bluuebunny/crossref_metadata_2025 huggingface dataset:
Metastatic potentials classified with hypoxia‐inducible factor 1 downstream genes in pan‐cancer cell lines
Authors: Nakamichi Kazuya , Yamamoto Yusuke , Semba Kentaro , Nakayama Jun
Published: December 2023

Hypoxia‐inducible factor 1 (HIF1) is a transcription factor that is stabilized under hypoxia conditions via post‐translational modifications. HIF1 regulates tumor malignancy and metastasis by gene transcriptions, such as Warburg effect and angiogenesis‐related genes, in cancer cells. However, the HIF1 downstream genes show varied expressional patterns in different cancer types. Herein, we performed the hierarchical clustering based on the HIF1 downstream gene expression patterns using 1406 cancer cell lines crossing 30 types of cancer to understand the relationship between HIF1 downstream genes and the metastatic potential of cancer cell lines. Two types of cancers, including bone and breast cancers, were classified based on HIF1 downstream genes with significantly altered metastatic potentials. Furthermore, different HIF1 downstream gene subsets were extracted to discriminate each subtype for these cancer types. HIF1 downstream subtyping classification will help to understand the novel insight into tumor malignancy and metastasis in each cancer type.
Refractory alopecia areata with single hairs imitating frontal fibrosing alopecia: a prospective observational study
Authors: Qiao Rui , Zhu Jiaping , Liu Yi , Zhao Xiaohui , Nie Jin , Lan Xuemei , Li Yufen , Jiang Yiqun
Published: December 2023

Background

Lonely hair sign is considered as a clue to the diagnosis of frontal fibrosing alopecia (FFA).

Objective

To report an undescribed variant of alopecia areata (AA) with which the patient developed single hairs and other features similar to FFA and to determine the underlying mechanism.

Methods

We conducted a prospective observational study in patients who presented with receding hairline and single hairs, evaluating the clinical, trichoscopic, and histological features and their correlation. Immunochemistry studies were performed to describe the microenvironment.

Results

Eighteen patients were enrolled in the study. Despite the similarity to FFA clinically, these patients showed different histopathology which revealed a normal number of pilosebaceous units, one anagen hair in one or more pilosebaceous units, and others in telogen stage, consistent with single hairs under the naked eye or under trichoscopy. The severity of the hair loss assessed by SALT was no more than 50, but the response to conventional therapy was poor.

Conclusions

This study reports a unique variant of AA. The pathological basis is an increase in the telogen hair follicles, with one anagen hair in one or more pilosebaceous units. Minimal inflammation consisting of CD3+ T lymphocytes and mast cells was demonstrated in the microenvironment.
Australian clinicians' perceptions of patients with very high risk of fracture
Authors: Girgis Christian M. , Choi Yoonah , Ebeling Peter R.
Published: December 2023

Background

International osteoporosis guidelines have recommended treatment approaches based on fracture risk stratification, in particular, anabolic therapy for patients with very high risk (VHR) of fragility fracture.

Aim

To summarise Australian clinicians' perceptions of patients at VHR of fracture.

Methods

Australian clinicians invited to educational webinars on anabolic treatments for osteoporosis were surveyed in March and April 2021 about a typical patient they had most recently seen and identified as at VHR of fracture.

Results

Of the 268 clinician attendees who were invited to complete the post‐webinar surveys, 67 (25%) responded and permitted the publication of aggregated data. A typical patient perceived to have a VHR of fracture was a woman in her 80's, living at home, who had been diagnosed with osteoporosis between 5 and 10 years ago, and received treatment for 1–5 years' duration, most commonly denosumab. The patient frequently had a T‐score below −3.0 SD (standard deviation), multiple fragility fractures and most commonly suffered a vertebral fracture in the past 12 months, whereas on an adequate regimen of osteoporosis medication. There was a mismatch between the patient being eligible for anabolic therapy (64.2%) and actually having been prescribed an anabolic treatment in the past (20.9%).

Conclusions

Australian clinicians' perceptions of patients with a VHR of fracture and the use of anabolic agents appear to be heavily influenced by local reimbursement criteria. The mismatch between patients deemed eligible for reimbursed anabolic therapy and those prescribed an anabolic agent suggests treatment inertia.
Pre‐service teacher knowledge of children's literature and attitudes to Reading for Pleasure: an international comparative study
Authors: Farrar Jennifer , Simpson Alyson
Published: December 2023

Reading for Pleasure (RfP) acknowledges the importance of reader engagement and the role of the teacher as a reader of children's literature. The foundational work of the Teachers as Readers (TARs) programme successfully illustrated the impact of RfP activities on student learning. Previous studies of teachers' reader identities have shown a strong need for professional learning to boost teachers' confidence with children's literature. However, less emphasis has been placed on the adoption of RfP pedagogy within initial teacher education (ITE) to develop pre‐service teachers' (PST) knowledge of children's literature, as well as their understanding of teachers as reading role models for future students. This paper analyses data from research into RfP undertaken in two ITE programmes for primary teachers informed by contrasting policies in Scotland and Australia. Though both countries aim to improve school student literacy success, the curriculum mandates differ, shaping the potential pathways available in ITE courses. It is within this context that we report on 3 years of data on PST reader knowledge collected from 300 students using survey tools adopted from the original TARs study. Emerging findings provide evidence that teacher educators need to act as circuit breakers to alter PST attitudes to reading.
Smart dynamic evacuation planning and online management using vehicular communication system
Authors: Idoudi Hassan , Ameli Mostafa , Nguyen Van Phu Cyril , Zargayouna Mahdi , Rachedi Abderrezak
Published: December 2023

