sample cities are below 1, indicating lower MRI effectiveness than the rest.

Conclusions

Although the overall equity of configuration at the provincial level is relatively good, equity varies at the municipal level. Our results demonstrate a low MRI utilization efficiency; accordingly, policymakers should dynamically adjust the policy based on equity and efficiency.
Low-Intensity mental health Support via a Telehealth Enabled Network for adults with diabetes (LISTEN): protocol for a hybrid type 1 effectiveness implementation trial
Authors: Holloway Edith E. , Gray Shikha , Mihalopoulos Cathrine , Versace Vincent L. , Le Gautier Roslyn , Chatterton Mary Lou , Hagger Virginia , Halliday Jennifer , Henshaw Kim , Harrap Benjamin , Manallack Sarah , Black Taryn , Van Bruggen Natasha , Hines Carolyn , O’Neil Adrienne , Skinner Timothy C. , Speight Jane , Hendrieckx Christel
Published: May 2023

Background

Mental health problems are common among people with diabetes. However, evidence-based strategies for the prevention and early intervention of emotional problems in people with diabetes are lacking. Our aim is to assess the real-world effectiveness, cost-effectiveness, and implementation of a Low-Intensity mental health Support via a Telehealth Enabled Network (LISTEN), facilitated by diabetes health professionals (HPs).

Methods

A hybrid type I effectiveness-implementation trial, including a two-arm parallel randomised controlled trial, alongside mixed methods process evaluation. Recruited primarily via the National Diabetes Services Scheme, Australian adults with diabetes (N = 454) will be eligible if they are experiencing elevated diabetes distress. Participants are randomised (1:1 ratio) to LISTEN—a brief, low-intensity mental health support program based on a problem-solving therapy framework and delivered via telehealth (intervention) or usual care (web-based resources about diabetes and emotional health). Data are collected via online assessments at baseline (T0), 8 weeks (T1) and 6 months (T2, primary endpoint) follow-up. The primary outcome is between-group differences in diabetes distress at T2. Secondary outcomes include the immediate (T1) and longer-term (T2) effect of the intervention on psychological distress, general emotional well-being, and coping self-efficacy. A within-trial economic evaluation will be conducted. Implementation outcomes will be assessed using mixed methods, according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Data collection will include qualitative interviews and field notes.

Discussion

It is anticipated that LISTEN will reduce diabetes distress among adults with diabetes. The pragmatic trial results will determine whether LISTEN is effective, cost-effective, and should be implemented at scale. Qualitative findings will be used to refine the intervention and implementation strategies as required.

Trial registration

This trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN: ACTRN12622000168752) on 1 February, 2022.
Determinants of point-of-care ultrasound lung sliding amplitude in mechanically ventilated patients
Authors: Briganti David N. , Choi Christine E. , Nguyen Julien , Lanks Charles W.
Published: May 2023

Background

Although lung sliding seen by point-of-care ultrasound (POCUS) is known to be affected to varying degrees by different physiologic and pathologic processes, it is typically only reported qualitatively in the critical care setting. Lung sliding amplitude quantitatively expresses the amount of pleural movement seen by POCUS but its determinants in mechanically ventilated patients are largely unknown.

Methods

This was a single-center, prospective, observational pilot study examining 40 hemithoraces in 20 adult patients receiving mechanical ventilation. Each subject had lung sliding amplitude measured in both B-mode and by pulsed wave Doppler at their bilateral lung apices and bases. Differences in lung sliding amplitude were correlated with anatomical location (apex vs base) as well as physiologic parameters including positive end expiratory pressure (PEEP), driving pressure, tidal volume and the ratio of arterial partial pressure of oxygen (PaO2) to fraction of inspired oxygen (FiO2).

Results

POCUS lung sliding amplitude was significantly lower at the lung apex compared to the lung base in both B-mode (3.6 ± 2.0 mm vs 8.6 ± 4.3 mm; p < 0.001) and the pulsed wave Doppler mode (10.3 ± 4.6 cm/s vs 13.9 ± 5.5 cm/s; p < 0.001) corresponding to expected distribution of ventilation to the lung bases. Inter-rater reliability of B-mode measurements was excellent (ICC = 0.91) and distance traversed in B-mode had a significant positive correlation with pleural line velocity (r2 = 0.32; p < 0.001). There was a non-statistically significant trend towards lower lung sliding amplitude for PEEP ≥ 10 cmH2O, as well as for driving pressure ≥ 15 cmH2O in both ultrasound modes.

Conclusion

POCUS lung sliding amplitude was significantly lower at the lung apex than the lung base in mechanically ventilated patients. This was true when using both B-mode and pulsed wave Doppler. Lung sliding amplitude did not correlate with PEEP, driving pressure, tidal volume or PaO2:FiO2 ratio. Our findings suggest that lung sliding amplitude can be quantified in mechanically ventilated patients in a physiologically predictable way and with high inter-rater reliability. A better understanding of POCUS derived lung sliding amplitude and its determinants may aid in the more accurate diagnosis of lung pathologies, including pneumothorax, and could serve as a means of further reducing radiation exposure and improving outcomes in critically ill patients.
Indigenous landscaping and biophilic urbanism: case studies in Noongar Six Seasons
Authors: Cabanek Agata , Newman Peter , Nannup Noel
Published: May 2023

Background

Indigenous landscaping has had a revival with Indigenous cultures as an important part of multiculturalism. The landscape elements are generally gleaned from Indigenous Elders and from anthropological texts and pre-invasion history texts (e.g. explorers’ notebooks) that enable an understanding of the ecological, food, and medicine aspects of their propagation. The purpose of this study was to examine how Indigenous landscaping (knowledge, values, management methods, use) can assist with biophilic urbanism, the new approach to bringing natural systems into the built environment. This emphasizes the importance of place meanings in biophilic design. It will illustrate this in Western Australia using the Noongar People’s Six Seasons of distinct landscape each with importance for providing a living environment (shelter, food, medicine, and spiritual nourishment) and as a basic requirement for biodiversity management over 60,000 years.

