bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived determinants of physical activity among women with prior severe preeclampsia: a qualitative assessment
Authors: Kókai Lili L. , van der Bijl Marte F. , Hagger Martin S. , Ó Ceallaigh Diarmaid T. , Rohde Kirsten I. M. , van Kippersluis Hans , van Lennep Jeanine E. Roeters , Wijtzes Anne I.
Published: April 2022

Background

The objective of this study was to (1) qualitatively identify the perceived determinants of physical activity among women who have experienced severe preeclampsia, and (2) examine whether these determinants are consistent with the overarching processes outlined in the integrated behavior change (IBC) model, a novel model that describes physical activity as being a result of motivational, volitional, and automatic processes.

Methods

Patients (n = 35) of the Follow-Up PreEClampsia (FUPEC) Outpatient Clinic, Erasmus MC, the Netherlands, participated in an anonymous online survey. The main outcomes under study were their perceived determinants of physical activity. Responses were analyzed using thematic analysis.

Results

Thirteen themes emerged from the analysis. Six themes corresponded with motivational processes (future health, perceived ability, attitude, future reward or regret, physical appearance, and doing it for others), two with volitional processes (scheduling and planning), and two with automatic processes (affect and stress). Three themes were classified as environmental factors (time constraint, social support, and physical environment).

Conclusions

A range of facilitating and hindering factors were described by women with prior severe preeclampsia as the determinants of their physical activity. These factors corresponded well with the overarching motivational, volitional, and automatic processes described in the IBC model. In addition, motivational and environmental factors beyond the IBC model were described. Addressing these perceived determinants could enhance the efficacy of physical activity interventions in this population.

Tweetable abstract: Motivational, volitional, automatic, and environmental factors drive physical activity in women with prior severe preeclampsia.
Online information about mammography screening in Italy from 2014 to 2021
Authors: Attena Francesco , Abagnale Lucia , Avitabile Angela
Published: April 2022

Background

Many studies have reported that the information women receive about the risk-to-benefit ratio of breast cancer screening is still scarce and biased toward benefit. In a study we conducted in 2014, we analysed online documents about breast cancer screening that were addressed to the general female public. In the present study, we used the same methodology to verify if the information provided to women was improved.

Methods

We evaluated documents addressed to the general female public and posted on the Internet by the Italian national and regional public health services. False-positive and false-negative screening results, biopsy-proven false-positive results, interval cancer, overdiagnosis, radiation exposure, and decrease in risk of mortality were analysed. In addition, quantitative data were searched.

Results

In 2021, the most frequently reported information was reduction in breast cancer mortality (58.2%). The most frequently reported risk was a false-positive mammogram (42.5%). Similar frequency rates were reported for interval cancer, false-negative result, and radiation exposure (35.8%, 31.3%, and 28.3%, respectively). Overdiagnosis and biopsy-proven false-positive result were the less reported risks (20.1% and 10.4%). Thirteen documents provided quantitative data about reduction of mortality risk (16.7%), and only 19 provided quantitative data about risks or harms (8.4%). Almost all organisations sent letters of invitation to women (92.5%) and provided screening free of charge (92.5%). The most recommended was biennial screening for women aged between 50 and 69 years (48.5%). Compared with the information in 2014, that in 2021 showed some improvements. The most marked improvements were in the numbers of reports on overdiagnosis, which increased from 8.0 to 20.1%, and biopsy-proven false-positive result, which increased from 1.4 to 10.4%. Regarding the benefits of breast cancer screening, reduced mortality risk became increasingly reported from 2014 (34.5%) to 2021 (58.2%). Conversely, quantitative data remained scarce in 2021.

Conclusions

Moderate improvements in information were observed from 2014 to 2021. However, the information on breast cancer screening in documents intended for women published on Italian websites remain scarce.
The relationship among psychosocial adaptation, medication adherence and quality of life in breast cancer women with adjuvant endocrine therapy
Authors: Jiang Haoran , Dong Yu , Zong Wei , Zhang Xiu-jie , Xu Hui , Jin Feng
Published: April 2022

Background

Patients undergoing endocrine therapy for breast cancer often suffer from poor psychosocial adaptation, low compliance with endocrine therapy and poor quality of life. However, the relationship among the three is not completely clear. The aims of this study were to investigate the status of psychosocial adaptation (PSA), medication adherence and quality of life (QOL) in breast cancer women with adjuvant endocrine therapy (AET), and to analyze the influencing factors of QOL and explore the relationship among them.

Methods

346 breast cancer women were selected who underwent endocrine therapy after surgery, and data collected by the general information questionnaire, the PSA questionnaire among breast cancer women with AET, Morisky Medication Adherence Scale and The Functional Assessment of Cancer Therapy-Breast (FACT-B). The relationship among the variables was investigated by univariate analysis, multiple stepwise regression analysis and mediating effect analysis.

Results

The scores of PSA, medication adherence and QOL were slightly above the medium level. Univariate analysis showed that there were significant differences in QOL among breast cancer women of AET with different types of exercise, medical payment methods, discomfort symptoms (headache, hypomnesis, arthralgia, perturbation), type of discomfort symptoms, medication adherence and PSA; Multi-factor analysis showed that PSA and medication adherence were the influential factors of QOL; mediating effect showed that medication adherence played a partial mediating role in PSA and QOL.