During disasters, swiftly and efficiently evacuating populations in hazardous situations is crucial to minimize losses. This study proposes a novel framework to address dynamic population evacuation (DPE) problems, which includes planning and online evacuation management phases facilitated by vehicular communication. In the planning phase, a shelter allocation problem (SAP) is solved dynamically for destination choice and a dynamic traffic assignment (DTA) for path choice toward the chosen destinations to obtain an initial evacuation plan. The initial plan is then enhanced by employing a vehicular ad hoc network (VANET) within the vehicular edge computing (VEC) architecture. This enhancement enables communication among evacuees, allowing them to revise their vehicle's route choice and planned destination. These revisions take into account the changing risk and traffic conditions. The proposed online DPE framework is applied to the real evacuation scenario of Mill Valley City, CA. The proposed model is evaluated with different VANET architectures, including vehicular cloud computing (VCC) and VEC. The results show that the VEC framework outperforms other configurations and improves the evacuation process compared to the scenario with an initial plan by more than 30% in network clearance time. Additionally, a performance analysis is carried out for evacuation scenarios with different penetration rates of connected vehicles in VANET.
Skin cancer prevention in extreme sports: Intervention in a 24‐h race
Authors: Martínez Alba Rodríguez , Pardal Carmen Vaz , Arjona José Aguilera , Ruiz Francisco Rivas , Molinero Diego Doncel , Paulano Manuel Ruiz , Subert Andras , Manzanedo Jose Vicente Gutiérrez , Cambil Martín Jacobo , de Gálvez Aranda Maria Victoria , López Leocricia Jiménez , Sánchez Nuria Blázquez , de Troya Martín Magdalena
Published: December 2023

Introduction

Excessive sun exposure and sunburns are the main preventable causes of skin cancer. The growing popularity of outdoor sports in developed countries has motivated the objective of this work to study the risk of photoexposure and the skin cancer prevention needs of athletes in an extreme race and evaluate an intervention targeted at this population.

Methods

An observational study was conducted during the XXIII edition of the 101 km de Ronda race, which consisted of trail running and mountain biking categories. Environmental and personal dosimetry, monitoring of meteorological conditions, evaluation of the athletes' photoprotection and skin examination habits, a dermatological checkup, and a satisfaction questionnaire were performed.

Results

The ultra‐endurance race was carried out under adverse conditions (maximum ultraviolet index (UVI) = 9.2, temperatures above 30°C, and relative humidity >35%). The mean effective erythema dose received by race athletes (n = 11) was 2959.2 ± 404.2 J/m2, equivalent to 29.6 standard erythema doses (SED). The CHACES questionnaire (n = 1145) showed a sunburn rate of 58% and poor protective habits: 62.9% of athletes do not usually use sunscreen and 67.2% do not self‐examine their skin. Actinic keratoses (4.7%) and suspicious skin cancer lesions (4.2%) were found in dermatologic screening exams (n = 170). On the satisfaction questionnaire (n = 111), this intervention was rated as excellent (95.5%).

Conclusion

This research highlights the extreme risk of photoexposure that athletes are subjected to during ultra‐endurance competitions. In the same way, it shows the need to carry out interventions aimed at the acquisition of healthy photoprotection habits and skin surveillance in this target group.
Phylogeny and taxonomy of five species associated with apricot canker in Beijing, China
Authors: Bai Yukun , Pan Meng , Lin Lu , Fan Xinlei
Published: December 2023

Apricot (Prunus armeniaca) is an economically important fruit tree in Beijing, China. However, canker diseases have become one of the main threats to apricot production. In the present study, a field survey was conducted in apricot orchards in Beijing and the disease incidence of apricots was surveyed (75.7%). Thirty fungal strains were isolated from branches of apricots. Five species were identified through multilocus phylogenetic (rDNA internal transcribed spacer [ITS], large subunit [LSU] and tef1‐a for Botryosphaeriales; ITS, act, rpb2, tef1‐a and tub2 for Cytospora) and morphological analyses, including two new species (Cytospora huairouensis and C. prunina) and three known species (C. leucostoma, Diplodia gallae and Phaeobotryon rhois). C. leucostoma and P. rhois were identified as the causal agents of canker of apricot by pathogenicity tests conducted on 3‐year‐old plants in the greenhouse. The current study contributed to a theoretical basis for predicting the potential risk of apricot canker in Beijing, China.
Employment transitions and COVID‐19 containment measures: Evidence from a developing country
Authors: Oyenubi Adeola
Published: December 2023