Results

The study presents key reasons to include Indigenous interpretive landscaping into biophilic urbanism. Case studies in Six Seasons Gardens are used to show how integrating a cultural element into landscaping can bring many advantages. From the analysis of the case studies, we identified qualities of Indigenous Local Native Gardens. Several reasons for prioritising Indigenous landscaping in urban settings are proposed. These highlight cultural, educational, and professional values that can be achieved.

Conclusions

In this paper, we presented three case studies of urban indigenous and native gardens. We highlighted implications for adding indigenous dimensions to the management of the natural and built environments and brought to attention how indigenous landscaping is a conveyor of meaning, inclusive culture, and the importance of biodiversity. The future of biophilic urbanism will depend on whether sufficient contact with historians, anthropologists, and remnant indigenous communities can be made in order to emphasize the value for all aspects of biophilic urbanism in creating a deeper sense of place.
Early diagnosis of congenital muscular pathologies using next-generation sequencing: experiences from a tertiary center in Morocco
Authors: El Kadiri Youssef , Ratbi Ilham , Ouhenach Mouna , Chafai Elalaoui Siham , Cherkaoui Jaouad Imane , Zrhidri Abdelali , Sahli Maryem , Birouk Nazha , Sefiani Abdelaziz , Lyahyai Jaber
Published: May 2023

Background

Congenital muscular dystrophies (CMD) and congenital myopathies (CM) are clinically and genetically heterogeneous groups of neuromuscular disorders resulting in prenatal or early-onset hypotonia, muscle weakness, myogenic pattern, and dystrophic or myopathic features on muscle biopsy. In this study, we provide a genetic and molecular characterization of CMD and CM in Moroccan patients.

Patients and methods

In this cohort, we investigated 23 Moroccan patients from 21 families who consented to genetic testing. Firstly, genetic analysis in the probands was conducted by next-generation sequencing (NGS) technology using two approaches: targeted NGS gene panel and clinical exome sequencing to study the mutational spectrum and to achieve an accurate diagnosis of these hereditary myopathies in Morocco.

Results

NGS data analysis revealed 16 pathogenic variants harbored in 17 unrelated patients that were genetically resolved. The phenotypic forms identified were in order: LAMA2-related CMD (52.94%), LMNA-CMD (23.53%), and RYR1-related congenital myopathy (17.65%). The congenital titinopathy group was less frequent (5.88%). Here, we identified two novel recessive variants in LAMA2 gene: c.2164G > A (p.Glu722Lys), and c.(6992 + 1_6993-1)_(7300 + 1_7301-1)del p.(Pro2332Glnfs*10). Additionally, we expanded the phenotypic spectrum of a known heterozygous LMNA c.1718C > T p.(Ser573Leu) variant, and we report it for the first time to a form of CMD.

Conclusions

The introduction of the NGS tool in clinical practice allowed us to improve the diagnosis and the management of these neuromuscular diseases and to highlight the importance of molecular genetic diagnosis of these disorders that are underestimated in the Moroccan population.
Health Data Sharing Perspectives of Patients Receiving Care in CancerLinQ-Participating Oncology Practices
Authors: Jagsi Reshma , Suresh Krithika , Krenz Chris D. , Jones Rochelle D. , Griffith Kent A. , Perry Lydia , Hawley Sarah T. , Zikmund-Fisher Brian , Spector-Bagdady Kayte , Platt Jodyn , De Vries Raymond , Bradbury Angela R. , Bansal Pranshu , Kaime Melissa , Patel Monaliben , Schilsky Richard L. , Miller Robert S. , Spence Rebecca
Published: May 2023

PURPOSE

CancerLinQ seeks to use data sharing technology to improve quality of care, improve health outcomes, and advance evidence-based research. Understanding the experiences and concerns of patients is vital to ensure its trustworthiness and success.

METHODS

In a survey of 1,200 patients receiving care in four CancerLinQ-participating practices, we evaluated awareness and attitudes regarding participation in data sharing.

RESULTS

Of 684 surveys received (response rate 57%), 678 confirmed cancer diagnosis and constituted the analytic sample; 54% were female, and 70% were 60 years and older; 84% were White. Half (52%) were aware of the existence of nationwide databases focused on patients with cancer before the survey. A minority (27%) indicated that their doctors or staff had informed them about such databases, 61% of whom indicated that doctors or staff had explained how to opt out of data sharing. Members of racial/ethnic minority groups were less likely to be comfortable with research (88% v 95%; P = .002) or quality improvement uses (91% v 95%; P = .03) of shared data. Most respondents desired to know how their health information was used (70%), especially those of minority race/ethnicity (78% v 67% of non-Hispanic White respondents; P = .01). Under half (45%) felt that electronic health information was sufficiently protected by current law, and most (74%) favored an official body for data governance and oversight with representation of patients (72%) and physicians (94%). Minority race/ethnicity was associated with increased concern about data sharing (odds ratio [OR], 2.92; P < .001). Women were less concerned about data sharing than men (OR, 0.61; P = .001), and higher trust in oncologist was negatively associated with concern (OR, 0.75; P = .03).

CONCLUSION

Engaging patients and respecting their perspectives is essential as systems like CancerLinQ evolve.