Conclusion

The QOL of breast cancer women with AET will be directly affected by PSA. Medication compliance has a weak mediating effect in the indirect impact of PSA on the QOL. In the future, clinical nursing work should take targeted measures to improve the PSA level of patients, and effectively improve the compliance of patients with medication, so as to better improve the QOL of breast cancer women.
Healthcare students’ attitudes towards patient centred care: a systematic review with meta-analysis
Authors: Bejarano Geronimo , Csiernik Ben , Young James J. , Stuber Kent , Zadro Joshua R.
Published: April 2022

Background

Patient centred care is commonly recommended in clinical practice guidelines to improve patient outcomes and reduce healthcare costs. Identifying measurement tools used to assess healthcare students’ attitudes towards patient centered care and determining their attitudes is the first step to ensuring patient centred care is provided in the future. The primary aim of this review was to describe the measurement tools used to assess healthcare students’ attitudes towards patient centred care. The secondary aim was to quantify healthcare students’ attitudes towards patient centred care.

Methods

An electronic database search was conducted in MEDLINE, EMBASE, CINAHL from inception until March 1, 2021, with combined terms relating to ‘patient centred care’, ‘attitudes’, and ‘healthcare students’. Studies that quantitatively assessed healthcare students’ attitudes towards patient centred care were included. Measurement tools used in the included studies were qualitatively described. Meta-analysis was conducted to quantify healthcare students’ attitudes towards patient centred care and assess the respective influence of gender, profession, and study geographical location on healthcare students’ attitudes towards patient centred care.

Results

The electronic search identified 3948 total studies. One hundred twenty-nine full texts were screened, and 49 studies were included. There were 16 measurement tools used to assess healthcare students’ attitudes towards patient centered care. Most studies (53%, n = 26) used the Patient-Practitioner Orientation Scale (PPOS) to assess patient centered care. Meta-analyses of 20 studies with 26 total groups resulted in a pooled mean PPOS score of 4.16 on a 0–6 scale (95% Confidence Interval [CI]: 3.95, 4.37), indicating low attitudes towards patient centered care. Additional analyses found that women have significantly higher attitudes towards patients centred care than men (pooled effect 0.14 [95% CI: 0.05, 0.23], n = 8 studies) and mean PPOS scores appear similar among sub-groups of only medical students (pooled mean 4.13, 95% CI: 3.85, 4.42, n = 13 studies) and only American healthcare students (pooled mean 4.49, 95% CI: 4.35, 4.64, n = 5 studies).

Conclusions

Several different measurement tools have been used to assess healthcare students’ attitudes towards patient centred care, but the most commonly used is the PPOS. Our results indicate that healthcare students have low attitudes towards patient centred care. Future studies should evaluate if attitudes towards patient centred care can be improved during healthcare education.
Adopting wearables to customize health insurance contributions: a ranking-type Delphi
Authors: Neumann Daniel , Tiberius Victor , Biendarra Florin
Published: April 2022

Background

Wearables, as small portable computer systems worn on the body, can track user fitness and health data, which can be used to customize health insurance contributions individually. In particular, insured individuals with a healthy lifestyle can receive a reduction of their contributions to be paid. However, this potential is hardly used in practice.

Objective

This study aims to identify which barrier factors impede the usage of wearables for assessing individual risk scores for health insurances, despite its technological feasibility, and to rank these barriers according to their relevance.

Methods

To reach these goals, we conduct a ranking-type Delphi study with the following three stages. First, we collected possible barrier factors from a panel of 16 experts and consolidated them to a list of 11 barrier categories. Second, the panel was asked to rank them regarding their relevance. Third, to enhance the panel consensus, the ranking was revealed to the experts, who were then asked to re-rank the barriers.

Results

The results suggest that regulation is the most important barrier. Other relevant barriers are false or inaccurate measurements and application errors caused by the users. Additionally, insurers could lack the required technological competence to use the wearable data appropriately.

Conclusion

A wider use of wearables and health apps could be achieved through regulatory modifications, especially regarding privacy issues. Even after assuring stricter regulations, users’ privacy concerns could partly remain, if the data exchange between wearables manufacturers, health app providers, and health insurers does not become more transparent.
The sulphated polysaccharides extract ulvans from Ulva armoricana limits Marek’s disease virus dissemination in vitro and promotes viral reactivation in lymphoid cells
Authors: Bussy Frédérick , Rémy Sylvie , Le Goff Matthieu , Collén Pi Nyvall , Trapp-Fragnet Laëtitia
Published: April 2022

Background

Marek’s disease (MD) is a highly contagious lymphoproliferative disease of chickens caused by an alphaherpesvirus, Marek’s disease virus (MDV). MD is presently controlled by systematic vaccination of animals, which protects efficiently against the development of clinical disease. However, MDV vaccines do not prevent the multiplication and spread of MDV field strains and may favor the emergence of strains with increased virulence. Therefore, MDV persists to be a major problem for the poultry industry and the development of new alternative strategies to control MDV is needed. Seaweed extracts have previously been shown to exert immunomodulatory and antiviral activities, especially against herpesviruses. The objective of the present study was to explore the effect of Ulva armoricana extracts on MDV infection in vitro.