Containment measures implemented to curb the spread of coronavirus (COVID‐19) disrupted labour markets across the world. While several studies focus on the impact of containment measures on job losses, this paper documents the effect of containment measures (specifically variation in the strictness of these measures) on employment patterns or transitions. COVID disruption can be viewed as multiple shocks to the labour market (as against a single shock). This is important because labour income is a key driver of aggregate inequality in developing countries, and such disruption has a knock‐on effect on the achievement of the Sustainable Development Goals. Therefore, we estimate the causal relationship between coronavirus containment measures and employment dynamics in South Africa. Exploiting the timing of interviews and within individual variation, we find that containment measures impact employment transitions. Specifically, stricter containment measures have a positive effect on the transition into unemployment, and the converse is true for the transition into employment. The implication of this causal relationship for development, ongoing management of COVID‐19 and future pandemics is discussed.
Genome‐wide association study reveals the genetic basis for petal‐size formation in rapeseed (Brassica napus) and CRISPR‐Cas9‐mediated mutagenesis of BnFHY3 for petal‐size reduction
Authors: Wang Ruisen , Li Yafei , Xu Shiqi , Huang Qi , Tu Mengxin , Zhu Yang , Cen Haiyan , Dong Jie , Jiang Lixi , Yao Xiangtan
Published: December 2023

Petals in rapeseed (Brassica napus) serve multiple functions, including protection of reproductive organs, nutrient acquisition, and attraction of pollinators. However, they also cluster densely at the top, forming a thick layer that absorbs and reflects a considerable amount of photosynthetically active radiation. Breeding genotypes with large, small, or even petal‐less varieties, requires knowledge of primary genes for allelic selection and manipulation. However, our current understanding of petal‐size regulation is limited, and the lack of markers and pre‐breeding materials hinders targeted petal‐size breeding. Here, we conducted a genome‐wide association study on petal size using 295 diverse accessions. We identified 20 significant single nucleotide polymorphisms and 236 genes associated with petal‐size variation. Through a cross‐analysis of genomic and transcriptomic data, we focused on 14 specific genes, from which molecular markers for diverging petal‐size features can be developed. Leveraging CRISPR‐Cas9 technology, we successfully generated a quadruple mutant of Far‐Red Elongated Hypocotyl 3 (q‐bnfhy3), which exhibited smaller petals compared to the wild type. Our study provides insights into the genetic basis of petal‐size regulation in rapeseed and offers abundant potential molecular markers for breeding. The q‐bnfhy3 mutant unveiled a novel role of FHY3 orthologues in regulating petal size in addition to previously reported functions.
Monetary union in Southeast Asia: An assessment of the optimum currency area theory*
Authors: Hafner Kurt A.
Published: December 2023

This paper applies optimum currency area (OCA) theory to Southeast Asia to assess the potential for a monetary union in that region. We construct a panel of 10 Southeast Asian countries over the period 1990–2018 and apply the dynamic OLS estimator to quantify the costs and benefits of a potential OCA. A possible monetary union in Southeast Asia is vulnerable to asymmetric shocks, although the degree of specialisation has decreased and the openness index increased. Estimates confirm that both OCA criteria favour an increase in the region's income and FDI inflows and a reduction of its unemployment rate. However, inadequate labour mobility and stagnating intra‐trade shares are major obstacles in this regard, but if addressed they could benefit economic development and GDP per capita in the ASEAN region. We conclude that Southeast Asia is far from being an optimum currency area, but if it were to form a common currency area, the loss of economic sovereignty and its costs would be more than offset by the resulting monetary efficiency gain.
Forecasting of Electricity Demand in Malaysia with Seasonal Highly Volatile Characteristics using SARIMA – GARCH Model
Authors: Zaim Syarranur , Wan Yusoff Wan Nur Syahidah , Mohamad Nurul Najihah , Ahmad Radi Noor Fadhilah , Yaziz Siti Roslindar
Published: December 2023

Developing an accurate forecasting model for electricity demand plays a vital role in maximising the efficiency of the planning process in the power generation industries. The time series data of electricity demand in Malaysia is highly volatile with seasonal characteristics. This study aims to evaluate the forecasting performance of the seasonal autoregressive integrated moving average (SARIMA) model with GARCH for weekly maximum electricity demand. The weekly maximum electricity demand data (in megawatt, MW) from 2005 to 2016 has been used for this study. The results show that SARIMA(1, 1, 0)(0, 1, 0)52−GARCH(1, 2) with generalized error distribution (GED) is the most appropriate model for forecasting electricity demand due to its parsimonious characteristic with low values of root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE) which are 644.1828, 523.8380 and 3.13%, respectively. The MAPE value of the proposed model which is less than 5% indicates that the SARIMA − GARCH model is relatively good in forecasting electricity demand for the case of Malaysia data. In conclusion, the proposed model of SARIMA with GARCH has great potential and provides a promising performance in forecasting electricity demand with seasonal highly volatile characteristics.
Reviewer Acknowledgements for Journal of Education and Training Studies, Vol. 12, No. 1
Authors: Smith Robert
Published: December 2023

