bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends of intestinal parasites among the patients attended at Yabelo General Hospital, Borena Zone, Southern Ethiopia
Authors: Aliyo Alqeer , Geleto Abdurahman
Published: December 2022

Objectives:

Intestinal parasitic infections (IPIs) still cause a major public health problem in developing countries. The most affected populations are those with low socioeconomic status, lack of latrines, inadequate water supply, and poor hygiene like in pastoralist community areas in Ethiopia. Therefore, the study assessed the trends of intestinal parasites among the patients attended at Yabelo General Hospital, Southern Ethiopia, from 2019 to 2021.

Methods:

This retrospective study was conducted on 6108 patients and recorded data from Yabelo General Hospital, which were extracted using a checklist. The complete data of sex, age, and laboratory stool examination result in the record book were included in the study. The data were double-entered using EpiData version 3 and exported to the Statistical Package for Social Sciences version 16 for analysis. The associated factors were analyzed using chi-square and a p-value <0.05 was considered statistically significant. The results were presented in tables, pie charts, and graphs.

Results:

The overall prevalence of intestinal parasites among the patients who attended Yabelo General Hospital was 48%. Of these, 37.8% (2310) were intestinal protozoa, and 10.2% (624) were intestinal helminths. The study indicates that 59% of patients aged above 45 years were seen infected with intestinal parasites. Of the total suspected patients, 2% (123) were found to have mixed parasite infections. The most reported parasites were Entamoeba histolytica/Entamoeba Dispar 22.6%, Giardia lamblia 15.3%, and Ascaris lumbricoides 1.8%. The trend analysis of intestinal parasites revealed that the overall prevalence declined from 55% in 2019 to 42.3% in 2021.

Conclusion:

The prevalence of IPI was high among patients seen at Yabelo General Hospital. The analysis showed that the prevalence declined from 2019 to 2021. To sustain the decrease in prevalence, all intestinal parasite prevention measures should be continuously exercised in the area.
Psychosocial experiences of patients diagnosed with COVID-19 at a teaching hospital in Ghana
Authors: Osei Evans Appiah , Oti-Boadi Ezekiel , Agyeman-Yeboah Joana , Hennor Emilia , Ofosuwaa Bertha , Agyeiwaa Joyce , Elikplem Ruby
Published: December 2022

Objectives:

The number of people affected with COVID-19 keeps rising globally resulting in increasing fear and anxiety among patients and their families. However, literature on the psychosocial experiences of these patients with COVID-19 in Africa is limited. Hence, this research explored the psychosocial experiences of patients infected with COVID-19 and undergoing treatment.

Methods:

The study employed a qualitative phenomenological approach. The sampling technique chosen for this study was purposive with a sample size of 34 determined by data saturation. Participants were selected from Korle-Bu Teaching Hospital, Ghana, and were interviewed face-face using a semi-structured interview guide. Data were analyzed using Interpretive Phenomenological Analysis.

Results:

Two main themes and seven sub-themes were generated from this study. The two themes included emotional burden of COVID-19 patients and effects of COVID-19 on patients and relatives. Sub-themes formulated under the emotional burden were reactions to COVID-19 diagnosis, suicidal thoughts, and sadness by fear of the unknown. Social restriction/isolation, stigmatization and disclosure, effect of COVID-19, and positive attitudes of staff emerged under the effect of COVID-19 on patients and relatives.

Conclusion:

Even though the recovery rate of COVID-19 has improved since the introduction of the COVID-19 vaccine, there is generally a global surge with respect to the incidence of the condition and an increasing number of patients on admission. Most interventions are targeted at the prevention of the disease than the effect of the psychosocial experience on the quality of life of the individuals affected which is equally essential. It is therefore recommended that current studies focus on improving the quality of life of those affected.
A congenital extranasal glioma in a newborn
Authors: Bailey Nicole A
Published: December 2022

