bluuebunny/crossref_metadata_2025 huggingface dataset:
ВИВЧЕННЯ ВПЛИВУ ДОПОМІЖНИХ РЕЧОВИН НА ФАРМАКО-ТЕХНОЛОГІЧНІ ПОКАЗНИКИ ТАБЛЕТОК НА ОСНОВІ БІСОПРОЛОЛУ ФУМАРАТУ З ІНДАПАМІДОМ
Authors: Malanchuk N. V. , Demchuk M. B. , Hroshovyi T. A.
Published: April 2024

Мета роботи. Вивчення впливу допоміжних речовин на фармако-технологічні показники маси для таблетування та таблеток бісопрололу фумарату з індапамідом.
Матеріали і методи. Для фармацевтичної розробки таблеток були обрані  субстанції бісопрололу фумарату та індапаміду; 27 допоміжних речовин із груп розпушувачів, ковзних речовин, змащуючих речовин, наповнювачів на основі мікрокристалічної целюлози та багатофункціональних наповнювачів. Для вивчення впливу ДР використовували п’ятифакторний експе­римент на підставі греко-латинського кубу другого порядку.
Таблетки отримували методом прямого пресування. Дослідження властивостей маси для таблетування і показників якості таблеток проводили згідно з вимогами Державної Фармакопеї України. Також оцінювали процес пресування таблеток, та їх зовнішній вигляд. Висновки щодо вибору оптимальних ДР робили за допомогою функції бажаності.
Результати і обговорення. Результати дослідження свідчать, що на текучість маси для таблетування, її насипну густину та густину після усадки, кут природного укосу та оцінку процесу пресування найбільше впливали ковзні речовини, а саме Neusilin US 2, а також зразки багатофункціональних наповнювачів (MagGran  або Cellactose 80) та наповнювачів на основі МКЦ (Vivapur марки 200 або 302). Кращі показники стійкості до роздавлювання та стираності таблеток забезпечували ковзні речовини, а саме Syloid 244 FP. Розпушуючі речовини, а саме натрію кроскармельоза мала визначальний вплив на час розпадання таблеток.
Для прийняття рішення про вибір оптимальних ДР використано узагальнений показник – функцію бажаності.
Висновки. Вивчено вплив 27-ми ДР на фармако-технологічні показники маси для таблетування та таблеток бісопрололу фумарату з індапамідом. Встановлено, що оптимальні показники якості таблеток бісопрололу фумарату з індапамідом були отримані при використанні натрій крохмаль гліколяту марки VivaStar, Neusilin US 2, ПЕГ-6000, Prosolv EASY tab SP і SacheLac 80. Результати цього дослідження є основою для визначення оптимального кількісного співвідношення допоміжних речовин у складі таблеток з використанням регресійного аналізу.
ВИКЛАДАННЯ ВІЙСЬКОВОЇ ГІГІЄНИ В ТЕРНОПІЛЬСЬКОМУ НАЦІОНАЛЬНОМУ МЕДИЧНОМУ УНІВЕРСИТЕТІ ІМЕНІ І. Я. ГОРБАЧЕВСЬКОГО МОЗ УКРАЇНИ З УРАХУВАННЯМ ОСОБЛИВОСТІ ВЕДЕННЯ БОЙОВИХ ДІЙ
Authors: Пашко К. О. , Лотоцький В. В. , Крицька Г. А. , Лотоцька О. В.
Published: April 2024

Анотація. У статті розглянуто особливості організації викладання військової гігієни в Тернопільському національному медичному університеті імені І. Я. Горбачевського МОЗ України з урахуванням сучасного досвіду ведення бойових дій ЗСУ. Висвітлено внесення змін у навчальні матеріали робочої програми з відповідних тем – розміщення військ, водопостачання особового складу, харчування особового складу з урахуванням особливостей забезпечення військовослужбовців ЗСУ в цих районах. Нанесення ворогом ракетно-бомбових ударів та застосування ним безпілотних літальних апаратів скорегувало організацію розміщення, водопостачання та харчування особового складу військових частин. Розміщення військовослужбовців у районах ведення бойових дій тепер можливе лише в уцілілих після масованих обстрілів російськими військами будівлях та в їх підвалах і погребах, а також у відкритих і закритих фортифікаційних спорудах. Замість ліжкової білизни військовослужбовці використовують спальні мішки.

Водопостачання військовослужбовців забезпечується переважно поставками бутильованої води, яку закуповує Міністерство оборони України та привозять волонтерські організації. Решту потреб вони задовольняють зазвичай із місцевих колодязів.

Гарячу їжу у невеликих підрозділах, де служать 10–30 військовослужбовців, вони готують самі для себе самостійно.

Харчування особового складу більших підрозділів на передовій організовують за двома варіантами. Перший: бійці на позиціях декілька днів споживають сухий пайок, різноманітні консерви, мівіну тощо.

