bluuebunny/crossref_metadata_2025 huggingface dataset:
Telepractice implementation experiences during the COVID-19 pandemic, a qualitative exploration of Australian disability allied health providers: A diamond in the rough
Authors: Benz Cloe , Dantas Jaya , Welsh Mai , Norman Richard , Hendrie Delia , Robinson Suzanne
Published: November 2023

Telepractice has existed for decades, but as a result of the COVID-19 pandemic, it gained value and increased desirability across the disability service and health sectors, as a mitigation strategy for the viral transmission risk. The increased desirability of telepractice encouraged organisations to invest and correspondingly enhance access to services delivered remotely via digital technology including allied health therapy interventions. The investment and uptake of telepractice provided greater learning opportunities and ability to investigate telepractice implementation in specific contexts such as disability services, enabling service providers the ability to tailor to specific population needs.

Methods

This study investigated the experience of telepractice implementation during the COVID-19 pandemic from 13 allied health clinicians and managers of disability organisations across Australia between November 2021 and February 2022. A contextualist and critical realist theory was applied through the study, with reflective thematic analysis used as the data analysis method and findings described using a metaphor method centring on diamond formation. The method selection aimed to produce findings grounded in qualitative methodology and methods while remaining accessible to the disability community.

Results

An exploration and analysis of the data by the authors identified six themes addressing the experiences of participants and used the metaphor of diamond formation to describe changes in allied health clinicians and disability organisations during the COVID-19 influenced telepractice implementation.

Conclusion

The allied health clinicians and managers who participated in this study demonstrated an overall sense of hope that telepractice would be a viable and sustainable delivery pathway for services in the future. This article endorses the integration of a planned telepractice delivery pathway that capitalises on the momentum created by the COVID-19 pandemic in a purposeful and accessible way that looks to enhance rather than replace current practices.
Triptychon: Usability evaluation and implementation of a web-based application for patients’ lab and vital parameters
Authors: Kittel Maximilian , Moorthy Preetha , Rao Sonika , Halfmann Marie , Thiaucourt Margot , Strauß Maximilian , Haselmann Verena , Santhanam Nandhini , Siegel Fabian , Neumaier Michael
Published: November 2023

Background

A major challenge in healthcare is the interpretation of the constantly increasing amount of clinical data of interest to inpatients for diagnosis and therapy. It is vital to accurately structure and represent data from different sources to help clinicians make informed decisions.

Objective

We evaluated the usability of our tool ‘Triptychon’ – a three-part visualisation dashboard of essential patients’ medical data provided by a direct overview of their hospitalisation information, laboratory, and vital parameters over time.

Methods

The study followed a cohort of 20 participants using the mixed-methods approach, including interviews and the usability questionnaires, Health Information Technology Usability Evaluation Scale (Health-ITUES), and User Experience Questionnaire (UEQ). The participant's interactions with the dashboard were also observed. A thematic analysis approach was applied to analyse qualitative data and the quantitative data's task completion time and success rates.

Results

The usability evaluation of the visualisation dashboard revealed issues relating to the terminology used in the user interface and colour coding in its left and middle panels. The Health-ITUES score was 3.72 (standard deviation (SD) = 1.0), and the UEQ score was 1.6 (SD = 0.74). The study demonstrated improvements in intuitive dashboard use and overall satisfaction with using the dashboard daily.

Conclusion

The Triptychon dashboard is a promising new tool for medical data presentation. We identified design and layout issues of the dashboard for improving its usability in routine clinical practice. According to users’ feedback, the three panels on the dashboard provided a holistic view of a patient's hospital stay.
Do Polishing Methods and Colorant Beverages Affect the Color Stainability of 3D-printed Permanent Restorations?
Authors: Ezmek Bahadır , Aydin Numan
Published: November 2023

Aim:

This in vitro study evaluated the effect of polishing methods on the color stainability of 3D-printed permanent restorations while immersed in colorant beverages (distilled water, tea, coffee, and red wine) for 30 days.

Materials and Methods:

A total of 120-disc-shaped samples (10 mm × 1.5 mm) were fabricated using a stereolithography printer (Formlabs 3B, Formlabs, Massachusetts) with a three-dimensional (3D)-printable permanent resin (Permanent Crown, Formlabs, Massachusetts). The samples were polished with mechanical polishing, Optiglaze (GC Dental Products Corp, Aichi, Japan), or Vita Akzent LC (VITA Zahnfabrik, Bad Säckingen, Germany) ( n = 40). Initial color measurements were performed using a spectrophotometer (VITA Easyshade V; Vita Zahnfabrik). Then the samples were divided into four different subgroups depending on beverages immersed in distilled water, coffee, tea, and red wine ( n = 10). After immersion in beverages for 30 days, color measurements were repeated. Color changes were calculated using the CIEDE2000 color change (Δ E00) formula. Δ E00 was evaluated according to 50:50% color perceptibility (PT00 = 0.81) and acceptability (AT00 = 1.81) thresholds. A two-way analysis of variance (ANOVA), Tukey HSD test with Bonferroni adjustment, and paired-sample t-tests were used for statistical evaluation.