Nasal gliomas are extremely rare in neonates with an incidence of 1 in 20,000 to 40,000. They often are asymptomatic but can present with respiratory distress depending on the size and location of the tumor. A newborn female was prenatally diagnosed with a left nasal mass. After her birth, she was transferred to a local children’s hospital for subspecialty evaluation and for diagnostic imaging. The mass was resected at 1 year of age. Pathology confirmed a nasal glioma. Several weeks after surgery, a nasal prosthetic device was applied to correct the nasal deformity caused by the pressure effect of the tumor. At almost 1 year of age, there was no evidence of metastasis or recurrence of the nasal glioma. The prognosis and outcome tend to be favorable. The rare case of a neonate with a congenital nasal glioma is presented.
Tetralogy of Fallot Repair After Neonatal Right Ventricular Outflow Tract Stenting: Initial Multicenter Experience in Argentina
Authors: Juaneda Ignacio , Peirone Alejandro , Diaz Juan , Azar Irma , Molinas Rodrigo , Guevara Antonio , Despuy Juan , Juaneda Ernesto
Published: December 2022

Initial management of patients with tetralogy of Fallot, unfavorable anatomy, and reduced pulmonary blood flow is controversial and continues to be a clinical challenge. Pulmonary to systemic shunt anastomosis or primary correction in neonates and small infants is associated with higher morbimortality and increased number of reoperations. Initial right ventricle outflow tract stenting palliation has emerged as an attractive alternative. We report our experience in 14 patients operated on with tetralogy of Fallot and previous right ventricle outflow tract stenting from March 2018 to June 2022. All stented patients had pulmonary annulus and main pulmonary artery Z score ≤ −2.5. Surgical outcomes, complications, and mortality at 30 days were evaluated. Patient's age and weight at surgery were 5.9 months (2-17) and 6.1 kg (3.9-8.9), respectively. Stents were completely removed in 57.1% of patients. A transannular patch was placed in 10 patients, 3 patients required a right ventricle to pulmonary artery conduit due to coronary anomalies and in 1 patient, the pulmonary valve was preserved. Length of stay and ventilation time were 13.6 days (5-27) and 44.8 h (6-44), respectively. Mean time for right ventricle outflow tract stent implantation to surgical correction was 4 months (2-16). There was no mortality, and mean follow-up time of this cohort was 23.1 month (1-41). Surgical correction of severe tetralogy of Fallot after right ventricle outflow tract stenting is an effective alternative achievable without an increase in morbidity and mortality. Difficulty in stent extraction is related to the time since implantation. More number of patients and longer follow-up time are needed to confirm these initial results.
Reliability of the ISAKOS Modification to Subclassify Rockwood Type III Acromioclavicular Joint Injuries
Authors: Velasquez Garcia Ausberto , Abdo Glen
Published: December 2022

Background:

To improve clinical management, the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) developed a specific subclassification of Rockwood type III acromioclavicular (AC) injuries: IIIA (no overriding distal clavicle) and IIIB (overriding distal clavicle).

Purpose/Hypothesis:

The study aimed to determine the inter- and intraobserver reliability of the radiographic classification proposed by ISAKOS for AC injuries. It was hypothesized that the strength of agreement for the ISAKOS modification will be substantial to almost perfect.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

We evaluated 40 radiographs of all types of AC joint injuries from patients at a single institution. The images were distributed to 6 shoulder and elbow fellowship–trained orthopaedic surgeons, along with standardized assessment questionnaires. The evaluators measured the bilateral coracoclavicular distance and the coracoclavicular ratio and classified the severity of the injuries according to the modified ISAKOS Rockwood classification. Four of the surgeons repeated the evaluation 6 weeks later to calculate intraobserver agreement. The kappa (κ) statistic was calculated for categorical inter- and intraobserver reliability. Intraclass correlation coefficient (ICC) estimates were calculated for the reliability of the coracoclavicular distance measurement. A 2-tailed test was performed to assess statistical significance.

Results:

Overall interobserver agreement was substantial (κ = 0.637; 95% CI, 0.595-0.680) among the 6 evaluators, and intraobserver agreement was also substantial among the 4 evaluators (κ = 0.616; 95% CI, 0.549-0.638). The interobserver agreement for evaluating types IIIA and IIIB was fair (κ = 0.215; 95% CI, 0.135-0.295) and moderate (κ = 0.473; 95% CI, 0.393-0.553), respectively. The agreement on the coracoclavicular distance measurements was excellent among the 6 evaluators on both the affected side (ICC, 0.982; 95% CI, 0.970-0.990) and the unaffected side (ICC, 0.930; 95% CI, 0.894-0.958).