Journal of Education and Training Studies (JETS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether JETS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 12, Number 1Akın Metli, Bilkent Erzurum Laboratory School (BELS), TurkeyArlene Kent-Wilkinson, University of Saskatchewan, CanadaAshraf Elsafty, Eslsca University, EgyptChris Mutseekwa, Bindura University of Science Education, ZimbabweEhab Gouda Tolba, Dr_ehabtolba@hotmail.com, EgyptFathia Lahwal, Elmergib University, LibyaHossein Chaharbashloo, Kharazmi University, IranIntakhab Khan, King Abdulaziz University, Saudi ArabiaJacinthe Rihan, Ain Shams University, EgyptJane Liang, California Department of Education, USAJoel Maligaya Cuadra, NU Laguna, PhilippinesJohn Cowan, Edinburgh Napier University, UKJohn Mark Asio, Gordon College, PhilippinesJonathan Chitiyo, University of Pittsburgh Bradford, USAJulio Cesar André, Center for Studies and Development of Health Education-CEDES, BrazilLinda J. Rappel, Yorkville University/University of Calgary, CanadaLisa Marie Portugal, American College of Education, USAMaria Rosa M. Prado, Faculdades Pequeno Príncipe, BrazilMaurizio Sajeva, Pellervo Economic Research PTT, FinlandMeral Seker, Alanya Alaaddin Keykubat University, TurkeyMustafa Çakır, Marmara University, TurkeyNiveen M. Zayed, MENA College of Management, JordanRichard H. Martin, Mercer University, USARichard Penny, University of Washington Bothell, USASabrine Chbichib, The Higher Institute of Computing and Multimedia Gabes Tunisia, TunisiaSarah Nabih Nasif, October University, EgyptSenem Seda Şahenk Erkan, Marmara University, TurkeyStamatis Papadakis, University of Crete, GreeceYuChun Chen, Louisiana Tech University, USARobert SmithEditorial AssistantOn behalf of, The Editorial Board of Journal of Education and Training StudiesRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAE-mail: jets@redfame.comURL: http://jets.redfame.com
Vyučovanie so štýlom na vysokej škole
Authors: Károly Tomáš
Published: December 2023

ŠEBEN ZAŤKOVÁ, Tímea, 2022. Vyučovanie so štýlom na vysokej škole. Trnava: Univerzita sv. Cyrila a Metoda v Trnave. 157 stran. ISBN 978-80-572-0274-5.
The ‘corkscrew’ sign: an indirect MRI hint for intracranial venous hypertension
Authors: Pinna Nicola , Piccoli Francesca , Pileggi Marco , Cianfoni Alessandro
Published: December 2023

Dural arteriovenous fistulas (DAVFs) are intracranial vascular abnormalities in which one or more meningeal arteries shunt into a venous structure, either a cortical vein or a venous sinus, causing cerebral venous hypertension and risk of haemorrhage. Imaging diagnosis and characterisation are of paramount importance to grade the haemorrhagic risk and direct management. Non-invasive vascular neuroimaging might pose a diagnostic suspicion, but invasive catheter digital subtraction angiography (DSA) is usually required. We present the case of a patient with an atypical acute cerebral haemorrhage in which admission imaging with CT angiography (CTA) and MR angiography (MRA) was unremarkable, while advanced morphological MR with susceptibility-weighted imaging (SWI) revealed specific findings suggesting unilateral chronic venous hypertension. Successively, DSA detected a small DAVF that was treated with endovascular embolization. This case report raises awareness on subtle but important conventional imaging findings that suggest the presence of an AV shunt, to avoid misdiagnosis and delayed treatment.
Northern Shanghai Study II: systematic assessment and management of early organ damage and its role in preventing and reducing cardiovascular risk—protocol of a prospective study
Authors: Hou Jingjing , Li Moran , Han Jun , Yu Shikai , Jia Xinming , Sun Fenyong , Zhang Yi
Published: December 2023

Introduction

Cardiovascular diseases are the leading cause of death and disease burden in China. However, there is a lack of prospective cohort studies suitable for evaluating early organ damage and its role in preventing and reducing cardiovascular risk among Chinese residents. This study intends to establish the first database based on the phenotypes of all early structural and functional damage of cardiovascular organs in Chinese population. Moreover, a digital follow-up mechanism will be formed, a prospective population cohort will be established, a biological sample bank for early cardiovascular organ damage will be established, and an intervention and management system for early damage of cardiovascular organs will be explored.

Methods and analysis

This study is a prospective cohort study built on the foundation of the Northern Shanghai Study I. People aged 18–75 years are enrolled. After the recruitment, first, corresponding physical measurements and clinical examinations are conducted to collect cardiovascular risk factors and establish the demographic baseline of the study population. Next, the latest equipment is used to evaluate early structural and functional cardiovascular organ damage including heart, macrovessels, microcirculation, renal function and fundus. Meanwhile, the blood, urine, faeces and other biological samples of participants are collected to establish the cardiometabolic and gut microbiota analysis databases. The population is followed up every 2 years. Comprehensive assessment of early organ damage will be used to predict cardiovascular risk, guide people to change lifestyles to achieve early prevention and provide corresponding treatment recommendations.

Ethics and dissemination

This study was approved by the Shanghai Tenth People’s Hospital Institutional Review Board. All participants signed a written consent form. The results of this study will be disseminated in peer-reviewed journals. Ethics approval: SHYS-IEC-5.0/22k148/P01.