Другий варіант (буває рідше), коли на відстані 3–10 кілометрів від зони зіткнення у приміщеннях чи в бліндажах обладнують польову кухню, готують гарячу їжу і в армійських термосах доставляють ближче до вогневих позицій за кілька кілометрів від передової та залишають у відповідному місці.
COMMUNICATION SKILLS FORMATION OF FOREIGN STUDENTS IN CONTECST OF MEDICAL UNIVERSITY
Authors: Humenna I. R. , Hantimurova N. I. , Hantimurov A. V.
Published: April 2024

Abstract. The article clarifies necessity of communication skills usage by foreign students during professional practice at higher medical education institutions. The essence of the term “communicationˮ is clarified. In order to determine the ways of effective training of communication and professional skills, the structure of professional medical communication is investigated and set of communication skills necessary for conversation in typical situations of professional activity is determined. It is established that the skills of listening and speaking, which are realized in speech at all stages of training at higher medical education institution and in all types of professional communication, should be reflected through the technology of forming communication skills. Linguodidactic principles for the formation of professional communication skills during the study of theoretical and clinical disciplines by foreign medical students have been formulated. Organizational and methodical approaches to the formation of foreign students’ professional communication skills in the learning process are disclosed. It is shown that the formation of communicative competence is carried out in stages from the first year of studying theoretical disciplines to the completion of studying clinical disciplines. We believe that teaching materials will help foreign students to apply freely communication skills in conversation with patients, reasonably express their own views on the course, treatment or prevention of the disease.
THE IMPORTANCE OF INNOVATIVE METHODS OF A PROFESSIONAL FOREIGN LANGUAGE TEACHING IN THE FORMATION OF COMMUNICATIVE COMPETENCE IN STUDENTS OF HIGHER MEDICAL EDUCATIONAL INSTITUTIONS
Authors: Vorona І. І. , Klishch H. I. , Kitura H. Ya.
Published: April 2024

Abstract. The article deals with grounding of the innovative methods use for a professional foreign language teaching in the formation of foreign language communicative competence in students of higher medical educational institutions. The essence of the innovative methods use for a professional foreign language teaching is found out, and the role of methods as an important component of the future medic’s communicative competence is considered. The need of innovative methods use for a professional foreign language teaching and also the formation of foreign language communicative competence in students of higher medical educational institutions are emphasized. English communicative approach to medical students’ professional competence is an integral aspect of professionally oriented study at the higher medical educational institution, and is formed through mastering the characteristic tendency to improve the communicative orientation of the educational process and to assimilate it with the real process of communication. Attention is focused on the need to analyse the educational, scientifically based innovative methods use as a fundamental basis for mastering the professional foreign language teaching in the formation of foreign language communicative competence in students of higher medical educational institutions. The issues of theoretic content for the innovative methods use for a professional foreign language teaching, selection of methods for educational material mastering, and development of communicative component in the process of students’ understanding of English language skills are under consideration. Main components of the innovative methods for a professional foreign language teaching are characterized; science-based classification of the innovative methods needed for the formation of foreign language communication is considered. Both theoretical and methodological aspects of communicative approach to learn English language educational material in English for Specific Purposes (ESP) are covered. Innovative methods of the foreign languages learning contribute to solve problems of a communicative, cognitive and educational nature, develop communication skills and abilities; establish emotional contact with students of students of higher medical educational institutions; teach them to work in a team and take into account the opinions of colleagues. High-quality foreign language training of medical students in classes of English for Specific Purposes is impossible without the use of innovative teaching methods that develop the ability to give an assessment, express an opinion, train attention, memory and thinking.
Тенденції процесів інформатизації університетів біомедичного спрямування.
Authors: Мінцер О. П.
Published: April 2024

Розглянуто останні світові та національні досягнення за напрямом інформатизації університетів. Підкреслено думку, що зі стрімким розвитком інформаційних технологій реформа університетських систем управління стала важливою проблемою в галузі освіти сьогодні. З безперервним розширенням масштабів університетів традиційні методи управління більше не можуть задовольнити потреби сучасних університетів. Узагальнено тенденції та завдання інформатизації університетів біомедичного спрямування за останні роки. Підкреслено, що інформатизація університетів біомедичного спрямування має динамічне визначати основні її напрями, встановлювати цілі, зміст дій і очікуваний результат за кожним напрямом, а також передбачати подальший розвиток інформатизації у вигляді технічних завдань, техноробочих проєктів, підпрограм, планів заходів, графіків робіт та інших документів. Інформатизація системи управління в університетах забезпечить адаптацію до потреб сучасного управління освітою, підвищення його ефективності та якості надання освітніх послуг. Зауважено, що конкордатність інформаційних технологій має відповідати принципам інформаційної безпеки, забезпеченню сталого розвитку університету та підтримки високого рівня паралелізму. Ці принципи є ключовими для забезпечення безперебійної роботи системи управління університетом. Отже, інформатизація закладу вищої освіти має ґрунтуватися на системах управління знаннями та прийняття рішень, а також забезпечувати реле-вантність організаційної структури.
РОЗРОБЛЕННЯ МОДЕЛІ МАШИННОГО НАВЧАННЯ ДЛЯ ДИФЕРЕНЦІЙНОЇ ДІАГНОСТИКИ ТРАНЗИТОРНИХ ВТРАТ СВІДОМОСТІ СИНКОПАЛЬНОГО ТА НЕСИНКОПАЛЬНОГО ПОХОДЖЕННЯ У ДІТЕЙ
Authors: Ковальчук Т. А. , Боярчук О. Р. , Богай С. Є.
Published: April 2024