Results

We could demonstrate that the ulvan extract as well as its vitamin-enriched formulation reduce the viral load by about 80% at 24 h post-infection in infected chicken fibroblasts at concentrations that are innocuous for the cells. We also observed a substantial decrease in MDV plaque size suggesting that ulvans impede MDV cell-to-cell spread in vitro. Moreover, we showed that ulvan extract could promote MDV reactivation in lymphoid cells.

Conclusions

Our data provide the first evidence that the use of the ulvan extract could be a good alternative to limit MDV infection in poultry.
Neurocognitive deficits and socioeconomic risk factors among children and adolescents living with HIV in sub-Saharan Africa: a systematic review
Authors: Musindo Otsetswe , Krabbendam Lydiah , Mutahi Joan , García Miguel Pérez , Bangirana Paul , Kumar Manasi
Published: April 2022

Introduction

Children and adolescents living with HIV (C/ALHIV) are at a risk for significant neurocognitive deficits. There is limited literature that addresses the role of socioeconomic factors in neurocognitive deficits among CALHIV in Sub Saharan Africa (SSA), as it is very difficult to establish this causal relationship. Our systematic review was guided by the biodevelopmental framework that assumes that foundations of health and adversity affect later development and life outcomes. This systematic review aims to assess available evidence on the relationship between neurocognitive deficits and socioeconomic factors among HIV children and adolescents in SSA region.

Method

Using a pre-determined search strategy, we searched electronic databases including PubMed, web of Science and EBSCOhost (CINAHL and MEDLINE). Peer-reviewed publications that address neurocognitive deficits, psychosocial and socioeconomic risk factors among children and adolescents living with HIV in SSA were included in review.

Results

Out of 640 articles, 17 studies from SSA met the inclusion criteria. Four studies reported no significant differences in the neurocognitive measures comparing children and adolescents with HIV infection to those uninfected. However, 10 studies suggest that C/ALHIV scored significantly low in general intellectual functions as compared to their uninfected peers. C/ALHIV were found to have substantial deficits in specific cognitive domains such as sequential processing, simultaneous processing, and learning. In addition, deficits in visuo-spatial processing, visual memory and semantic fluency were mentioned. Socioeconomic factors such as lower socioeconomic status (income, education and occupation), child orphanhood status and under-nutrition were linked with neurocognitive deficits.

Conclusion

Our findings suggest that CALHIV presented with poorer neurocognitive outcomes when compared to other populations which were associated with specific socioeconomic factors.
Movements of free-range pigs in rural communities in Zambia: an explorative study towards future ring interventions for the control of Taenia solium
Authors: Van Damme Inge , Pray Ian , Mwape Kabemba E. , Trevisan Chiara , Coudenys Fien , Mubanga Chishimba , Mwelwa Chembesofu , Vaernewyck Victor , Dorny Pierre , O’Neal Seth E. , Gabriël Sarah
Published: April 2022

Background

Taenia solium typically affects resource-poor communities where pigs are allowed to roam freely, and sanitation and hygiene levels are suboptimal. Sustainable, long-term strategies are urgently needed to control the disease. Geographically targeted interventions, i.e. screening or treatment of taeniosis among people living near infected pigs (defined as ring screening and ring treatment, respectively), have been shown to be effective control options in Peru. However, these results might not be directly generalizable to sub-Saharan African settings. Pig movements play a vital role in the transmission and, consequently, the success of ring interventions against T. solium. The aim of the present study was to explore roaming patterns of pigs in T. solium endemic communities in Zambia as a first step toward evaluating whether ring interventions should be considered as a treatment option in Zambia.

Methods

In total, 48 free-roaming pigs in two rural neighborhoods in the Eastern Province of Zambia were tracked using a Global Positioning System (GPS) receiver. Tracking took place in April (end of the rainy season) 2019 and October (end of the dry season) 2019. The number of revisitations and the time spent within rings of different radii (50, 100 and 250 m) around the coordinates of each pig owner’s household were calculated for each pig.

Results

The total tracking time for 43 pigs in the final analysis set ranged between 43 and 94 h. Pigs spent a median of 31% and 13% of the tracked time outside the 50- and 100-m radius, respectively, although large variations were observed between pigs. Overall, 25 pigs (58%) went outside the 250-m ring at least once, and individual excursions lasting up to 16 h were observed. In the dry season, 17 out of 23 pigs went outside the 250-m radius compared to only eight out of 20 pigs in the rainy season (P = 0.014).

Conclusions

In our study sites in Zambia, the majority of pigs spent most of their time within 50 or 100 m of their owner’s home, and these results are comparable with those on Peruvian pigs. Both radii could therefore be considered reasonable options in future ring interventions.

Graphical Abstract
Serving His Lord
Authors: Cunningham Anthony
Published: April 2022

This essay considers devotional addiction in Kazuo Ishiguro’s The Remains of the Day. The novel tells the story of Mr. Stevens, a constant English butler in a rapidly changing world. Having spent his best years in service to Lord Darlington, he must adjust to an American employer, someone untethered to the traditions that have ruled life at Darlington Hall. Told in the form of a travel journal, covering a span of six days in 1956, the journey is an inner one at heart, an extended bout of self-reflection, with Mr. Stevens thinking about his calling as he has never done before. In the end, how clearly he sees himself and his vocation remains an open question, but careful consideration of his story can illuminate vital details about dedication—addiction in the sense of steadfast devotion. Specifically, the novel explores how Mr. Stevens is embodied by his vocation, having become what he does in a world where professional butlers revere their station and its duties. Unlike external addictions, like drugs or alcohol, devotional addictions cultivate and ultimately constitute a self in ways resistant to changing course at will. In the case of Stevens, the self gathers around a calling that can only be jettisoned at the risk of implosion.
Vicissitudes and Their Inscriptions
Authors: Shapiro Carolyn
Published: April 2022