Results:

The highest ΔE00 was noted in mechanical polishing groups ( p < .001). Red wine caused the most significant discoloration in the mechanical polishing group ( p < .05). ΔE00 of mechanical polish groups showed a significantly higher color change than the perceptibility and acceptability thresholds ( p < .001). Optiglaze can reduce 3D-printed permanent restoration discoloration caused by all beverages, Vita Akzent LC can reduce discoloration caused by tea and red wine.

Conclusion:

Glaze materials can reduce the restoration discoloration caused by colorant beverages.
Influence of Inflammatory Bowel Disease on Patients Undergoing Primary Total Joint Arthroplasty: A Systematic Review and Meta-analysis of Cohort Studies
Authors: Yan Shuo , Zhang Xiaofei , Zhang Shuhao , Wang Zheng , Dai Zhengxu , Zhou Xuyang , Liu Jianchao , Li Bing , Liu Jun
Published: November 2023

Background:

Inflammatory bowel disease (IBD) is recognized as a global disease. Although IBD is commonly diagnosed in the young male population, it also occurs in patients aged >60 years. With the advent of an aging society, it is expected that an increasing number of patients with IBD will undergo total joint arthroplasty (TJA).

Purpose:

To assess the impact of IBD on the risk of complications and revision as well as the length of stay (LOS) and treatment costs after TJA.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

Utilizing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, articles were searched in the PubMed/MEDLINE, Embase, and Cochrane Library databases from the date of inception to August 31, 2022, using the following search terms: (1) “Inflammatory Bowel Diseases”[MeSH] and (2) “Arthroplasty, Replacement”[MeSH]. The study quality was scored according to the Newcastle-Ottawa Scale. A fixed-effects or random-effects model was used to calculate odds ratios or mean differences with 95% confidence intervals.

Results:

Of 232 studies initially retrieved, 8 retrospective cohort studies consisting of 33,758 patients with IBD and 386,238 patients without IBD were included. Patients with IBD had a higher incidence of complications ( P < .05), readmission and revision ( P < .05), experienced a longer LOS ( P < .01), and paid higher treatment costs after TJA compared with patients without IBD .

Conclusion:

The results of our review demonstrated that IBD increased the risk of postoperative complications, prolonged the LOS, and increased treatment costs.
Radiological Findings of the Lumbar Spine in High School and Collegiate Sumo Wrestlers
Authors: Nakagawa Yasuaki , Mukai Shogo , Miyata Masahiko , Minami Kazufumi , Hattori Yuji , Yamagishi Hiroya
Published: November 2023

Background:

Sumo wrestling is a traditional sport in Japan and becoming popular worldwide. Risk factors for lower back injuries in sumo wrestlers are heavier weight and larger body mass index (BMI). The mawashi (loincloth belt) worn by sumo wrestlers has been shown to restrict motion of the lumbar spine.

Purpose:

To study the effects of sumo wrestling on the lumbar spine of high school and freshmen collegiate wrestlers, investigating the relationship between radiological findings, wearing of the mawashi during training, and lower back symptoms.

Study Design:

Case series; Level of evidence, 4.

Methods:

From 2001 to 2017, a total of 197 members of the Japanese Sumo Federation (55 high school and 142 college freshman students) underwent routine radiographic examination of their lumbar spines and answered a questionnaire regarding lumbar symptoms. Wrestlers were classified as symptomatic and asymptomatic based on responses to a custom questionnaire. We used the unpaired t test to evaluate patient demographics and the chi square test to analyze radiographic lumbar spine abnormalities between symptomatic and asymptomatic wrestlers.

Results:

The wrestlers’ mean height, weight, BMI, and duration in the sport were 174.0 ± 6.7 cm, 107.1 ± 22.4 kg, 35.2 ± 6.4, and 8.0 ± 3.2 years, respectively. There were 91 participants in the symptomatic group (46.2%) and 106 (53.8%) in the asymptomatic group. Ten wrestlers (5.1%) had osteophyte formations in the lumbar body; 8 of the 11 osteophytes (72.7%) appeared in the upper lumbar spine. Of the total, 48 wrestlers (24.4%) had deformities (Schmorl nodules) in the lumbar body, and 23 of 50 (46.0%) and 10 of 16 (62.5%) deformities were found in the upper lumbar spine of collegiate and high school wrestlers, respectively. Five wrestlers of the total 197 athletes (2.5%) had disc space narrowing in the lumbar body, with 3 of the 5 cases of disc space narrowing (60.0%) found in the upper lumbar spine. Spondylolysis in the lumbar body was found in 25 wrestlers (12.7%); 19 of the 91 symptomatic wrestlers (20.9%) had spondylolysis, compared with 6 of the 106 (5.7%) asymptomatic wrestlers ( P = .0028).