Trial registration number

NCT05435898.
Trends in liver cancer mortality in China from 1990 to 2019: a systematic analysis based on the Global Burden of Disease Study 2019
Authors: Chen Taili , Zhang Yan , Liu Jiayi , Rao Zhenzhen , Wang Mian , Shen Hong , Zeng Shan
Published: December 2023

Objective

We aimed to examine trends in overall mortality rates for liver cancer and those within subgroups according to sex, age, aetiological factors and modifiable risk factors in China from 1990 to 2019.

Design

The design of this study involved analysing liver cancer mortality rates in China from 1990 to 2019 using joinpoint regression analysis to identify significant changes in mortality rates. Annual percentage changes (APCs) and 95% CIs were used to quantify the magnitude of changes in mortality rates. The study also conducted subgroup analyses based on sex, age, aetiological factors and risk factors to better understand trends in liver cancer mortality rates.

Results

The age-standardised mortality from liver cancer in China first increased from 28.12 to 31.54 deaths per 100 000 population in 1990–1996 (APC=2.1%, 95% CI: 1.5% to 2.6%), then dropped at varying rates (1996–2000, APC=−3.7%, 95% CI: −5.2% to –2.1%; 2000–2004, APC=−17.4%, 95% CI: −18.7% to –16.1%; 2004–2007, APC=−5.4%, 95% CI: −8.3% to –2.3%; and 2007–2012, APC=−1.4%, 95% CI: −2.3% to –0.4%), and began to increase again after 2012 (APC=1.3%, 95% CI: 0.9% to 1.7%). Hepatitis B and C virus infections accounted for 63% and 18% of liver cancer-related deaths, respectively, in China from 1990 to 2019. Smoking, drug use, alcohol use and elevated body mass index were the four leading risk factors for liver cancer mortality in China during the study period. Notable variations in both liver cancer mortality rates and changes in mortality rates were observed across sexes and age groups.

Conclusions

The age-standardised liver cancer mortality rate in China significantly decreased from 1996 to 2019. The major differences in liver cancer mortality rates and inconsistent changes in mortality rates between 1990 and 2019 merit the attention of researchers and policymakers.
Have interventions aimed at assisting general practitioners in facilitating earlier diagnosis of type 1 diabetes in children been successful? A systematic review protocol
Authors: Beccia Chiara , Hunter Barbara , Birkic Vesna , White Mary , Manski-Nankervis Jo-Anne
Published: December 2023

Background

Early diagnosis of type 1 diabetes in children is critical to prevent deterioration to diabetic ketoacidosis (DKA), a state where the body’s insulin levels are critically low resulting in the use of fat for fuel and the accumulation of ketones. DKA is a life-threatening emergency where dehydration and cerebral oedema can quickly develop and lead to death. Despite treatment, DKA also has harmful impacts on cognition and brain development. Most children admitted to a hospital with DKA see their general practitioner in the week leading up to their admission. A delay in referral from general practice can result in delays in commencing lifesaving insulin therapy. Prior systematic reviews have explored publicity campaign interventions aimed at recognising type 1 diabetes earlier; however, no reviews have explored these interventions targeted at reducing the delay after presentation to the general practitioner. This systematic review aims to summarise interventions that target the diagnostic delay emerging from general practice and to evaluate their effectiveness in reducing DKA admissions.

Methods

Six databases (Ovid (MEDLINE), Web of Science, EMBASE, CINAHL, Evidence-Based Medicine Reviews (EBMR) and Google Scholar) will be searched to identify studies exploring interventions to reduce diagnostic delay in children with type 1 diabetes, and hence DKA, in general practice. The primary outcome will be the number of DKA admissions to a hospital following a delay in general practice. The secondary outcome will be the behaviour of general practitioners with respect to urgent referral of children with type 1 diabetes. Title, abstract and full-text screening for exclusion and inclusion of publications will be completed by two independent reviewers. Any risks of bias within individual studies will be assessed by two independent reviewers, using the Risk Of Bias In Non-Randomized Studies of Interventions tool. Our confidence in the overall body of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation.

Ethics and dissemination

The systematic review will be disseminated via publication and potentially in conference presentations. Ethics is not required for a systematic review of secondary data.

PROSPERO registration number

CRD42023412504
Optimisation of Organ Preservation treatment strategies in patients with rectal cancer with a good clinical response after neoadjuvant (chemo)radiotherapy: Additional contact X-ray brachytherapy versus eXtending the observation period and local excision (OPAXX) — protocol for two multicentre, parallel, single-arm, phase II studies
Authors: Geubels Barbara M , van Triest Baukelien , Peters Femke P , Maas Monique , Beets Geerard L , Marijnen Corrie A M , Custers Petra A , Rutten Harm J T , Theuws Jaqueline C M , Verrijssen An-Sofie E , Cnossen Jeltsje S , Burger Jacobus W A , Grotenhuis Brechtje A
Published: December 2023

Introduction

Standard treatment for patients with intermediate or locally advanced rectal cancer is (chemo)radiotherapy followed by total mesorectal excision (TME) surgery. In recent years, organ preservation aiming at improving quality of life has been explored. Patients with a complete clinical response to (chemo)radiotherapy can be managed safely with a watch-and-wait approach. However, the optimal organ-preserving treatment strategy for patients with a good, but not complete clinical response remains unclear. The aim of the OPAXX study is to determine the rate of organ preservation that can be achieved in patients with rectal cancer with a good clinical response after neoadjuvant (chemo)radiotherapy by additional local treatment options.