In his marking of the consequential vicissitudes that attend the more primary instincts, Freud articulates history as the discursive operation of the psychoanalytic undertaking. But his ambivalence toward the requisite writing of that articulated history comes through when he introduces the narrative genre of the case study. The first part of this article examines Freud’s implicit proposition that psychoanalysis is a complex articulation of history in that symptoms are noted and inscribed as consequential, present indicators of causal instincts (Triebe) that have been variously and “fatefully” rerouted. The second part reads Freud’s defensive presentation of the first case history, the “broken fragment” of Dora and her hysteria, considering Freud’s ambivalence toward his own historiographic operation. Freud’s ambivalence in relation to his new genre of narrative writing illustrates the more general productive ambivalence of historiography as outlined by Michel de Certeau.
Φλεγμονή των καρωτιδικών αθηρωματικών πλακών
Authors: Κουτάγιαρ Ιωσήφ
Published: April 2022

Σκοπός: Η διερεύνηση της σχέσης μεταξύ των μετρήσεων θερμοκρασίας με την ακτινομετρία μικροκυμάτων (microwave radiometry-MWR) και της πρόσληψης φθοριοδεοξυγλυκόζης (fluorodeoxyglucose-FDG) στο καρωτιδικό τοίχωμα και η εκτίμηση της συσχέτισής τους με τα ευρήματα της ιστολογικής και ανοσοϊστοχημικής ανάλυσης σε ασθενείς με σημαντικού βαθμού καρωτιδική στένωση. Μέθοδος και αποτελέσματα: Σε 21 ασθενείς οι οποίοι υπεβλήθησαν σε ενδαρτηρεκτομή καρωτίδας, η φλεγμονή του καρωτιδικού τοιχώματος εκτιμήθηκε τόσο με FDG ποζιτρονική/αξονική τομογραφία (FDG-PET/CT), όσο και με τις μετρήσεις της ακτινομετρίας μικροκυμάτων. Η εκτίμηση της φλεγμονής των καρωτίδων με FDG-PET/CT ημιποσοτικοποιήθηκε ως ο λόγος στόχου προς τον περιβάλλοντα ιστό (target-to-background ratio-TBR) σε διαδοχικές μετρήσεις σε εγκάρσιες τομές 2 εκατοστά κάτωθεν έως 2 εκατοστά άνωθεν του καρωτιδικού διχασμού. Η διαφορά θερμοκρασίας (ΔΤ) με την ακτινομετρία μικροκυμάτων υπολογίσθηκε ως η διαφορά της μέγιστης μείον την ελάχιστη τιμή θερμοκρασίας στα αντίστοιχα καρωτιδικά τμήματα. Η έκταση του λιπώδους πυρήνα, η επασβέστωση καθώς και τα επίπεδα CD68 και CD31 προσδιορίσθηκαν στα εκταμηθέντα καρωτιδικά ιστολογικά τμήματα. Παρατηρήθηκε μια σημαντική συσχέτιση μεταξύ των τιμών ΔΤ και της πρόσληψης FDG (R =0.40, P = 0.01), αλλά όχι μεταξύ του βαθμού της αγγειογραφικής στένωσης και των τιμών ΔΤ (R = 0.02, P = 0.91) ή πρόσληψης ραδιοφαρμάκουω(R = - 0.28, P = 0.86). Οι ασθενείς με αθηρωματικές πλάκες πλούσιες σε λιπώδη πυρήνα ή χαμηλή επασβέστωση είχαν υψηλότερες τιμές ΔΤ (P = 0.001 και P < 0.001, αντίστοιχα) και πρόσληψης ραδιοφαρμάκου (P = 0.02 and P = 0.02, αντίστοιχα). Οι ασθενείς με αθηρωματικές πλάκες που περιείχαν αυξημένα επίπεδα CD68 είχαν υψηλότερες τιμές ΔΤ και πρόσληψης ραδιοφαρμάκου. Συμπέρασμα: Οι μετρήσεις θερμοκρασίας ως δείκτης φλεγμονής της καρωτιδικής πλάκας συσχετίσθηκαν με τους απεικονιστικούς βιοδείκτες της ποζιτρονικής/τομογραφίας. Η ανωτέρω συσχέτιση επιβεβαιώθηκε από τα ευρήματα της ιστολογικής και ανοσοϊστοχημικής ανάλυσης. Οι δομικές αλλαγές δεν συνδέονται με τη φλεγμονώδη διεργασία. Η σημασία των ανωτέρω ευρημάτων στη δαιστρωμάτωση κινδύνου και στην αντιμετώπιση ασθενών με αθηροσκλήρωση καρωτίδων καθώς και ο ακριβής αλγόριθμος για δυνητική χρήση της MWR και της PET/CT στην κλινική πράξη θα πρέπει να διερευνηθεί.
Easy Cases of Deadlock Detection in Train Scheduling
Authors: Dal Sasso Veronica , Lamorgese Leonardo , Mannino Carlo , Tancredi Antonio , Ventura Paolo
Published: April 2022