Перенесений епізод транзиторної втрати свідомості (ТВС) у дитячому віці досі залишається складною діагностичною дилемою для цілого ряду клініцистів. Дослідження спрямовано на створення ефективної моделі машинного навчання для диференційної діагностики ТВС синкопального та несинкопального генезу, що забезпечить лікарям-педіатрам, дитячим кардіоревматологам і неврологам високу точність диференційної діагностики синкопальних і несинкопальних ТВС. Обстежено 140 пацієнтів із синкопе та 58 - із несинкопальними причинами ТВС віком 8-17 років. Для побудови моделі машинного навчання використовували алгоритм XGBoost. Про ефективність запропонованої моделі машинного навчання свідчили метрики точності, влучності, чутливості, fa-міри, специфічності, ROC AUC і PR AUC. Найінфор-мативнішими показниками моделі виявились Modified Calgary Syncope Seizure Score, швидкість ранкового підвищення систолічного артеріального тиску, серцевий індекс, ранкове підвищення діастолічного артеріального тиску, частота епізодів тахікардії упродовж 24-годинного моніторування за Холтером, нічне зниження діастролічного артеріального тиску, загальний периферичний опір судин, вік дитини, варіабельність добового діастолічного артеріального тиску, pNN50, співвідношення LF/HF, перцентильний розподіл відносно зростання, діастолічного артеріального тиску та індексу маси тіла. Отже, застосування описаної моделі машинного навчання дає змогу диференціювати синкопальні та несинкопальні ТВС у дітей та може використовуватися педіатрами, дитячими кардіоревматологами та неврологами як додатковий інструмент поряд із класичними діагностичними критеріями синкопе (вазовагальних синкопе, синкопе внаслідок ортостатичної гіпотензії та кардіогенних синкопе) і несинкопальних причин розвитку ТВС (епілепсії, первинного неспровокованого епілептичного нападу, психогенних псевдосинкопе, психогенних неепілептичних судом) на першому етапі діагностики.
Angiotensin-Converting Enzyme 2 Posttranslational Modifications and Implications for Hypertension and SARS-CoV-2: 2023 Lewis K. Dahl Memorial Lecture
Authors: Elgazzaz Mona , Filipeanu Catalin M. , Lazartigues Eric
Published: April 2024

ACE2 (angiotensin-converting enzyme 2), a multifunctional transmembrane protein, is well recognized as an important member of the (RAS) renin–angiotensin system with important roles in the regulation of cardiovascular function by opposing the harmful effects of Ang-II (angiotensin II) and AT1R (Ang-II type 1 receptor) activation. More recently, ACE2 was found to be the entry point for the SARS-CoV-2 virus into cells, causing COVID-19. This finding has led to an exponential rise in the number of publications focused on ACE2, albeit these studies often have opposite objectives to the preservation of ACE2 in cardiovascular regulation. However, notwithstanding accumulating data of the role of ACE2 in the generation of angiotensin-(1–7) and SARS-CoV-2 internalization, numerous other putative roles of this enzyme remain less investigated and not yet characterized. Currently, no drug modulating ACE2 function or expression is available in the clinic, and the development of new pharmacological tools should attempt targeting each step of the lifespan of the protein from synthesis to degradation. The present review expands on our presentation during the 2023 Lewis K. Dahl Memorial Lecture Sponsored by the American Heart Association Council on Hypertension. We provide a critical summary of the current knowledge of the mechanisms controlling ACE2 internalization and intracellular trafficking, the mutual regulation with GPCRs (G-protein–coupled receptors) and other proteins, and posttranslational modifications. A major focus is on ubiquitination which has become a critical step in the modulation of ACE2 cellular levels.
Social Determinants of Cardiovascular Risk Factors Among Asian American Subgroups
Authors: Zhu Alicia L. , Le Austin D. , Li Yuemeng , Palaniappan Latha P. , Srinivasan Malathi , Shah Nilay S. , Wong Sally S. , Valero‐Elizondo Javier , Elfassy Tali , Yang Eugene
Published: April 2024

Background

Social determinants of health (SDOH) play a significant role in the development of cardiovascular risk factors. We investigated SDOH associations with cardiovascular risk factors among Asian American subgroups.

Methods and Results

We utilized the National Health Interview Survey, a nationally representative survey of US adults, years 2013 to 2018. SDOH variables were categorized into economic stability, neighborhood and social cohesion, food security, education, and health care utilization. SDOH score was created by categorizing 27 SDOH variables as 0 (favorable) or 1 (unfavorable). Self‐reported cardiovascular risk factors included diabetes, high cholesterol, high blood pressure, obesity, insufficient physical activity, suboptimal sleep, and nicotine exposure. Among 6395 Asian adults aged ≥18 years, 22.1% self‐identified as Filipino, 21.6% as Asian Indian, 21.0% as Chinese, and 35.3% as other Asian. From multivariable‐adjusted logistic regression models, each SD increment of SDOH score was associated with higher odds of diabetes among Chinese (odds ratio [OR], 1.45; 95% CI, 1.04–2.03) and Filipino (OR, 1.24; 95% CI, 1.02–1.51) adults; high blood pressure among Filipino adults (OR, 1.28; 95% CI, 1.03–1.60); insufficient physical activity among Asian Indian (OR, 1.42; 95% CI, 1.22–1.65), Chinese (OR, 1.58; 95% CI, 1.33–1.88), and Filipino (OR, 1.24; 95% CI, 1.06–1.46) adults; suboptimal sleep among Asian Indian adults (OR, 1.20; 95% CI, 1.01–1.42); and nicotine exposure among Chinese (OR, 1.56; 95% CI, 1.15–2.11) and Filipino (OR, 1.50; 95% CI, 1.14–1.97) adults.