Conclusion:

Almost one-third of sumo wrestlers had ≥1 abnormal radiological finding in the lumbar spine. There was a significant relationship between symptomatic wrestlers and spondylolysis.
Fleshing Out Identity of Untouchables in Hindi Public Sphere: A Study of Chand’s ‘Untouchable Issue’ (May 1927)
Authors: Yadav Suman , Kumar Amit
Published: November 2023

This research examines both privileged and underprivileged literati’s views on the representation of Dalit identity in the Hindi public sphere, specifically focusing on the Hindi magazine Chand (May 1927). This article investigates their response to the prevailing caste system and religious conversion portrayed in the Chand. It also inspects the conception of untouchability by examining the role of caste associations and social institutions in colonial North India, shaping Dalit identity. The special issue of Chand Achhut Ank (May 1927) played a significant role in establishing a new cultural identity among Dalits within the broader framework of Hinduism by redefining the problem of untouchability. It is essential to analyse the social discourse on untouchability that brings consciousness among marginalized sections to comprehend their identity. It had generated anxiety and social distress among the educated middle class as was seen in their active engagement in Dalit literary discourse within the Hindi public sphere. Ultimately, it is necessary to comprehend the sociocultural reform movements aimed indirectly to maintain the existing social structure and how it resulted in the anxieties expressed by middle-class intellectuals in their writings. This work goes beyond by comprehensively examining various crucial facets of the farming Dalit identity.
Book review: Mangalu Charan Biswal, The Starved
Authors: Ranjan Alok , Shuchi
Published: November 2023

Mangalu Charan Biswal, The Starved. Hachette India, 2023, 142 pp., ₹399 (Paperback). ISBN: 9789393701817.*
A Grounded Theory Analysis of Civil and Administrative Cases Pursued by the Security and Exchange Commission
Authors: Caines Matthew , Gerber Jurg
Published: November 2023

In the midst of the Great Depression, the U.S. government created the Securities and Exchange Commission (SEC) to help control questionable business practices and prevent future economic crises. The SEC remains responsible for the administration of securities laws and enforcement actions against violators but has increasingly gained enforcement capacities over its lifespan. This research uses a grounded theory approach to explore themes across the way the SEC proceedings against detected. Publicly available litigation releases available through the agency’s website are used. Overall, the SEC is observed to operate in a generally predictable and equitable manner in which most of those who are charged are ultimately sanctioned in some way. Particularly interesting interactions were observed between entities and sanctioning outcomes. 1
Impact of Gaming (Gamification) on Diabetes Self-Care Behaviors and Glycemic Outcomes Among Adults With Type 2 Diabetes
Authors: Brady Veronica Joyce , Mathew Joseph Nitha , Ju Hsiao-Hui
Published: November 2023

Purpose:

The purpose of this systematic review was to determine if the use of gaming (gamification) among persons with type 2 diabetes improves diabetes self-management behaviors and diabetes outcomes.

Methods:

A systematic review was conducted using electronic databases including MEDLINE, Embase, Web of Science, and CINAHL. Studies reporting on the impact of gaming on at least 1 of the Association of Diabetes Care and Education Specialists self-care behaviors (ADCES7) were included.

Results:

The review included 9 studies, 8 of which were of strong/high quality. Five of the self-care behaviors were addressed in at least 1 of the included studies. However, taking medications and problem solving were not reported in any of the studies. Physical activity and self-efficacy or quality of life (healthy coping) were the most frequently reported ADCES7 behaviors. Six of the studies used A1C as an outcome measure, with a reduction reported in all the studies except 1.

Conclusion:

Type 2 diabetes affects a person holistically, necessitating a range of self-care behaviors to effectively manage the chronic condition. Novel gaming interventions may improve coping mechanisms, lifestyle behaviors, medication engagement, and monitoring of risks and problems, all of which are essential in facilitating optimal diabetes self-management.
Combined Trochlear, Patellar, Medial and Lateral Condyle Fresh Osteochondral Allograft Transplantation: A Case Report
Authors: Varone Bruno Butturi , Leal Daniel Peixoto , Gobbi Riccardo Gomes , Tirico Luís Eduardo Passarelli
Published: November 2023

Background:

This is a case report of a 41-year-old man with torsional knee trauma in 2019 and chondral lesions. Previous microfracture had failed, and the patient presented with a dull pain and knee effusion. Imaging revealed multiple focal lesions including trochlea, patella, medial condyle, and lateral condyle. Fresh osteochondral allograft (OCA) transplantation is a versatile treatment for large defects as it is based on mature, living hyaline cartilage attached to a bone interface. A patient with multiple chondral lesions is rare, and this report presents a case with multiple symptomatic large focal lesions in the knee that underwent a fresh OCA in all 3 knee compartments.

Indications:

Osteochondral allograft is indicated for patients who present with activity-related pain and recurrent knee effusion. Contraindications are patient clinical conditions that may lead to complications, such as tobacco use, inflammatory arthritis, or septic arthritis.

Technique Description:

After the chondral defect is exposed, an appropriate allograft Mega-OATS sizer (15-30 mm) is chosen. Cartilage and the subchondral bone are drilled until the desired depth. The donor allograft is drilled in the desired diameter, and excess bone is removed according to the previous measurements of the recipient site. The graft is advanced with firm pressure into the created socket. Postoperative rehabilitation includes a limited range of motion and proprioceptive weightbearing in the first 2 weeks but expected total weightbearing and a full range of motion by the sixth week.

Results:

Range of motion was full by 6 weeks of surgery. The effusion lasted for 2 months after the surgery. Fresh OCA is a good surgical option for patients with multiple large chondral defects.

Discussion/Conclusion:

Patient satisfaction is high since the mature cartilage leads to a fast rehabilitation compared with the other surgical procedures for large chondral defects. This technique appears to be effective also for multiple focal lesions as presented in this article.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form.
Increased glymphatic system activity in migraine chronification by diffusion tensor image analysis along the perivascular space
Authors: Zhang Xue , Wang Wei , Bai Xiaoyan , Zhang Xueyan , Yuan Ziyu , Jiao Bingjie , Zhang Yingkui , Li Zhiye , Zhang Peng , Tang Hefei , Zhang Yaqing , Yu Xueying , Bai Ruiliang , Wang Yonggang , Sui Binbin
Published: November 2023

Background

Preliminary evidence suggests that several headache disorders may be associated with glymphatic dysfunction. However, no studies have been conducted to examine the glymphatic activity in migraine chronification.