In a railway network, a deadlock occurs when two or more trains are preventing each other from moving forward by each occupying the tracks required by the other. Deadlocks are rare but pernicious events in railroad operations, and, in most cases, they are caused by human errors and involve only two extra-long trains missing their last potential meet location. In “Easy Cases of Deadlock Detection in Train Scheduling,” V. Dal Sasso, L. Lamorgese C. Mannino, A. Tancredi, and P. Ventura prove that the identification of two-train deadlocks can be performed in polynomial time. Moreover, they also present a pseudo-polynomial but efficient oracle that allows real-time early detection and prevention of any (potential) two-train deadlock in the Union Pacific (a U.S. class 1 rail company) railroad network. A deadlock prevention module based on the work in this paper will be put in place at Union Pacific to prevent all deadlocks of this kind.
UMA BREVE BIOGRAFIA DE PLÍNIO, O JOVEM: OS VACILOS DE SEU TEMPO
Authors: Amaya Lucas Caminati
Published: April 2022

Um pequeno leque de informações e grandes abismos de ausência de dados formam o estabelecimento histórico atual de boa parte dos grandes homens e, principalmente, mulheres da Antiguidade, o que leva a constantes revisões e até mesmo revoluções sobre o entendimento que temos de Roma e da Grécia antigas. Neste artigo, demonstramos como a reconstrução e o entendimento da vida de um dos homens mais relevantes da segunda metade do século I EC é complexa e depende de fatores nem sempre concretos. Para isso, faremos uma breve biografia de Plínio, o Jovem, apontando as dificuldades e as lacunas que geram debates e possíveis reinterpretações de sua obra e da história de sua geração.
REVERBERAÇÕES DESCONSTRUCIONISTAS E TRANSCRIADORAS NAS TRADUÇÕES (A)CALIGRAMÁTICAS DOS TECHNOPAEGNIA DE SÍMIAS DE RODES: O MACHADO, AS ASAS E O OVO
Authors: Dos Santos Júnior Cristóvão José
Published: April 2022

Neste trabalho, são debatidas algumas premissas desconstrucionistas e transcriadoras tomadas como aspectos norteadores para a tradução dos technopaegnia de Símias de Rodes (séc. III a.C.). Os poemas traduzidos são caligramas, apresentando forma de machado, asas e ovo, de modo que se inserem na tradição de escrita constrangida ou, mais especificamente, na tradição dos carmina figurata. Efetuamos duas traduções de cada obra, uma em prosa e acaligramática, além de outra, poética e caligramática, a partir da edição bilíngue greco-alemã de Christine Luz (2010). Em nossas formulações poéticas, também buscamos apresentar, além da conformação caligramática, versos metrificados, o que parece ser algo inédito, pelo que nos foi permitido saber. Desse modo, buscamos refletir contributos pós-estruturalistas e, sobretudo, desconstrucionistas, a fim de melhor compreender o fenômeno tradutório com vistas a nosso labor particularmente considerado.
Barrow Neurological Institute, Nurse Fellowship
Authors: Wadeson Andrea
Published: April 2022

This article discusses what Andrea Wadeson learned during her nurse fellowship at the Barrow Neurological Institute, Phoenix, Arizona, in terms of understanding how patients with vestibular schwannoma were managed, what pathways were in place and the multidisciplinary management that they used.
Current management of secondary progressive multiple sclerosis in the UK: a multiple sclerosis specialist nurse perspective
Authors: Wilkinson Carmel
Published: April 2022

Secondary progressive multiple sclerosis is a complex and multifaceted condition often characterised by a progressive worsening of neurological disability, independent of relapses, that follows an initial relapsing–remitting course. This article discusses the current management of this condition from a nursing perspective, highlighting some of the recent service-level and disease-specific challenges faced by specialist nurses involved in the diagnosis and management of secondary progressive multiple sclerosis. The review also considers ways the multiple sclerosis community can work together to maximise opportunities to optimise patient outcomes. This includes improving working relationships within clinical teams and defining clearer referral pathways when disease progression is suspected, embracing technology, as well as addressing recent evidence demonstrating variability in current practices for diagnosing secondary progressive multiple sclerosis and communicating diagnoses to patients.
Comparing models of organised inpatient stroke care
Authors: Hill James E , Thetfor Clare , Gibson Josephine
Published: April 2022

This comment gives an evidence summary based on the following systematic review: Langhorne P, Ramachandra S. Organised inpatient (stroke unit) care for stroke: network meta-analysis. Cochrane Database Syst Rev. 2020;4:CD000197. https://doi.org/10.1002/14651858.CD000197.pub4
A survey on functional disabilities and perceived need for allied health and complementary therapies for Thai individuals with Parkinson’s disease
Authors:   Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom Province, Thailand, Khacharoen Suweena , Tretriluxana Jarugool ,   Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom Province, Thailand, Boonprasop Sira ,   Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom Province, Thailand, Srivanitchapoom Prachaya ,   Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, Upachit Theeraya ,   Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom Province, Thailand
Published: April 2022