Conclusions

Unfavorable SDOH are associated with higher odds of cardiovascular risk factors in Asian American subgroups. Culturally specific interventions addressing SDOH may help improve cardiovascular health among Asian Americans.
Multiple Object Tracking Without Pre-attentive Indexing
Authors: Ayare Shubhamkar , Srivastava Nisheeth
Published: April 2024

Multiple object tracking (MOT) involves simultaneous tracking of a certain number of target objects amongst a larger set of objects as they all move unpredictably over time. The prevalent explanation for successful target tracking by humans in MOT involving visually identical objects is based on the Visual Indexing Theory. This assumes that each target is indexed by a pointer using a non-conceptual mechanism to maintain an object’s identity even as its properties change over time. Thus, successful tracking requires successful indexing and the absence of identification errors. Identity maintenance and successful tracking are measured in terms of identification (ID) and tracking accuracy respectively, with higher accuracy indicating better identity maintenance or better tracking. Existing evidence suggests that humans have high tracking accuracy despite poor identification accuracy, suggesting that it might be possible to perform MOT without indexing. Our work adds to existing evidence for this position through two experiments, and presents a computational model of multiple object tracking that does not require indexes. Our empirical results show that identification accuracy is aligned with tracking accuracy in humans for tracking up to three, but is lower when tracking more objects. Our computational model of MOT without indexing accounts for several empirical tracking accuracy patterns shown in earlier studies, reproduces the dissociation between tracking and identification accuracy produced earlier in the literature as well as in our experiments, and makes several novel predictions.
Preliminary Evidence for Global Properties in Human Listeners During Natural Auditory Scene Perception
Authors: McMullin Margaret A. , Kumar Rohit , Higgins Nathan C. , Gygi Brian , Elhilali Mounya , Snyder Joel S.
Published: April 2024

Theories of auditory and visual scene analysis suggest the perception of scenes relies on the identification and segregation of objects within it, resembling a detail-oriented processing style. However, a more global process may occur while analyzing scenes, which has been evidenced in the visual domain. It is our understanding that a similar line of research has not been explored in the auditory domain; therefore, we evaluated the contributions of high-level global and low-level acoustic information to auditory scene perception. An additional aim was to increase the field’s ecological validity by using and making available a new collection of high-quality auditory scenes. Participants rated scenes on 8 global properties (e.g., open vs. enclosed) and an acoustic analysis evaluated which low-level features predicted the ratings. We submitted the acoustic measures and average ratings of the global properties to separate exploratory factor analyses (EFAs). The EFA of the acoustic measures revealed a seven-factor structure explaining 57% of the variance in the data, while the EFA of the global property measures revealed a two-factor structure explaining 64% of the variance in the data. Regression analyses revealed each global property was predicted by at least one acoustic variable (R2 = 0.33–0.87). These findings were extended using deep neural network models where we examined correlations between human ratings of global properties and deep embeddings of two computational models: an object-based model and a scene-based model. The results support that participants’ ratings are more strongly explained by a global analysis of the scene setting, though the relationship between scene perception and auditory perception is multifaceted, with differing correlation patterns evident between the two models. Taken together, our results provide evidence for the ability to perceive auditory scenes from a global perspective. Some of the acoustic measures predicted ratings of global scene perception, suggesting representations of auditory objects may be transformed through many stages of processing in the ventral auditory stream, similar to what has been proposed in the ventral visual stream. These findings and the open availability of our scene collection will make future studies on perception, attention, and memory for natural auditory scenes possible.
Two new cavernicolous species of Pseudochthonius Balzan, 1892 (Pseudoscorpiones, Chthoniidae) from Lagoa Santa karst, Minas Gerais, Brazil
Authors: SCHIMONSKY DIEGO MONTEIRO VON
Published: April 2024

Two new pseudoscorpion species of the genus Pseudochthonius Balzan, 1892 are described from caves in the Lagoa Santa karst area in Southeast Brazil. Pseudochthonius limettioides sp. nov. was collected in ten caves and is a troglobite that lacks eyes and body pigmentation. Pseudochthonius lundi sp. nov. was collected in three caves and is considered a troglophile with only one pair of eyes. Both species might be threatened by mining projects and more studies are needed to better understand many aspects of their biology.
Ostracism Experiences of Sexual Minorities: Investigating Targets’ Experiences and Perceptions by Others
Authors: Büttner Christiane M. , Rudert Selma C. , Kachel Sven
Published: April 2024

Lesbian, gay, and bisexual (LGB) people face frequent discrimination, maltreatment, and violence for transgressing gender roles upheld in heteronormative societies. Ostracism (i.e., being excluded and ignored) is likely another, understudied form of discrimination against sexual minorities. In a multi-method approach using a nationally representative panel ( N = 4104) and experience sampling data ( N = 467, 14 days, k = 926 ostracism experiences), we find that LGB individuals report more ostracism experiences than straight individuals. In line with the idea that ostracism toward sexual minorities occurs as a function of gender role nonconformity, lesbians and gay men are rated by an independent rater sample as more likely to be ostracized ( k = 10,760 ratings) when they are also rated as more lesbian/gay and less gender role conforming. Our findings speak in favor of ostracism as a discriminatory experience of LGB individuals that is driven by transgressions of heteronormativity.
Capivasertib: A Novel AKT Inhibitor Approved for Hormone-Receptor-Positive, HER-2-Negative Metastatic Breast Cancer
Authors: Luboff Alexa J. , DeRemer David L.
Published: April 2024

Objective:

To review the pharmacology, efficacy, and safety of capivasertib for the treatment of adults with hormone receptor-positive, HER2-negative (HR+/HER2–) locally advanced or metastatic breast cancer with 1 or more PIK3CA/AKT1/PTEN alterations.