Conclusion:

Substantial agreement was found when categorizing AC joint injuries using the ISAKOS modification of the Rockwood classification, with excellent reliability demonstrated for the quantitative assessment of vertical displacement of the clavicle. Visual examination was unreliable in differentiating type IIIA injuries from type IIIB injuries.
An experimental investigation and multi-objective optimization of abrasive jet machining on Ti-6Al-4V ELI bio-material
Authors: Tomy Anu , Hiremath Somashekhar S.
Published: December 2022

Titanium is extensively utilized in aerospace and medical scenarios owing to its outstanding mechanical properties and corrosion resistance. Conventional machining of titanium alloys is challenging because of its innate characteristics like hardness, lofty reactivity, modest thermal conductivity and elastic modulus. Therefore, an attempt has been made to study the ease with which titanium alloy (Ti-6Al-4V) can be machined using abrasive jet machining (AJM). Machining of holes in Ti-6Al-4V was executed by incorporating a group of input parameters—air pressure, abrasive grit size and standoff distance. The output responses such as material removal rate (MRR), circularity, radial overcut (ROC) and taper angle (TA) are chosen for the evaluation of the experiment. The machining parameters are optimized for higher MRR (case 1) and for lower ROC and TA (case 2) using multi-objective grey relational analysis to choose a moderate course among the output parameters.
Effects of High-Temperature Growth of Dislocation Filter Layers in GaAs-on-Si
Authors: Kim HoSung , Geum Dae-Myeong , Ko Young-Ho , Han Won-Seok
Published: December 2022

GaAs-on-Si templates with two different dislocation filter layers (DFLs) were grown at 550 °C low-temperature (LT)-DFL and 660 °C high-temperature (HT)-DFL using metal organic vapor-phase epitaxy and the effects of the growth temperature were studied. The threading dislocation density (TDD) values of LT-DFL and HT-DFL were 5.2 × 107 cm−2 and 1.5 × 107 cm−2, respectively. The 1.5 × 107 cm−2 of TDD in HT-DFL is reduced by almost one order compared to the 1.2 × 108 cm−2 of that in the control sample without DFLs. The annihilation process was mainly observed in the HT-DFL by a transmission electron microscope, resulting in a lower TDD. The 500-nm-thick GaAs bulk layer and InAs QDs were regrown on GaAs-on-Si templates and the optical properties were also evaluated by photoluminescence (PL). The highest PL peak intensity of the HT-DFL indicates that less non-radiative recombination in both the GaAs bulk and QDs occurred due to the reduced TDD. The GaAs p–i–n diodes were also fabricated to analyze the bulk leakage (JB) and the surface leakage current. The JB of HT-DFL shows the lowest value of 3.625 × 10–7 A/cm−2 at applied bias voltage of 1 V, which is 20 times lower than the JB of the control sample without DFLs. This supports that the high-temperature growth of DFL can make a good performance GaAs device on Si.
Lactobacillus spp. in the reproductive system of female moths and mating induced changes and possible transmission
Authors: Zhao Qing-Yi , Zhang Luo-Yan , Fu Da-Ying , Xu Jin , Chen Peng , Ye Hui
Published: December 2022

Background

The microbiome in the insect reproductive tract is poorly understood. Our previous study demonstrated the presence of Lactobacillus spp. in female moths, but their distribution and function remain unclear. Lactobacillus spp. are known as the ‘healthy’ vaginal microbiome in humans.