Background: Evidence regarding functional disability and the need for alternative health care services to improve abilities among Thai individuals with Parkinson’s disease (PD) is limited. Objectives: The study aims to survey PD patients on their functional difficulties and determined the correlation between personal- and disease-related factors on the difficulties they experience. Additionally, we asked about the need for, utilization of, and satisfaction with allied health care (AHC) and alternative complementary therapy (ACT) to minimize these difficulties in PD. Materials and methods: Researchers conducted one-on-one interviews in a movement disorder clinic in a Thai university hospital. The survey consisted of interviews for personal and disease data at first, followed by the self-rating of functional disabilities and the need for and experience of AHC and ACT. Results: Patients with severe disease had regressive disability in some activities. There were 4 factors related to the level of functional disability: stage of severity, duration of disease, cognitive performance, and depression score. Half of the participants needed treatment via AHC and ACT. Of the patients, 37%, 50% and 38.9% had experience with physical therapy, massage, and acupuncture, respectively. Almost all of them were satisfied with massage and physical therapy, while a small number of patients were satisfied with acupuncture. Conclusion: These results indicate that functional disability worsens as the disease progresses. A small number of patients have experience with AHC and ACT; however, they need alternative treatment. Further research regarding related factors for utilizing AHC and ACT in Thai PD patients’ needs to be conducted.
Omicron surge and the future of COVID-19 vaccinations
Authors: Burhan Erlina , Rachmadi Rizky Abi
Published: April 2022

The global surge of Omicron has caused significant concern. Omicron has caused new wave of infections in nations with adequate vaccine coverage. Omicron has around 30 mutations that are similar to the previous variant of concerns, possibly decreasing vaccine effectiveness (VE). Hence, the emergence of Omicron is predicted to be a significant public health challenge and may alter the future of COVID-19 vaccinations. Furthermore, other issues may affect vaccine policy in the future such as the never-ending vaccine inequity, waning immunity of current COVID-19 vaccines, decreasing VE against new emerging strains, and new findings regarding hybrid immunity. This literature review aimed to explore the possible steps forward using the most updated knowledge on COVID-19 vaccines and Omicron.
Ethicomedicolegal aspects of the COVID-19 health services in preparing regulations and intermediaries for clinical dispute resolution: a systematic review
Authors: Purwadianto Agus , Sugiharto Ade Firmansyah , Sari Fitri Ambar , Roberia  , Cahyono Uud , Budiningsih Yuli , Alim Denys Putra , Faddila Nadia Ulfah
Published: April 2022

BACKGROUND The COVID-19 pandemic has caused many medical, ethical, and medicolegal changes, including constant adjustments in service guidelines. Continuing to revise healthcare regulations and guidelines can potentially cause clinical disputes or medical negligence that require ethical and legal solutions. This study aimed to determine the ethical and medicolegal aspects of the potential factors that cause clinical disputes during the pandemic and provide anticipative solutions to national ethicomedicolegal policies.

METHODS A systematic literature search in PubMed, ScienceDirect, ClinicalKey, and Google Scholar was performed using keywords “clinical dispute,” “ethics,” “medicolegal,” “ethicolegal,” and “COVID-19”. The inclusion criteria were articles that contained information on shortage, justice, ethical distribution in intensive care, the possibility of lawsuits and disputes among stakeholders during the pandemic, and stakeholders’ roles in managing the pandemic. Key evidence was analyzed and synthesized following national ethicomedicolegal policies.

RESULTS We identified 19 articles from the 4 databases. Based on the literature, the main ethicomedicolegal impact of the COVID-19 pandemic appears in 3 aspects: (1) a shortage of fair and ethical intensive care services with fair and ethical distribution efforts, (2) legal protection for medical personnel from legal charges while providing health services during the pandemic, and (3) the government’s role in managing the pandemic together with the stakeholders involved.

CONCLUSIONS Ethicomedicolegal clinical dispute management and its norms require an update, especially when deciding the complexity of COVID-19 service standards. Ethicomedicolegal professionals are needed as intermediaries to manage cases of clinical disputes and to implement fair malpractice criteria in Indonesia.
Association of P-glycoprotein expression and response to anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer
Authors: Yulian Erwin Danil , Dasawala Filipus , Siregar Nurjati Chairani
Published: April 2022

BACKGROUND Neoadjuvant chemotherapy (NACT) has been shown to improve the overall survival of locally advanced breast cancer (LABC) patients with pathological complete response. However, the efficacy may be reduced due to chemoresistance mediated by P-glycoprotein (Pgp). This study aimed to explore the association between Pgp expression and patients’ response to NACT.

METHODS A prospective cohort study was carried out from May 2018 to October 2019 at Cipto Mangunkusumo Hospital and Koja Hospital. Treatment-naïve LABC patients were consecutively enrolled in the study. Immunohistochemistry analysis of the biopsy samples was done to semi-quantitatively measure Pgp expression. The clinical response was evaluated after 3 cycles of NACT, while the pathological response was evaluated for subjects who underwent surgery post-NACT.

RESULTS Mean age of the subjects was 46.2 (9.6) years old, and most of the cases were invasive ductal (78%) and luminal B subtype (61%). Pgp was strongly expressed in 21/27 subjects (78%). There were no differences between Pgp-positive and -negative subjects for clinical response (relative risk [RR] 1.1, 95% confidence interval [CI] 0.33–4.01, p = 0.61) and pathological response (RR 1.3, 95% CI 0.8–1.9, p = 0.22). Other clinicopathologic variables were not associated with either clinical or pathological responses.