Data sources:

A literature search was conducted using PubMed and MEDLINE databases, published abstracts, and studies from ClinicalTrials.gov between 2003 and February 2024. Keywords included capivasertib, AZD5363, PI3K/AKT/mTOR pathway, and breast cancer.

Data extraction:

All applicable publications, package inserts, meeting abstracts, and clinical trials with capivasertib were reviewed.

Data synthesis:

Capivasertib is a first-in-class inhibitor of 3 isoforms of AKT (AKT-1, AKT-2, and AKT-3) which is an essential component in the PI3K/AKT/mTOR signaling pathway involved in oncogenesis. In the phase III CAPItello-291 trial, capivasertib in combination with fulvestrant (C+F) demonstrated improved progression-free survival (PFS) (7.3 vs 3.1 months) compared with placebo-fulvestrant (P+F) cohort in AKT-altered pathway patients who had progressed through prior aromatase inhibitor. The most common adverse reactions of any grade reported in the C+F group were diarrhea, cutaneous skin reactions, nausea, fatigue, and vomiting.

Relevance to patient care and clinical practice in comparison with existing drugs:

HR+/HER2– advanced breast cancer patients experience progression following endocrine therapies and cyclin-dependent kinase (CDK) 4/6 inhibitors. Capivasertib is a viable treatment option for patients with PIK3CA/AKT1/PTEN activating mutations following progression on endocrine-based regimens in the metastatic setting or recurrence within 12 months of completing adjuvant therapy.

Conclusion:

Integration of capivasertib into clinical practice is ongoing; intermittent dosing and favorable toxicity are attractive for future novel combination prospective trials.
Comparative analysis of proteomic adaptations in Enterococcus faecalis and Enterococcus faecium after long term bile acid exposure
Authors: Dreyer Annika , Lenz Christof , Groß Uwe , Bohne Wolfgang , Zautner Andreas Erich
Published: April 2024

Background

All gastrointestinal pathogens, including Enterococcus faecalis and Enterococcus faecium, undergo adaptation processes during colonization and infection. In this study, we investigated by data-independent acquisition mass spectrometry (DIA-MS) two crucial adaptations of these two Enterococcus species at the proteome level. Firstly, we examined the adjustments to cope with bile acid concentrations at 0.05% that the pathogens encounter during a potential gallbladder infection. Therefore, we chose the primary bile acids cholic acid (CA) and chenodeoxycholic acid (CDCA) as well as the secondary bile acid deoxycholic acid (DCA), as these are the most prominent bile acids. Secondly, we investigated the adaptations from an aerobic to a microaerophilic environment, as encountered after oral-fecal infection, in the absence and presence of deoxycholic acid (DCA).

Results

Our findings showed similarities, but also species-specific variations in the response to the different bile acids. Both Enterococcus species showed an IC50 in the range of 0.01- 0.023% for DCA and CDCA in growth experiments and both species were resistant towards 0.05% CA. DCA and CDCA had a strong effect on down-expression of proteins involved in translation, transcription and replication in E. faecalis (424 down-expressed proteins with DCA, 376 down-expressed proteins with CDCA) and in E. faecium (362 down-expressed proteins with DCA, 391 down-expressed proteins with CDCA). Proteins commonly significantly altered in their expression in all bile acid treated samples were identified for both species and represent a “general bile acid response”. Among these, various subunits of a V-type ATPase, different ABC-transporters, multi-drug transporters and proteins related to cell wall biogenesis were up-expressed in both species and thus seem to play an essential role in bile acid resistance. Most of the differentially expressed proteins were also identified when E. faecalis was incubated with low levels of DCA at microaerophilic conditions instead of aerobic conditions, indicating that adaptations to bile acids and to a microaerophilic atmosphere can occur simultaneously.

Conclusions

Overall, these findings provide a detailed insight into the proteomic stress response of two Enterococcus species and help to understand the resistance potential and the stress-coping mechanisms of these important gastrointestinal bacteria.
Guillain–Barre syndrome of acute motor axonal neuropathy (AMAN) type associated with herpes zoster: a case report
Authors: Wanninayake Leonard , Rajapaksha Dilani , Nair Narmada , Gunarathne Kamal , Ranawaka Udaya
Published: April 2024

Guillain Barre syndrome (GBS) following Varicella zoster is a rare presentation and has only been reported in a few cases around the world. Of the reported cases, the type of GBS is not specified in the majority, and where specified is of the acute inflammatory demyelinating polyradiculoneuropathy (AIDP) type. We report a case of acute motor axonal neuropathy (AMAN) type GBS following herpes zoster in a 27-year-old male who presented with bilateral lower limb weakness and left sided lower motor neuron type facial nerve palsy a week after herpes zoster infection.
Impact of recipient and donor pretransplantation body mass index on early postosperative complications after lung transplantation
Authors: Atchade E. , De Tymowski C. , Lepitre E. , Zappella N. , Snauwaert A. , Jean-Baptiste S. , Tran-Dinh A. , Lortat-Jacob B. , Messika J. , Mal H. , Mordant P. , Castier Y. , Tanaka S. , Montravers P.
Published: April 2024

Background

Prior studies have assessed the impact of the pretransplantation recipient body mass index (BMI) on patient outcomes after lung transplantation (LT), but they have not specifically addressed early postoperative complications. Moreover, the impact of donor BMI on these complications has not been evaluated. The first aim of this study was to assess complications during hospitalization in the ICU after LT according to donor and recipient pretransplantation BMI.