Methods and analysis

The OPAXX study is a Dutch multicentre study that investigates the efficacy of two additional local treatments aiming at organ preservation in patients with a good, but not complete response to neoadjuvant treatment (ie near-complete response or a small residual tumour mass <3 cm). The sample size will be 168 patients in total. Patients will be randomised (1:1) between two parallel single-arm phase II studies: study arm 1 involves additional contact X-ray brachytherapy (an intraluminal radiation boost), while in study arm 2 the observation period is extended followed by a second response evaluation and optional transanal local excision. The primary endpoint of the study is the rate of successful organ preservation at 1 year following randomisation. Secondary endpoints include toxicity, morbidity, oncological and functional outcomes at 1 and 2 years of follow-up. Finally, an observational cohort study for patients who are not eligible for randomisation is conducted.

Ethics and dissemination

The trial protocol has been approved by the medical ethics committee of the Netherlands Cancer Institute (METC20.1276/M20PAX). Informed consent will be obtained from all participants. The trial results will be published in an international peer-reviewed journal.

Trial registration number

NCT05772923.
What factors facilitate partnerships between higher education and local mental health services for students? A case study collective
Authors: Broglia Emma , Nisbet Kirsty , Bone Claire , Simmonds-Buckley Melanie , Knowles Louise , Hardy Gillian , Gibbon Laura , Barkham Michael
Published: December 2023

Background

Higher education institutions face challenges in providing effective mental health services for diverse student needs. In the UK, discrepancies between healthcare and education service provision create barriers for students and require stronger alignment through partnerships.

Objectives

This study aimed to identify risks, barriers and enablers to developing service partnerships between universities and the National Health Service (NHS) in England. It investigated existing partnerships and strategies that facilitate effective collaborative working.

Design and setting

A case study approach was employed, including coproduction and stakeholder involvement with staff and service users, to gather information from eight English universities developing regional student mental health hubs. This research received appropriate ethical approval.

Participants

In total, 27 professional staff from counselling, mental health, disability and well-being services participated and represented their respective services.

Outcome measures

Descriptive information was collected from service websites, handbooks, reports and 11 focus groups using a standardised data collection template. Inter-rater reliability was used to determine the agreement between coders and finalise focus group themes. EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Standards for Reporting Qualitative Research were adopted.

Results

Using inductive thematic analysis, five themes were identified for developing partnerships: building blocks, facing barriers, achieving positive outcomes, shaping student services and developing coordinated care. Fleiss’ kappa showed strong agreement between raters regarding the partnership factors (k=0.84 (95% CI 0.81 to 0.87), p<0.0005). Effective communication, shared understanding and trust were essential. Barriers included restrictions to information sharing and incompatible data infrastructures between services.

Conclusions

Stronger partnerships between universities and NHS are needed to meet increasing student mental health demands. Addressing barriers and implementing strategies to develop partnerships can enhance student services.

Preregistration

https://osf.io/u54qk/
Antibiotic use among hospitalised patients in Sierra Leone: a national point prevalence survey using the WHO survey methodology
Authors: Kamara Ibrahim Franklyn , Kanu Joseph , Maruta Anna , Fofanah Bobson Derrick , Kamara Kadijatu Nabie , Sheriff Bockarie , Katawera Victoria , D'Almeida Selassi A , Musoke Robert , Nuwagira Innocent , Lakoh Sulaiman , Kamara Rugiatu Z , Tengbe Sia Morenike , Mansaray Abdul Razak , Koroma Zikan , Thomas Fawzi , Abiri Onome T , Koroma Aminata Tigiedankay , Russell James Baligeh Walter , Squire James , Vandi Mohamed Alex
Published: December 2023

Objective

Inappropriate use of antibiotics is a major driver of antibiotic resistance. A few studies conducted in Africa have documented that about half of hospitalised patients who receive antibiotics should not have received them. A few hospital-based studies that have been conducted in Sierra Leone have documented a high usage of antibiotics in hospitals. Therefore, we conducted a nationwide point prevalence survey on antibiotic use among hospitalised patients in Sierra Leone.

Design

We conducted a hospital-based, cross-sectional survey on the use of antibiotics using the WHO point prevalence survey methodology.

Setting

The study was conducted in 26 public and private hospitals that are providing inpatient healthcare services.

Participants

All patients admitted to paediatric and adult inpatient wards before or at 08:00 on the survey date were enrolled.

Outcome measures

Prevalence of antibiotic use, antibiotics Access, Watch and Reserve (AWaRe) categorisation, indication for antibiotic use prevalence and proportion of bacteria culture done.

Results

Of the 1198 patient records reviewed, 883 (73.7%, 95% CI 71.1% to 76.2%) were on antibiotics. Antibiotic use was highest in the paediatric wards (306, 85.7%), followed by medical wards (158, 71.2%), surgical wards (146, 69.5%), mixed wards (97, 68.8%) and lowest in the obstetrics and gynaecology wards (176, 65.7%). The most widely prescribed antibiotics were metronidazole (404, 22.2%), ceftriaxone (373, 20.5%), ampicillin (337, 18.5%), gentamicin (221, 12.1%) and amoxicillin (90, 5.0%). Blood culture was only done for one patient and antibiotic treatments were given empirically. The most common indication for antibiotic use was community-acquired infection (484, 51.9%) followed by surgical prophylaxis (222, 23.8%).