CONCLUSIONS These results showed that Pgp is expressed in most LABC patients, but its role as a predictive factor could not be established. However, due to the limited subjects and a lack of standardized Pgp measurement, careful consideration must be done when interpreting these results.
Procalcitonin prognostic value in predicting mortality among adult patients with sepsis due to Gram-negative bacteria
Authors: Effendi Bonita , Pitoyo Ceva Wicaksono , Sinto Robert , Suwarto Suhendro
Published: April 2022

BACKGROUND Sepsis is a leading cause of mortality and morbidity globally. Gram-negative bacteremia was reported to have a high risk of septic shock and poor prognosis. This study aimed to evaluate the role of procalcitonin in predicting mortality in patients with sepsis due to Gram-negative bacteria.

METHODS This was a retrospective cohort study performed based on medical records and sepsis registry of Tropical and Infectious Disease Division, Department of Internal Medicine, Cipto Mangunkusumo Hospital. The inclusion criteria were patients aged ≥18 years diagnosed with sepsis due to Gram-negative bacteria based on blood culture on admission and hospitalized between March 2017 and October 2020. Data taken from medical records included subjects’ characteristics, laboratory parameters, and 28-day mortality outcomes during hospitalization. Receiver operating characteristic was used to determine the area under the curve (AUC) of procalcitonin and its accuracy.

RESULTS A total of 128 patients were eligible. The cumulative survival of patients with Gram-negative bacteremia was 48.4% (standard error 0.96%). The AUC of procalcitonin to predict mortality was 0.45 (95% confidence interval 0.36–0.54). Escherichia coli was the predominant microorganism in blood culture (n = 38, 29.7%).

CONCLUSIONS Procalcitonin has a poor performance in predicting mortality of patients with sepsis due to Gram-negative bacteria.
Knowledge of neuroscience boosts motivation and awareness of learning strategies in science vocational education students
Authors: Ruiz Mejías Marcel , Pérez Nora , Carrió-Llach Mar
Published: April 2022

Interest in how neuroscience can support education has grown over the last few years. Based on the concept that neuroscience can help to tailor education, we carried out a workshop-based intervention for young adult students, with the goal of impacting their self-concept as learners. We surmised that educating participants about brain structure and function, and about the nature of learning, may change how students perceive themselves and elicit a positive mindset for learning situations. The aim of this research was to transform students’ self-concept, enhance their motivation, and provide them with useful tools for their education and long-life challenges as learners. For this, the MSLQ instrument and qualitative students’ assesment was used to collect data before, immediately after and 10 months after the intervention. Our results show that a program about neuroeducation and  learning strategies, directly impacted student motivation. Also, students reported long-term use of such tools. We conclude that similar interventions may be useful in different learning contexts to help students become aware of self-motivation and the strategies they use, and thereby more effective learners.
Implementación de un programa basado en el aprendizaje cooperativo informal en las clases prácticas de fisioterapia respiratoria para la adquisición de las competencias transversales del grado de Fisioterapia. Propuesta educativa para el curso 2020-2021.
Authors: Cortés Amador Sara Cortés
Published: April 2022

Al finalizar su proceso de formación universitaria, el/la alumno/a de fisioterapia debe haber adquirido las competencias transversales propias de la titulación. Las competencias transversales hacen referencia a la capacidad del alumno/a para tomar decisiones, trabajar en equipo, capacidad de análisis y pensamiento crítico entre otras. El objetivo de la presente propuesta educativa es el de explorar el impacto del aprendizaje cooperativo (AC) y del aprendizaje individualista (AI) en la adquisición de competencias transversales, rendimiento académico y motivación entre el alumnado de fisioterapia. Para este propósito, 90 alumnos/as serán asignados a un grupo de aprendizaje cooperativo (GAC) y a un grupo de aprendizaje individualizado (GAI). Se realizarán dos evaluaciones antes y después de la implementación de la propuesta educativa. Los resultados que se esperan son que el GAC, obtengan un mejora significativa de todas las variables estudiadas (grado de competencia transversal adquirido, rendimiento académico y nivel de motivación) después de la intervención (p<0.05). En contraste el GAI, se estima que sus mejoras significativas sólo se den en rendimiento académico (P<0.05). En conclusión, se espera confirmar que tanto el aprendizaje cooperativo como el individualizado son estrategias que favorecen el rendimiento académico del alumnado, mientras que sólo el aprendizaje cooperativo mejorará el nivel de competencias transversales y motivación por el estudio.
Hybrid-structure network and network comparative study for deep-learning-based speckle-modulating optical coherence tomography
Authors: Ni Guangming , Wu Renxiong , Zhong Junming , Chen Ying , Wan Ling , Xie Yao , Mei Jie , Liu Yong
Published: April 2022