Methods

All the recipients who underwent LT at Bichat Claude Bernard Hospital, Paris, between January 2016 and August 2022 were included in this observational retrospective monocentric study. Postoperative complications were analyzed according to recipient and donor BMIs. Univariate and multivariate analyses were also performed. The 90-day and one-year survival rates were studied. P < 0.05 was considered to indicate statistical significance. The Paris-North Hospitals Institutional Review Board approved the study.

Results

A total of 304 recipients were analyzed. Being underweight was observed in 41 (13%) recipients, a normal weight in 130 (43%) recipients, and being overweight/obese in 133 (44%) recipients. ECMO support during surgery was significantly more common in the overweight/obese group (p = 0.021), as were respiratory complications (primary graft dysfunction (PGD) (p = 0.006), grade 3 PDG (p = 0.018), neuroblocking agent administration (p = 0.008), prone positioning (p = 0.007)), and KDIGO 3 acute kidney injury (p = 0.036). However, pretransplantation overweight/obese status was not an independent risk factor for 90-day mortality. An overweight or obese donor was associated with a decreased PaO2/FiO2 ratio before organ donation (p < 0.001), without affecting morbidity or mortality after LT.

Conclusion

Pretransplantation overweight/obesity in recipients is strongly associated with respiratory and renal complications during hospitalization in the ICU after LT.
Perception, practice, and barriers toward research among pediatric undergraduates: a cross-sectional questionnaire-based survey
Authors: Zhan Canyang , Zhang Yuanyuan
Published: April 2024

Background

Scientific research activities are crucial for the development of clinician-scientists. However, few people pay attention to the current situation of medical research in pediatric medical students in China. This study aims to assess the perceptions, practices and barriers toward medical research of pediatric undergraduates.

Methods

This cross-sectional study was conducted among third-year, fourth-year and fifth-year pediatric students from Zhejiang University School of Medicine in China via an anonymous online questionnaire. The questionnaires were also received from fifth-year students majoring in other medicine programs [clinical medicine (“5 + 3”) and clinical medicine (5-year)].

Results

The response rate of pediatric undergraduates was 88.3% (68/77). The total sample of students enrolled in the study was 124, including 36 students majoring in clinical medicine (“5 + 3”) and 20 students majoring in clinical medicine (5-year). Most students from pediatrics (“5 + 3”) recognized that research was important. Practices in scientific research activities are not satisfactory. A total of 51.5%, 35.3% and 36.8% of the pediatric students participated in research training, research projects and scientific article writing, respectively. Only 4.4% of the pediatric students contributed to publishing a scientific article, and 14.7% had attended medical congresses. None of them had given a presentation at a congress. When compared with fifth-year students in the other medicine program, the frequency of practices toward research projects and training was lower in the pediatric fifth-year students. Lack of time, lack of guidance and lack of training were perceived as the main barriers to scientific work. Limited English was another obvious barrier for pediatric undergraduates. Pediatric undergraduates preferred to participate in clinical research (80.9%) rather than basic research.

Conclusions

Although pediatric undergraduates recognized the importance of medical research, interest and practices in research still require improvement. Lack of time, lack of guidance, lack of training and limited English were the common barriers to scientific work. Therefore, research training and English improvement were recommended for pediatric undergraduates.
Empowerment of individuals in Iranian health systems: a qualitative study using the Z-cognitive map approach
Authors: Izadi Mostafa , Seiti Hamidreza
Published: April 2024

The empowerment of people is considered as one of the most effective approaches in national healthcare systems. Identifying the effective criteria for this empowerment approach can be useful for planning enhancements. Therefore, studying and researching different aspects of people empowerment, and identifying the various relationships among related factors are of great importance. In this study – after identifying and extracting the effective factors in empowering individuals/insured persons, and interviewing health insurance and healthcare experts through content analysis – a causal model examining variables and their impact intensity through cognitive mapping is designed and drawn up. In modeling the concept of empowerment, to cover the ambiguity of expert comments, a combination of the Z-number approach with cognitive mapping has been used. Results demonstrate how various factors relate to insured empowerment. According to the results of empowerment strategies, the insurance participation strategy with the highest central index was determined as the most effective strategy, and the appropriate component for individuals gained the highest score in the centrality index. The results of this article help a lot to policy making in medical insurance.
Early age at menarche and history of sexually transmitted infections significantly predict cervical cancer screening uptake among women aged 25–49 years: evidence from the 2021 Côte d’Ivoire demographic and health survey
Authors: Okyere Joshua , Ayebeng Castro , Dickson Kwamena Sekyi
Published: April 2024

Introduction

Cervical cancer is the second dominant type of cancer among Ivorian women with an estimated age-standardised incidence and mortality rate of 31.2 cases and 22.8 deaths per 100,000 women in 2020, respectively. The Ivorian government through its Ministry of Health implemented the National Cancer Control Programme (NCCP) in 2003 with the aim of improving the prevention, early detection and treatment of cancers in Côte d’Ivoire. Yet, there is a low uptake of CCS (1.2%). Thus, making CCS uptake an important public health concern in the country. Understanding of the extent to which reproductive factors predict CCS uptake is limited in literature. This study aimed to investigate reproductive factors as a predictor of women’s uptake of CCS in Côte d’Ivoire.

Methods

Data from the 2021 Côte d’Ivoire Demographic and Health Survey. A sample of 9,078 women aged 25–49 years were analyzed. The outcome variable was CCS uptake while other variables considered included age at menarche, history of STI, sexual debut, parity, age, educational level, wealth index, health insurance, place of residence, and media exposure. A multivariable logistic regression model was fitted to examine the association between the outcome of interest and predictors at 95% confidence interval.