Purposes

To investigate the glymphatic activity of migraine chronification in patients with episodic migraine (EM) and chronic migraine (CM) using the diffusion tensor image analysis along the perivascular space (DTI-ALPS) method.

Methods

In this cross-sectional study, patients with EM, CM, and healthy controls (HCs) were included. All participants underwent a standard brain magnetic resonance imaging (MRI) examination. Bilateral DTI-ALPS indexes were calculated for all participants and compared among EM, CM, and HC groups. Correlations between the DTI-ALPS index and clinical characteristics were analyzed.

Results

A total of 32 patients with EM, 24 patients with CM, and 41 age- and sex-matched HCs were included in the analysis. Significant differences were found in the right DTI-ALPS index among the three groups (p = 0.011), with CM showing significantly higher values than EM (p = 0.033) and HCs (p = 0.015). The right DTI-ALPS index of CM group was significantly higher than the left DTI-ALPS index (p = 0.005). And the headache intensity was correlated to DTI-ALPS index both in the left hemisphere (r = 0.371, p = 0.011) and in the right hemisphere (r = 0.307, p = 0.038), but there were no correlations after Bonferroni correction.

Conclusions

Glymphatic system activity is shown to be increased instead of impaired during migraine chronification. The mechanism behind this observation suggests that increased glymphatic activity is more likely to be a concomitant phenomenon of altered vascular reactivity associated with migraine pathophysiology rather than a risk factor of migraine chronification.
Development and validation of non-invasive prediction models for migraine in Chinese adults
Authors: Duan Shaojie , Xia Hui , Zheng Tao , Li Guanglu , Ren Zhiying , Ding Wenyan , Wang Ziyao , Liu Zunjing
Published: November 2023

Background

Migraine is a common disabling neurological disorder with severe physical and psychological damage, but there is a lack of convenient and effective non-invasive early prediction methods. This study aimed to develop a new series of non-invasive prediction models for migraine with external validation.

Methods

A total of 188 and 94 subjects were included in the training and validation sets, respectively. A standardized professional questionnaire was used to collect the subjects' 9-item traditional Chinese medicine constitution (TCMC) scores, Pittsburgh Sleep Quality Index (PSQI) score, Zung's Self-rating Anxiety Scale and Self-rating Depression Scale scores. Logistic regression was used to analyze the risk predictors of migraine, and a series of prediction models for migraine were developed. Receiver operating characteristic (ROC) curve and calibration curve were used to assess the discrimination and calibration of the models. The predictive performance of the models were further validated using external datasets and subgroup analyses were conducted.

Results

PSQI score and Qi-depression score were significantly and positively associated with the risk of migraine, with the area of the ROC curves (AUCs) predicting migraine of 0.83 (95% CI:0.77–0.89) and 0.76 (95% CI:0.68–0.84), respectively. Eight non-invasive predictive models for migraine containing one to eight variables were developed using logistic regression, with AUCs ranging from 0.83 (95% CI: 0.77–0.89) to 0.92 (95% CI: 0.89–0.96) for the training set and from 0.76 (95% CI: 0.66–0.85) to 0.83 (95% CI: 0.75–0.91) for the validation set. Subgroup analyses showed that the AUCs of the eight prediction models for predicting migraine in the training and validation sets of different gender and age subgroups ranged from 0.80 (95% CI: 0.63–0.97) to 0.95 (95% CI: 0.91–1.00) and 0.73 (95% CI: 0.64–0.84) to 0.93 (95% CI: 0.82–1.00), respectively.

Conclusions

This study developed and validated a series of convenient and novel non-invasive prediction models for migraine, which have good predictive ability for migraine in Chinese adults of different genders and ages. It is of great significance for the early prevention, screening, and diagnosis of migraine.
Multilayer network alignment based on topological assessment via embeddings
Authors: Cinaglia Pietro , Milano Marianna , Cannataro Mario
Published: November 2023

Background

Network graphs allow modelling the real world objects in terms of interactions. In a multilayer network, the interactions are distributed over layers (i.e., intralayer and interlayer edges). Network alignment (NA) is a methodology that allows mapping nodes between two or multiple given networks, by preserving topologically similar regions. For instance, NA can be applied to transfer knowledge from one biological species to another. In this paper, we presentDANTEml, a software tool for the Pairwise Global NA (PGNA) of multilayer networks, based on topological assessment. It builds its own similarity matrix by processing the node embeddings computed from two multilayer networks of interest, to evaluate their topological similarities. The proposed solution can be used via a user-friendly command line interface, also having a built-in guided mode (step-by-step) for defining input parameters.