Optical coherence tomography (OCT), a promising noninvasive bioimaging technique, can resolve sample three-dimensional microstructures. However, speckle noise imposes obvious limitations on OCT resolving capabilities. Here we proposed a deep-learning-based speckle-modulating OCT based on a hybrid-structure network, residual-dense-block U-Net generative adversarial network (RDBU-Net GAN), and further conducted a comprehensively comparative study to explore multi-type deep-learning architectures’ abilities to extract speckle pattern characteristics and remove speckle, and resolve microstructures. This is the first time that network comparative study has been performed on a customized dataset containing mass more-general speckle patterns obtained from a custom-built speckle-modulating OCT, but not on retinal OCT datasets with limited speckle patterns. Results demonstrated that the proposed RDBU-Net GAN has a more excellent ability to extract speckle pattern characteristics and remove speckle, and resolve microstructures. This work will be useful for future studies on OCT speckle removing and deep-learning-based speckle-modulating OCT.
1.14 kW peak power mid-infrared Er:YAG planar waveguide MOPA laser
Authors: Ye Xianlin , Xu Xiafei , Ren Huaijin , Wei Xingbin , Zhang Lei , Zhang Bin , Fan Guobin
Published: April 2022

We report on a quasi-continuous Er:YAG planar waveguide laser operated at 2.94 µm based on the major oscillator power amplification configuration. With the total pump peak power of 32.01 kW, a maximum output peak power of 1.14 kW was obtained at the seed injection peak power of 184.4 W operated at 400µs, 40 Hz. Furthermore, the numerical simulation results indicate that better performance of the laser could be obtained with the higher injected seed laser power. To the best of our knowledge, this is the first experimental demonstration of 2.94 µm planar waveguide laser with an Er doped host material.
High-performance scanning-mode polarization based computational ghost imaging (SPCGI)
Authors: Li Dekui , Xu Chenxiang , Yan Lusha , Guo Zhongyi
Published: April 2022

Computational ghost imaging (CGI) uses preset patterns and single-pixel detection, breaking through the traditional form of point-to-point imaging. In this paper, based on the Monte Carlo model, a reflective polarization based CGI (PCGI) system has been proposed and constructed under the foggy environments. And the imaging performances of the PCGI at different optical distances have been investigated and analyzed quantitatively. When the targets and the background have a small difference in reflectivity, the difference of polarization characteristics between the targets and the background can help the CGI to remove the interference of scattering light and improve the imaging contrast. Besides, in order to further improve imaging efficiency, a scanning-mode polarization based CGI (SPCGI) has also been proposed, in which the combination of polarization characteristics and the scanning-mode plays an important role to improve the CGI’s imaging efficiency and imaging quality.
Social benefits and individual costs of creativity in art and science: A statistical analysis based on a theoretical framework
Authors: Zagonari Fabio , Giacomoni Elena
Published: April 2022

In this study, we statistically identified and characterized the relationship between the long-run social benefits of creativity and the in-life individual costs (in terms of happiness and health) of creativity. To do so, we referred to a theoretical framework that depicts a creator’s life. We generated a balanced dataset of 200 creators (i.e., composers, painters, mathematicians and physicists, and biologists and chemists born between 1770 and 1879), and calculated standardized evaluations of the long-run social benefits in different domains (performances, exhibitions, citations). We performed regression analysis and identified the statistical determinants of the relationship between a creator’s social benefits and the costs to their happiness and health. We found that creativity represented an individual cost for all four creator groups, with a larger impact on happiness than on health; the cost was greater if creativity was based more on divergent than on convergent thinking or if authors faced greater language issues. The impacts of long-run social benefits on individual happiness and health were similar in the arts and sciences if institutional differences were taken into account.
Factors associated with coronary heart disease in COPD patients and controls
Authors: Svendsen Christina D. , Kuiper Karel K. J. , Ostridge Kristoffer , Larsen Terje H. , Nielsen Rune , Hodneland Vidar , Nordeide Eli , Bakke Per S. , Eagan Tomas M.
Published: April 2022

Background

COPD and coronary heart disease (CHD) frequently co-occur, yet which COPD phenotypes are most prone to CHD is poorly understood. The aim of this study was to see whether COPD patients did have a true higher risk for CHD than subjects without COPD, and to examine a range of potential factors associated with CHD in COPD patients and controls.

Methods

347 COPD patients and 428 non-COPD controls, were invited for coronary computed tomography angiography (CCTA) and pulmonary CT. Arterial blood gas, bioelectrical impedance and lung function was measured, and a detailed medical history taken. The CCTA was evaluated for significant coronary stenosis and calcium score (CaSc), and emphysema defined as >10% of total area <-950 Hounsfield units.

Results

12.6% of the COPD patients and 5.7% of the controls had coronary stenosis (p<0.01), whereas 55.9% of the COPD patients had a CaSc>100 compared to 31.6% of the controls (p<0.01). In a multivariable model adjusting for sex, age, body composition, pack-years, CRP, cholesterol/blood pressure lowering medication use and diabetes mellitus, the OR (95% CI) for having significant stenosis was 1.80 (0.86–3.78) in COPD patients compared with controls. In a similar model, the OR (95% CI) for having CaSc>100 was 1.68 (1.12–2.53) in COPD patients compared with controls. Examining the risk of significant stenosis and CaSc>100 among COPD patients, no variable was associated with significant stenosis, whereas male sex [OR 2.85 (1.56–5.21)], age [OR 3.74 (2.42–5.77)], statin use [OR 2.23 (1.23–4.50)] were associated with CaSc>100, after adjusting for body composition, pack-years, C-reactive protein, use of angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), diabetes, emphysema score, GOLD category, exacerbation frequency, eosinophilia, and hypoxemia.

Conclusion

COPD patients were more likely to have CHD, but neither emphysema score, lung function, exacerbation frequency, nor hypoxemia predicted presence of either coronary stenosis or CaSc>100.