Results

Approximately, 7.52% of women aged 25–49 years had ever undergone testing for cervical cancer by a healthcare provider. Early menarche was associated with lower odds of CCS uptake [AOR = 0.78; CI = 0.65–0.95]. Compared to those who had no STI, women with a history of STI were more likely to screen for cervical cancer [AOR = 2.63; CI = 2.02–3.42]. Increasing age, higher educational attainment, having health insurance, and being exposed to media were significantly associated with CCS uptake.

Conclusion

In Cote d’Ivoire, age at menarche and STI history constitute reproductive factors that were significantly associated with women’s uptake of CCS. It is imperative for public policy to focus on increasing CCS in these higher-risk women (i.e., women who experienced early menarche, women with early sexual debut and higher parity) through increased sensitization on cervical cancer risk factors.
Trends in antidiabetic drug use and expenditure in public hospitals in Northwest China, 2012-21: a case study of Gansu Province
Authors: Cao Wenxuan , Feng Hu , Yang Yaya , Wang Lei , Wang Xuemei , Ma Yongheng , Zhao Defang , Hu Xiaobin
Published: April 2024

Background

Since the twenty-first century, the prevalence of diabetes has risen globally year by year. In Gansu Province, an economically underdeveloped province in northwest China, the cost of drugs for diabetes patients accounted for one-third of their total drug costs. To fundamentally reduce national drug expenditures and the burden of medication on the population, the relevant departments of government have continued to reform and improve drug policies. This study aimed to analyse long-term trends in antidiabetic drug use and expenditure in Gansu Province from 2012 to 2021 and to explore the role of pharmaceutical policy.

Methods

Data were obtained from the provincial centralised bidding and purchasing (CBP) platform. Drug use was quantified using the anatomical therapeutic chemistry/defined daily dose (ATC/DDD) method and standardised by DDD per 1000 inhabitants per day (DID), and drug expenditure was expressed in terms of the total amount and defined daily cost (DDC). Linear regression was used to analyse the trends and magnitude of drug use and expenditure.

Results

The overall trend in the use and expenditure of antidiabetic drugs was on the rise, with the use increasing from 1.04 in 2012 to 16.02 DID in 2021 and the expenditure increasing from 48.36 in 2012 to 496.42 million yuan in 2021 (from 7.66 to 76.95 million USD). Some new and expensive drugs changed in the use pattern, and their use and expenditure shares (as the percentage of all antidiabetic drugs) increased from 0 to 11.17% and 11.37%, but insulins and analogues and biguanides remained the most used drug class. The DDC of oral drugs all showed a decreasing trend, but essential medicines (EMs) and medical insurance drugs DDC gradually decreased with increasing use. The price reduction of the bid-winning drugs was over 40%, and the top three drugs were glimepiride 2mg/30, acarbose 50mg/30 and acarbose 100mg/30.

Conclusions

The implementation of pharmaceutical policies has significantly increased drug use and expenditure while reducing drug prices, and the introduction of novel drugs and updated treatment guidelines has led to changes in use patterns.
Identifying changes in dynamic plantar pressure associated with radiological knee osteoarthritis based on machine learning and wearable devices
Authors: Li Gege , Li Shilin , Xie Junan , Zhang Zhuodong , Zou Jihua , Yang Chengduan , He Longlong , Zeng Qing , Shu Lin , Huang Guozhi
Published: April 2024

Background

Knee osteoarthritis (KOA) is an irreversible degenerative disease that characterized by pain and abnormal gait. Radiography is typically used to detect KOA but has limitations. This study aimed to identify changes in plantar pressure that are associated with radiological knee osteoarthritis (ROA) and to validate them using machine learning algorithms.

Methods

This study included 92 participants with variable degrees of KOA. A modified Kellgren–Lawrence scale was used to classify participants into non-ROA and ROA groups. The total feature set included 210 dynamic plantar pressure features captured by a wearable in-shoe system as well as age, gender, height, weight, and body mass index. Filter and wrapper methods identified the optimal features, which were used to train five types of machine learning classification models for further validation: k-nearest neighbors (KNN), support vector machine (SVM), random forest (RF), AdaBoost, and eXtreme gradient boosting (XGBoost).

Results

Age, the standard deviation (SD) of the peak plantar pressure under the left lateral heel (f_L8PPP_std), the SD of the right second peak pressure (f_Rpeak2_std), and the SD of the variation in the anteroposterior displacement of center of pressure (COP) in the right foot (f_RYcopstd_std) were most associated with ROA. The RF model with an accuracy of 82.61% and F1 score of 0.8000 had the best generalization ability.

Conclusion

Changes in dynamic plantar pressure are promising mechanical biomarkers that distinguish between non-ROA and ROA. Combining a wearable in-shoe system with machine learning enables dynamic monitoring of KOA, which could help guide treatment plans.
Natural products as potential drug treatments for acute promyelocytic leukemia
Authors: Chen Jiaxin , Ding Zuoqi
Published: April 2024

Acute promyelocytic leukemia (APL), which was once considered one of the deadliest types of leukemia, has become a curable malignancy since the introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) as clinical treatments. ATO, which has become the first-line therapeutic agent for APL, is derived from the natural mineral product arsenic, exemplifying an important role of natural products in the treatment of APL. Many other natural products, ranging from small-molecule compounds to herbal extracts, have also demonstrated great potential for the treatment and adjuvant therapy of APL. In this review, we summarize the natural products and representative components that have demonstrated biological activity for the treatment of APL. We also discuss future directions in better exploring their medicinal value, which may provide a reference for subsequent new drug development and combination therapy programs.
Impacts of attacks to female health care workers in three territories of Colombia
Authors: Echeverry-López María Esperanza , Marín-Uribe Alejandra , Garcés-Palacio Isabel C. , Borrero-Ramírez Yadira , Hernández-Holguin Dora María , Pacheco-Sánchez Carlos Iván , Haar Rohini J.
Published: April 2024

Background

This study explores the impacts of attacks perpetrated in the context of armed conflict, to female health workers in three Colombian territories.