Results

We investigated the performance ofDANTEmlbased on (i) performance evaluation on synthetic multilayer networks, (ii) statistical assessment of the resulting alignments, and (iii) alignment of real multilayer networks.DANTEmlover performed a method that does not consider the distribution of nodes and edges over multiple layers by 1193.62%, and a method for temporal NA by 25.88%; we also performed the statistical assessment, which corroborates the significance of its own node mappings. In addition, we tested the proposed solution by using a real multilayer network in presence of several levels of noise, in accordance with the same outcome pursued for the NA on our dataset of synthetic networks. In this case, the improvement is even more evident: +4008.75% and +111.72%, compared to a method that does not consider the distribution of nodes and edges over multiple layers and a method for temporal NA, respectively.

Conclusions

DANTEmlis a software tool for the PGNA of multilayer networks based on topological assessment, that is able to provide effective alignments both on synthetic and real multi layer networks, of which node mappings can be validated statistically. Our experimentation reported a high degree of reliability and effectiveness for the proposed solution.
Exogenous γ-aminobutyric acid improves the photosynthesis efficiency, soluble sugar contents, and mineral nutrients in pomegranate plants exposed to drought, salinity, and drought-salinity stresses
Authors: Zarbakhsh Saeedeh , Shahsavar Ali Reza
Published: November 2023

Background

γ-aminobutyric acid (GABA), as a regulator of many aspects of plant growth, has a pivotal role in improving plant stress resistance. However, few studies have focused on the use of GABA in increasing plants’ resistance to interactional stresses, such as drought-salinity. Therefore, the focus of this study was to examine the effect of foliar application of GABA (0, 10, 20, and 40 mM) on growth indices and physio-biochemical parameters in plants of two pomegranate cultivars, ‘Rabab’ and ‘Atabaki’ exposed to drought, salinity, and drought-salinity.

Results

Under stress conditions, the photosynthetic capacity of two pomegranate cultivars, including transpiration rate, net photosynthetic rate, intercellular carbon dioxide concentration, stomatal conductance of water vapour, and mesophyll conductance, was significantly reduced. This resulted in a decrease in root morphological traits such as fresh and dry weight, diameter, and volume, as well as the fresh and dry weight of the aerial part of the plants. However, the application of GABA reversed the negative effects caused by stress treatments on growth parameters and maintained the photosynthetic capacity. GABA application has induced the accumulation of compatible osmolytes, including total soluble carbohydrate, starch, glucose, fructose, and sucrose, in charge of providing energy for cellular defense response against abiotic stresses. Analysis of mineral nutrients has shown that GABA application increases the absorption of potassium, potassium/sodium, magnesium, phosphorus, manganese, zinc, and iron. As concentration increased up to 40 mM, GABA prevented the uptake of toxic ions, sodium and chloride.

Conclusions

These findings highlight the potential of GABA as a biostimulant strategy to enhance plant stress tolerance.
Pediatric pharmaceutical interventions in self-medication: a descriptive study in community pharmacies
Authors: Bedhomme Sabrina , Vaillant-Roussel Hélène , Vorilhon Philippe , Lafarge Elodie , Pereton Bénédicte , Prunet-Spano Céline , Pereira Bruno , Vennat Brigitte , Savanovitch Chantal
Published: November 2023

Background

The practice of self-medication is common but not without risk, especially for vulnerable populations such as the pediatric population. Community pharmacists have an important role of vigilance in dispensing drugs available without a medical prescription, with the possibility of carrying out a Pharmaceutical Intervention (PI) if necessary. The aim of our study was to characterize the Pediatric Pharmaceutical Interventions (PPIs) in self-medication carried out during a spontaneous request for a drug at the community pharmacy.

Methods

We conducted a descriptive study in 139 pharmacies in the Auvergne-Rhône-Alpes region (France). Data were collected from students under the supervision of internship masters in the pharmacy, using the validated GIPAMED (GrId for PhArmaceutical Self-MEDication interventions) notification grid, the first week of each month, from February to May for five years (2017 to 2021). Collected data were entered on a secure university platform.

Results

Of the 3,552 PIs collected, 8,3% (n = 286) were PPIs. Of these PPIs, 35% (n = 100) was generated by requests for optional prescription drugs contraindicated by the pathophysiological condition, 28.3% for drugs requiring a prescription and 20.6% for over the counter drugs not indicated by the symptomatology. Finally, 10% of requests required a referral for a medical consultation. Four Anatomical Therapeutic Chemical (ATC) classes accounted for more than 90% of the requests: respiratory system (39.5%), alimentary tract and metabolism (19.2%), nervous system (11.5%), and musculoskeletal system (10.8%). The most common drugs generating PPIs were: ibuprofen, oxomemazine and combination camphor/essential oils, mainly due to age-related or weight-related contraindication. Paracetamol also generated PPIs frequently, mainly due to problems with drug compliance and more precise infra-therapeutic doses. When these PPIs were dispensed, the pharmacist’s proposed solutions were accepted in 94.8% (n = 271) of the cases.

Conclusions

The community pharmacist has an important role in providing information about medicines and their correct use to patients. Our research shows that this attention benefits vulnerable populations, such as children, even for drugs that are widely used (e.g. paracetamol and non-steroidal anti-inflammatory drugs) or active substances for which there are age-related or weight-related contraindications (e.g. antitussives, camphor combinations).
Physical activity interventions for cardiopulmonary fitness in obese children and adolescents: a systematic review and meta-analysis
Authors: Wang Chaochao , Tian Zuguo , Hu Yuting , Luo Qiaoyou
Published: November 2023

Purpose

This study [PROSPERO CRD42023416272] systematically analysed the effects of a physical activity intervention on cardiorespiratory fitness in obese children and adolescents and elucidated the factors that influenced those effects.