Conclusion

There was high usage of antibiotics in hospitals in Sierra Leone as the majority of patients admitted received an antibiotic. This has the potential to increase the burden of antibiotic resistance in the country. We, therefore, recommend the establishment of hospital antimicrobial stewardship programmes according to the WHO core components.
Prevalence and influencing factors of sleep disorders in patients with CRS: a protocol for systematic review and meta-analysis
Authors: Wu Yuqi , Fu Yijie , He Yuanqiong , Gong Xinru , Fan Hongli , Han Zhoutong , Zhu TianMin , Li Hui
Published: December 2023

Background

Chronic rhinosinusitis (CRS) is a common chronic disease that seriously affects patients’ quality of life and imposes a heavy physical and mental burden on patients. There is growing evidence that sleep disorders are strongly associated with patients with CRS. However, there is no systematic evidence to clarify the prevalence and influencing factors of sleep disorders in patients with CRS with nasal polyps (NP) (CRSwNP) and CRS without NP (CRSsNP). For this reason, this study will systematically analyse the prevalence of sleep disorders in patients with CRSwNP and CRSsNP and explore the related influencing factors.

Methods and analysis

We will electronically search PubMed, Web of Science, Embase, Cochrane, Ovid, Scopus, the China National Knowledge Infrastructure, the Wanfang database, the China Biomedical Literature Database and the China Scientific Journals Database from the establishment of the database to September 2023 to collect the prevalence of sleep disorders in patients with CRSwNP or CRSsNP and related studies on factors affecting sleep disorders. Two researchers will independently conduct literature screening and data extraction and evaluate the quality of the included studies using the Newcastle-Ottawa Quality Scale and Agency for Healthcare Research and Quality scales. The extracted data will be meta-analysed using Review Manager 5.3 and Stata 14.0 software, and the quality of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation. Publication bias will be assessed using the funnel plots, Egger’s test and Begg’s test.

Ethics and dissemination

This review will not require ethical approval, as we will only use research data from the published documents. Our final findings will be published in a peer-reviewed, open-access journal for dissemination.

PROSPERO registration number

CRD42023446833.
Perceptions of medical error among general practitioners in rural China: a qualitative interview study
Authors: Li Hange , Guo Ziting , Yang Wenbin , He Yanrong , Chen Yanhua , Zhu Jiming
Published: December 2023

Background

Medical error (ME) is a serious public health problem and a leading cause of death. The reported adverse incidents in China were much less than western countries, and the research on patient safety in rural China’s primary care institutions was scarce. This study aims to identify the factors contributing to the under-reporting of ME among general practitioners in township health centres (THCs).

Methods

A qualitative semi-structured interview study was conducted with 31 general practitioners working in 30 THCs across 6 provinces. Thematic analysis was conducted using a grounded theory approach.

Results

The understanding of ME was not unified, from only mild consequence to only almost equivalent to medical malpractice. Common coping strategies for THCs after ME occurs included concealing and punishment. None of the participants reported adverse events through the National Clinical Improvement System website since they worked in THCs. Discussions about ME always focused on physicians rather than the system.

Conclusions

The low reported incidence of ME could be explained by unclear concept, unawareness and blame culture. It is imperative to provide supportive environment, patient safety training and good examples of error-based improvements to rural primary care institutions so that ME could be fully discussed, and systemic factors of ME could be recognised and improved there in the future.
Surgical informed consent practices and influencing factors in sub-Saharan Africa: a scoping review of the literature
Authors: Pittalis Chiara , Sackey Cherie , Okeny Paul , Nandi Bip , Gajewski Jakub
Published: December 2023

Introduction

Current international standards in consent to surgery practices are usually derived from health systems in Western countries, while little attention has been given to other contexts such as sub-Saharan Africa (SSA), despite this region facing the highest burdens of disease amenable to surgery globally. The aim of this study was to examine how the concept of informed consent for surgery is interpreted and applied in the context of SSA, and factors affecting current practices.

Methods

A systematic search of Medline, Embase and African Journal OnLine databases as well as grey sources was executed in May 2023 to retrieve relevant literature published since 2010 in English language against a set of given criteria. The socioecological framework for health was used for organising and summarising the identified evidence.

Results

A total of 27 papers were included in the review. Findings revealed that consent to surgery practices is generally substandard across SSA and the process is not adequate. Patients’ understanding of informed consent is limited, likewise awareness of their rights to decision-making. A range of factors at the individual, interpersonal, institutional and system/societal levels affect the informed consent process.

Conclusion

There is a need to find more culturally acceptable and ethical ways to include the participation of patients in the decision-making process for surgical treatment in the SSA and define standards more closely aligned with the local context.
Home-based supportive care in advanced cancer: systematic review
Authors: Hwang In Young , Woo Go-Un , Lee Sun Young , Yoo Shin Hye , Kim Kyae Hyung , Kim Min-Sun , Shin Jeongmi , Jeong Hye Jin , Jang Min Seol , Baek Sun Kyung , Jung Eun Hee , Lee Dong-Wook , Cho Belong
Published: December 2023

Objectives

This study systematically reviewed the literature on the effect of home-based supportive care (HbSC) programmes on the quality of life (QoL) of patients with advanced cancer.