Methods

We conducted a document review of the reports and databases of the Colombian Truth Commission, 17 in-depth semi-structured interviews with experts on the national and regional armed conflict and the medical mission, and 26 female health workers who were victims of attacks.

Results

Experts and female health workers reported attacks to health activities, facilities, equipment, and personnel, including attacks to traditional doctors belonging to indigenous communities. The most frequent attacks were threats and retention of health personnel; theft of supplies and medicines; damage and use of infrastructure and means of transport for purposes other than health care; and hinderance of health service provision. The attacks occurred in a framework of structural violence that intersects with poverty, racism, and gender bias. The impacts of these attacks include gender-based violence, significant disruption of the lives of health workers, and physical, emotional, psychological, social, and economic effects on the victims and their families. The government response to protect victims and populations has been absent or insufficient.

Conclusions

Attacks to health care were reported in all the studied territories obstructing adequate health care. Impacts of these attacks affect negatively the professional and personal life of the workers and are aggravated by structural violence and absent or little institutional response.
Birth weight and premature ovarian insufficiency: a systematic review and meta-analysis
Authors: Jiang Chengyang , Gao Tongqing , Wang Yuwei , Yang Wenqiang , Huang Huan , Li Yushan , Yang Xinghai
Published: April 2024

Objective

To comprehensively evaluate the effect of low birth weight on premature ovarian insufficiency.

Methods

We performed a systematic review of the literature by searching MEDLINE, EMBASE, Web of Science, Scopus, Wanfang and CNKI up to August 2023. All cohort and case-control studies that included birth weight as an exposure and premature ovarian insufficiency as an outcome were included in the analysis. Data were combined using inverse-variance weighted meta-analysis with fixed and random effects models and between-study heterogeneity evaluated. We evaluated risk of bias using the Newcastle Ottawa Scale and using Egger’s method to test publication bias. All statistical analyses were performed with the use of R software.

Results

Five articles were included in the review. A total of 2,248,594 women were included, including 21,813 (1%) cases of premature ovarian insufficiency, 150,743 cases of low birth weight, and 220,703 cases of macrosomia. We found strong evidence that changed the results of the previous review that low birth weight is associated with an increased risk of premature ovarian insufficiency (OR = 1.15, 95%CI 1.09–1.22) in adulthood compared with normal birth weight. No effect of macrosomia on premature ovarian insufficiency was found.

Conclusions

Our meta-analysis showed strong evidence of an association between low birth weight and premature ovarian insufficiency. We should reduce the occurrence of low birth weight by various methods to avoid the occurrence of premature ovarian insufficiency.
5-EPIFAT trial protocol: a multi-center, randomized, placebo-controlled trial of the efficacy of pharmacotherapy for fatigue using methylphenidate, bupropion, ginseng, and amantadine in advanced cancer patients on active treatment
Authors: Miladinia Mojtaba , Jahangiri Mina , White Sharon Jackson , Karimpourian Hossein , Inno Alessandro , Chan Sally Wai-Chi , Ganji Reza , Maniati Mahmood , Zarea Kourosh , Ghalamkari Marziyeh , Farahat Ali , Fagerström Cecilia
Published: April 2024

Background

Cancer-related fatigue (CRF) is still undertreated in most patients, as evidence for pharmacological treatments is limited and conflicting. Also, the efficacy of the pharmacological agents relative to each other is still unclear. Therefore, medications that may potentially contribute to improving CRF will be investigated in this head-to-head trial. Our main objective is to compare the efficacy of methylphenidate vs. bupropion vs. ginseng vs. amantadine vs. placebo in patients with advanced cancer.

Methods

The 5-EPIFAT study is a 5-arm, randomized, multi-blind, placebo-controlled, multicenter trial that will use a parallel-group design with an equal allocation ratio comparing the efficacy and safety of four medications (Methylphenidate vs. Bupropion vs. Ginseng vs. Amantadine) versus placebo for management of CRF. We will recruit 255 adult patients with advanced cancer who experience fatigue intensity ≥ 4 based on a 0–10 scale. The study period includes a 4-week intervention and a 4-week follow-up with repeated measurements over time. The primary outcome is the cancer-related fatigue level over time, which will be measured by the functional assessment of chronic illness therapy-fatigue (FACIT-F) scale. To evaluate safety, the secondary outcome is the symptomatic adverse events, which will be assessed using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events in cancer clinical trials (PRO-CTCAE). Also, a subgroup analysis based on a decision tree-based machine learning algorithm will be employed for the clinical prediction of different agents in homogeneous subgroups.

Discussion

The findings of the 5-EPIFAT trial could be helpful to guide clinical decision-making, personalization treatment approach, design of future trials, as well as the development of CRF management guidelines.

Trial registration

IRCT.ir IRCT20150302021307N6. Registered on 13 May 2023.