Methods

A systematic review of the literature on physical activity interventions for improving cardiopulmonary fitness in obese children and adolescents from January 1, 2011, to March 1, 2023, was conducted. The search was performed on the Web of Science and PubMed databases, and the selected literature was first screened and then assessed for quality. Finally, a systematic review was conducted.

Results

Out of the initially identified 1424 search records, 28 studies were eventually included in the systematic review. These studies encompassed a total of 2724 participants aged 5 to 18 years, with the publication dates of the literature primarily ranging from 2011 to 2023. Physical activity was found to effectively improve the following parameters in obese children and adolescents: weight [mean difference (MD), -2.03 (95% confidence interval, -2.59 to -1.47), p < 0.00001], maximal oxygen consumption [MD, -1.95 (95% CI, -1.06 to -2.84), p < 0.0001], heart rate [MD, -2.77 (95% CI, -4.88 to -0.67), p = 0.010], systolic blood pressure [MD, -8.11 (95% CI, -11.41 to -4.81), p < 0.00001], and diastolic blood pressure [MD, -4.18 (95% CI, -5.32 to -3.03), p < 0.00001]. High-intensity exercise was found to yield greater improvements than low- to moderate-intensity exercise in maximal oxygen consumption [MD, 1.43 (95% CI, 0.04 to 2.82), p = 0.04] and diastolic blood pressure [MD, -6.94 (95% CI, -10.61 to -3.26), p = 0.0002] in obese children and adolescents.

Conclusion

Physical activity can effectively improve the body weight, maximal oxygen consumption, heart rate, systolic blood pressure, and diastolic blood pressure of obese children and adolescents. The type of physical activity directly influences the participation interest of obese children and adolescents, with moderate- to high-intensity physical activity showing the most significant impact on intervention outcomes. High-frequency, long-term interventions yield better results than short-term interventions.
Assessment of oral emergency services during COVID-19: a retrospective study of 14,885 cases in Shanghai
Authors: Wang Jian , Zhao Jun-Jun , Tai Zhao-Wei , Wang Xue-Chun , Tao Jiang , Liao Qian
Published: November 2023

Background

To assess the impact of coronavirus disease-2019 (COVID-19) in its outbreak stage (Spring Festival in 2020) on oral emergency services.

Methods

Oral emergency cases in Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, during the Spring Festival after the outbreak of the COVID-19 epidemic in 2020 were collected and compared with those in 2018 and 2019. Electronic medical records including the visited department, age, sex, time, date, region, and diagnosis were collected and analyzed. The results were statistically analyzed using Pearson’s Chi-square test and one-way analysis of variance (ANOVA).

Results

Compared with that in 2018 and 2019, the total number of patients decreased during the Spring Festival in 2020 (p < 0.001), but the proportions of patients visiting Oral Surgery and Oral, Head, and Neck Oncology Emergency departments increased. The average age of patients increased, and the number of night visits decreased. Toothache diseases involving endodontic and periodontal diseases increased, while the proportion of maxillofacial trauma decreased. The wasn’t a linear association between diagnosis or genders (P > 0.001) across years. However, a linear-by-linear association between age groups and years, visited departments and years were observed (P < 0.001).

Conclusions

The study revealed that the transmission of COVID-19 affected the patient population and structure of disease types and oral services in 2020 during the Spring Festival, compared with those in the previous two years. The visits to oral emergency departments and the proportions of patients who were children and adolescents reduced; meanwhile, the percentage of the elderly people increased during the outbreak of COVID-19. The clear trend of age groups and visiting divisions could be used as a marker to reflect the severity of the COVID-19 pandemic. These results may serve as a reference for dental practitioners involved in oral emergency services and to allocate the limited emergency health resources.
Bacterial isolates and antibiotic susceptibility among women with abnormal vaginal discharge attending the gynecology clinic at a tertiary hospital in southwestern Uganda: a cross-sectional study
Authors: Ahabwe Onesmus Magezi , Kabanda Taseera , Abesiga Lenard , Mugisha Julius , Kayondo Musa , Ngonzi Joseph , Tugume Rodgers , Agaba Collins David , Byamukama Onesmus , Tibaijuka Leevan , Lugobe Henry Mark
Published: November 2023

Background

Abnormal vaginal discharge is a common complaint among women of reproductive age, affecting about one- third of all women. In resource-limited settings where access to laboratory services is limited, treatment is usually syndromic. This approach may result in ineffective treatment, with high recurrence rates and a potential of developing antibiotic resistance. This study aimed to determine the bacterial isolates and antibiotic susceptibility among women with an abnormal vaginal discharge attending the gynecology clinic at a tertiary hospital in Southwestern Uganda.

Methods

We conducted a hospital based cross-sectional study among 361 women aged 15–49 years, presenting with abnormal vaginal discharge at the gynecology clinic of Mbarara Regional Referral Hospital from December 2020 to June 2021. Demographic characteristics were collected using a structured questionnaire. We collected cervical and vaginal sterile swabs and subjected them to wet preparation and gram stain. The specimens were cultured for bacterial isolates. Susceptibility testing was performed on samples with bacterial isolates using the Kirby-Bauer disc diffusion method, on the commonly prescribed antibiotics in this setting. We summarized and described the bacterial isolates and antibiotic susceptibility patterns as frequencies and percentages.