Methods

The research question ‘Do home-based supportive care programmes for patients with advanced cancer improve their QoL?’ was addressed. After registering the plan with PROSPERO (CRD42022341237), literature published from 1 January 1990 to 30 May 2023 was searched on PubMed, Embase, Cochrane database, CINAHL and Web of Science, and reviewed for inclusion based on predefined criteria. This review only included trial studies published in English.

Results

Of 5,276 articles identified, 17 studies were judged suitable for inclusion in this review. The components of HbSC programmes included home visits, patient and caregiver education, home nursing, psychotherapy, exercise, telephone consultation, and multidisciplinary team meetings. Nine studies reported improvements in QoL, including social functioning, emotional functioning, and subjective QoL.

Conclusion

HbSC programmes appear to enable the improvement of the QoL of patients with advanced cancer. The area of QoL that shows improvement could vary depending on the HbSC components. More studies that address HbSC programmes are needed to select patients at the proper time and provide suitable programmes for patients to benefit most.
Parametric analysis: Compressibility of rubber on bandgap for phononic crystals
Authors: Lyu Muyun , Xu Guxin , Cheng Baozhu , Xia Zhaowang
Published: December 2023

The capacity of Phononic crystals (PCs) to form bandgaps (BGs) that limit the transmission of elastic/acoustic waves is a key property that is particularly beneficial for vibration/sound isolation and signal processing. In this work, a parametric analysis of Poisson’s ratio of rubber, and the density, geometry and size of scatterer on the BGs of porous, solid/solid, fluid/solid and solid/fluid PCs is presented. Based on the simulation results, it is found that the width of the first absolute bandgaps (FABGs) of porous PCs is not necessarily proportional to the porosity due to the pore shape; when Poisson’s ratio of compressible and incompressible rubber is increased, the FABG width of porous PC decreases dramatically. In addition, the FABGs of solid/solid PCs are strongly dependent on whether the rubber is a matrix or scatterer; the fluctuation of the FABGs is also highly related to the density of the solid. Fluid–structure PCs have smaller FABGs than porous and solid/solid PCs, and these FABGs usually occur within higher-order energy bands. Rubber compressibility significantly affects the FABGs of porous and solid/solid PCs, but almost not fluid-structural PCs. The results presented in this work offer guidance to tune the BG and design acoustic devices in various practical applications such as noise and vibration insulators.
Chaotic Model of Muscle and Joint Interactions Based on CPG for Rehabilitation of Incomplete Spinal Cord Injury Patients
Authors: Maleki Monireh , Rahatabad Fereidoun Nowshiravan , Pouladian Majid
Published: December 2023

The aim of modeling musculoskeletal systems is to understand the mechanisms of locomotion control in terms of neurophysiology and neuroanatomy. The complexity and unique nature of neuromuscular systems, however, make control problems in these systems very challenging due to several characteristics including speed and precision. Thus, their investigation requires the use of simple and analyzable methods. Consequently, taking into account the central pattern generator’s (CPG) function, we attempted to create a structured chaotic model of how human joints and muscles interact for the purpose of facilitating gait and rehabilitation in patients with incomplete spinal cord injury. The four muscle groups used in this model are gluteus, and hip flexor groups for flexion and extension of the hip joints as well as hamstring muscles and vasti muscles for flexion and extension of the knee joint. The results indicate that the output of the chaotic model of muscle and joint interactions in a healthy state would be chaotic, while in the incomplete spinal cord injury state, it would remain a fixed point. For model rehabilitation, afferent nerve stimulation is used in a CPG model; based on the modeling results, by applying coefficients of 1.98, 2.21, and 3.1 to the values of Ia, II, and Ib afferent nerves, the incomplete spinal cord injury model state is changed from a fix-point to periodic in a permanent fashion, suggesting locomotion with rehabilitation in our model. Based on the results obtained from the chaotic model of muscle and joint interactions as well as the comparisons made with reference papers, it can be stated that this model has acceptable output while enjoying simple computations and can predict different norms.
Infinitely Many Coexisting Attractors and Scrolls in a Fractional-Order Discrete Neuron Map
Authors: Ren Lujie , Qin Lei , Jahanshahi Hadi , Mou Jun
Published: December 2023

The neural network activation functions enable neural networks to have stronger fitting abilities and richer dynamical behaviors. In this paper, an improved fractional-order discrete tabu learning neuron (FODTLN) model map with a nonlinear periodic function as the activation function is proposed. The fixed points of the map are discussed. Then, the rich and complex dynamical behaviors of the map under different parameters and order conditions are investigated by using some common nonlinear dynamical analysis methods combined with the fractional-order approximate entropy method. Furthermore, it is found that fractional-order differential operators affect the generation of multiscrolls, and the model has infinitely many coexisting attractors obtained by changing the initial conditions. Interestingly, attractor growth and state transition are found. Finally, the map is implemented on the DSP hardware platforms to verify the realizability. The results show that the map exhibits complex and interesting dynamical behaviors. It provides a fundamental theory for the research of artificial neural networks.