Results

We enrolled 361 women with abnormal vaginal discharge. Bacteria were isolated in 29.6% (107/361) of the women, and the commonest isolates included; Staphylococcus aureus 48.6% (52/107), Klebsiella pneumoniae 29.9% (32/107) and Enterococcus faecalis 15% (16/107). Yeast cells were found in 17.7% (64/361) of the women with abnormal vaginal discharge. Cefuroxime (90.7%) and Ciprofloxacin (81.3%) had a high level of sensitivity while high levels of resistance were observed for Doxycycline (86.0%) and Azithromycin (67.0%).

Conclusion

The common bacterial isolates were Staphylococcus aureus, Klebsiella pneumoniae and Enterococcus faecalis. The isolated bacteria were most sensitive to Cefuroxime and Ciprofloxacin but resistant to Doxycycline and Azithromycin. There is need for routine culture and susceptibility testing of women with abnormal vaginal discharge so as to guide treatment, minimize inappropriate antibiotic use and consequently reduce antibiotic resistance.
Predictors of home-based cardiac rehabilitation exercise adherence among patients with chronic heart failure: a theory-driven cross-sectional study
Authors: Yang Zhen , Jia Honghong , Wang Aiping
Published: November 2023

Background

The factors influencing home-based cardiac rehabilitation exercise adherence among patients with chronic heart failure remain unclear. This study aimed to explore predictors of home-based cardiac rehabilitation exercise adherence in these patients, based on the theory of planned behavior.

Methods

This theory-driven, cross-sectional study used convenience sampling to recruit patients with chronic heart failure undergoing home-based cardiac rehabilitation. Instruments used included the Home-Based Cardiac Rehabilitation Exercise Adherence Scale, the Multidimensional Self-Efficacy for Exercise Scale, the Perceived Social Support Scale, and the Tampa Scale for Kinesiophobia Heart. Multivariate linear hierarchical regression analysis was employed to examine the factors influencing exercise adherence.

Results

A total of 215 patients with chronic heart failure undergoing home-based cardiac rehabilitation participated in the study. The overall score for home cardiac rehabilitation exercise adherence was (48.73 ± 3.92). Multivariate linear hierarchical regression analysis revealed that age (β=-0.087, p = 0.012), education level (β = 0.080, p = 0.020), fear of movement (β=-0.254, p < 0.001), perceived social support (β = 0.451, p < 0.001), and exercise self-efficacy (β = 0.289, p < 0.001) influenced home-based cardiac rehabilitation exercise adherence. In the second model, fear of exercise explained 23.60% of the total variance, while perceived social support and exercise self-efficacy explained 26.60% of the total variance in the third model.

Conclusion

This study found that home-based cardiac rehabilitation exercise adherence in patients with chronic heart failure was suboptimal, and identified its influencing factors. Targeted interventions addressing these factors, such as tailored education, support, and addressing fear of exercise, may help improve exercise adherence.
Isthmin-1 attenuates allergic Asthma by stimulating adiponectin expression and alveolar macrophage efferocytosis in mice
Authors: Tee Jong Huat , Vijayakumar Udhaya , Shanmugasundaram Mahalakshmi , Lam Terence Y. W. , Liao Wupeng , Yang Yuansheng , Wong W. S. Fred , Ge Ruowen
Published: November 2023

Background

Allergic asthma is a common respiratory disease that significantly impacts human health. Through in silico analysis of human lung RNASeq, we found that asthmatic lungs display lower levels of Isthmin-1 (ISM1) expression than healthy lungs. ISM1 is an endogenous anti-inflammatory protein that is highly expressed in mouse lungs and bronchial epithelial cells, playing a crucial role in maintaining lung homeostasis. However, how ISM1 influences asthma remains unclear. This study aims to investigate the potential involvement of ISM1 in allergic airway inflammation and uncover the underlying mechanisms.

Methods

We investigated the pivotal role of ISM1 in airway inflammation using an ISM1 knockout mouse line (ISM1−/−) and challenged them with house dust mite (HDM) extract to induce allergic-like airway/lung inflammation. To examine the impact of ISM1 deficiency, we analyzed the infiltration of immune cells into the lungs and cytokine levels in bronchoalveolar lavage fluid (BALF) using flow cytometry and multiplex ELISA, respectively. Furthermore, we examined the therapeutic potential of ISM1 by administering recombinant ISM1 (rISM1) via the intratracheal route to rescue the effects of ISM1 reduction in HDM-challenged mice. RNA-Seq, western blot, and fluorescence microscopy techniques were subsequently used to elucidate the underlying mechanisms.

Results

ISM1−/− mice showed a pronounced worsening of allergic airway inflammation and hyperresponsiveness upon HDM challenge. The heightened inflammation in ISM1−/− mice correlated with enhanced lung cell necroptosis, as indicated by higher pMLKL expression. Intratracheal delivery of rISM1 significantly reduced the number of eosinophils in BALF and goblet cell hyperplasia. Mechanistically, ISM1 stimulates adiponectin secretion by type 2 alveolar epithelial cells partially through the GRP78 receptor and enhances adiponectin-facilitated apoptotic cell clearance via alveolar macrophage efferocytosis. Reduced adiponectin expression under ISM1 deficiency also contributed to intensified necroptosis, prolonged inflammation, and heightened severity of airway hyperresponsiveness.

Conclusions

This study revealed for the first time that ISM1 functions to restrain airway hyperresponsiveness to HDM-triggered allergic-like airway/lung inflammation in mice, consistent with its persistent downregulation in human asthma. Direct administration of rISM1 into the airway alleviates airway inflammation and promotes immune cell clearance, likely by stimulating airway adiponectin production. These findings suggest that ISM1 has therapeutic potential for allergic asthma.

Graphical abstract
Homologous recombination deficiency (HRD) testing on cell-free tumor DNA from peritoneal fluid
Authors: Roussel-Simonin Cyril , Blanc-Durand Felix , Tang Roseline , Vasseur Damien , Le Formal Audrey , Chardin Laure , Yaniz Elisa , Gouy Sébastien , Maulard Amandine , Scherier Stéphanie , Sanson Claire , Lacroix Ludovic , Cotteret Sophie , Mauny Lea , Zaccarini François , Rouleau Etienne , Leary Alexandra
Published: November 2023

Background

Knowing the homologous recombination deficiency (HRD) status in advanced epithelial ovarian cancer (EOC) is vital for patient management. HRD is determined by BRCA1/BRCA2 pathogenic variants or genomic instability. However, tumor DNA analysis is inconclusive in 15–19% of cases. Peritoneal fluid, available in > 95% of advanced EOC cases, could serve as an alternative source of cell-free tumor DNA (cftDNA) for HRD testing. Limited data show the feasibility of cancer panel gene testing on ascites cfDNA but no study, to date, has investigated HRD testing.

Methods

We collected ascites/peritoneal washings from 53 EOC patients (19 from retrospective cohort and 34 from prospective cohort) and performed a Cancer Gene Panel (CGP) using NGS for TP53/HR genes and shallow Whole Genome Sequencing (sWGS) for genomic instability on cfDNA.

Results

cfDNA was detectable in 49 out of 53 patients (92.5%), including those with limited peritoneal fluid. Median cfDNA was 3700 ng/ml, with a turnaround time of 21 days. TP53 pathogenic variants were detected in 86% (42/49) of patients, all with HGSOC. BRCA1 and BRCA2 pathogenic variants were found in 14% (7/49) and 10% (5/49) of cases, respectively. Peritoneal cftDNA showed high sensitivity (97%), specificity (83%), and concordance (95%) with tumor-based TP53 variant detection. NGS CGP on cftDNA identified BRCA2 pathogenic variants in one case where tumor-based testing failed. sWGS on cftDNA provided informative results even when tumor-based genomic instability testing failed.

Conclusion

Profiling cftDNA from peritoneal fluid is feasible, providing a significant amount of tumor DNA. This fast and reliable approach enables HRD testing, including BRCA1/2 mutations and genomic instability assessment. HRD testing on cfDNA from peritoneal fluid should be offered to all primary laparoscopy patients.
A potential strategy against clinical carbapenem-resistant Enterobacteriaceae: antimicrobial activity study of sweetener-decorated gold nanoparticles in vitro and in vivo
Authors: Liu Haifeng , Huang Zeyu , Chen Huanchang , Zhang Ying , Yu Pingting , Hu Panjie , Zhang Xiaotuan , Cao Jianming , Zhou Tieli
Published: November 2023

Background

Carbapenem-resistant Enterobacteriaceae (CRE) present substantial challenges to clinical intervention, necessitating the formulation of novel antimicrobial strategies to counteract them. Nanomaterials offer a distinctive avenue for eradicating bacteria by employing mechanisms divergent from traditional antibiotic resistance pathways and exhibiting reduced susceptibility to drug resistance development. Non-caloric artificial sweeteners, commonly utilized in the food sector, such as saccharin, sucralose, acesulfame, and aspartame, possess structures amenable to nanomaterial formation. In this investigation, we synthesized gold nanoparticles decorated with non-caloric artificial sweeteners and evaluated their antimicrobial efficacy against clinical CRE strains.

Results

Among these, gold nanoparticles decorated with aspartame (ASP_Au NPs) exhibited the most potent antimicrobial effect, displaying minimum inhibitory concentrations ranging from 4 to 16 µg/mL. As a result, ASP_Au NPs were chosen for further experimentation. Elucidation of the antimicrobial mechanism unveiled that ASP_Au NPs substantially elevated bacterial reactive oxygen species (ROS) levels, which dissipated upon ROS scavenger treatment, indicating ROS accumulation within bacteria as the fundamental antimicrobial modality. Furthermore, findings from membrane permeability assessments suggested that ASP_Au NPs may represent a secondary antimicrobial modality via enhancing inner membrane permeability. In addition, experiments involving crystal violet and confocal live/dead staining demonstrated effective suppression of bacterial biofilm formation by ASP_Au NPs. Moreover, ASP_Au NPs demonstrated notable efficacy in the treatment of Galleria mellonella bacterial infection and acute abdominal infection in mice, concurrently mitigating the organism's inflammatory response. Crucially, evaluation of in vivo safety and biocompatibility established that ASP_Au NPs exhibited negligible toxicity at bactericidal concentrations.

Conclusions

Our results demonstrated that ASP_Au NPs exhibit promise as innovative antimicrobial agents against clinical CRE.

Graphical Abstract