Results

Here, we studied the microbiome in the reproductive system (RS) and gut of Spodoptera frugiperda using 16S rDNA sequences. The obtained 4315 bacterial OTUs were classified into 61 phyla and 642 genera, with Proteobacteria, Firmicutes and Bacteroidota being the top three dominant phyla and Enterococcus and Asaia being dominant genera in most samples. Mating dramatically increased the abundance of pathogens or pathogenic functions in the gut, while in the RS, the change range was trivial. Taxonomy assignment identified thirteen Lactobacillus spp. in S. frugiperda, with Lactobacillus crustorum and Lactobacillus murinus showing high abundance. Three species found in S. frugiperda, namely L. reuteri, L. plantarum and L. brevis, have also been identified as human ‘healthy’ vaginal bacterial species. Lactobacillus spp. showed higher abundance in the RS of virgin females and lower abundance in the RS of virgin males and the gut of virgin females. Mating reduced their abundance in the RS of females but increased their abundance in the RS of males, especially in males mated with multiple females. The RS of virgin females and of multiple mated males were very similar in terms of composition and abundance of Lactobacillus species, with Lactobacillus crustorum showing much higher abundance in both tissues, potentially due to sexual transmission.

Conclusions

Lactobacillus spp. showed high abundance and diversity in the RS of female moths. The higher abundance of Lactobacillus spp. in the RS of female moths and the similarity of Lactobacillus species in female moths with human ‘healthy’ vaginal Lactobacillus spp. suggest that these bacterial strains are also an important microbiome in the RS of female moths.
Growth inhibition of Trichophyton rubrum by laser irradiation: exploring further experimental aspects in an in vitro evaluation study
Authors: Zhang Ruina , Zhao Junying , Li Linfeng
Published: December 2022

Background

According to the results of the clinical trials, laser therapy is effective for the treatment of onychomycosis, but the in vitro findings are inconsistent among studies. This study aimed to explore the experimental conditions of laser for the inhibition of Trichophyton rubrum growth in vitro. A 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser was used to irradiate colonies using a small (6-mm diameter) or large (13-mm diameter) area, and using 300, 408, or 600 J/cm2. The surface temperature of the colony was measured after irradiation and every 2 min. The growth area was calculated until the 7th or 10th day of incubation daily.

Results

For the small area group, at 300 J/cm2, the immediate surface temperature was 25.2 ± 0.2°C, but without effect on growth (P = 0.516). At 408 J/cm2, the immediate surface temperature was 32.0 ± 0.4°C; growth was inhibited for 7 days (P < 0.001). At 600 J/cm2, the immediate surface temperature was 38.1 ± 0.4°C; the growth was completely stopped for at least 10 days (P < 0.001). For the large area group, the temperature patterns were similar to those of the small area group, but the highest temperature was lower than in the small area groups, and no growth inhibition effect was observed (all P > 0.05).

Conclusions

When the irradiation area is small, a 1064-nm Nd:YAG laser at 408 or 600 J/cm2 can be effective in suppressing T. rubrum growth in vitro.
Validation of a simple-to-use, affordable, portable, wavefront aberrometry-based auto refractometer in the adult population: A prospective study
Authors: Rao Divya Parthasarathy , Negiloni Kalpa , Gurunathan Sivasundaravadivel , Velkumar Selvaraj , Sivaraman Anand , Baig Adeeb Ulla , Kumari B. , Murali Kaushik
Published: December 2022

Background

Refraction is one of the key components of a comprehensive eye examination. Auto refractometers that are reliable and affordable can be beneficial, especially in a low-resource community setting. The study aimed to validate the accuracy of a novel wave-front aberrometry-based auto refractometer, Instaref R20 against the open-field system and subjective refraction in an adult population.

Methods

All the participants underwent a comprehensive eye examination including objective refraction, subjective acceptance, anterior and posterior segment evaluation. Refraction was performed without cycloplegia using WAM5500 open-field auto refractometer (OFAR) and Instaref R20, the study device. Agreement between both methods was evaluated using Bland-Altman analysis. The repeatability of the device based on three measurements in a subgroup of 40 adults was assessed.

Results

The refractive error was measured in 132 participants (mean age,30.53 ± 9.36 years, 58.3% female). The paired mean difference of the refraction values of the study device against OFAR was − 0.13D for M, − 0.0002D (J0) and − 0.13D (J45) and against subjective refraction (SR) was − 0.09D (M), 0.06 (J0) and 0.03D (J45). The device agreed within +/− 0.50D of OFAR in 78% of eyes for M, 79% for J0 and 78% for J45. The device agreed within +/− 0.5D of SR values for M (84%), J0 (86%) and J45 (89%).

Conclusion

This study found a good agreement between the measurements obtained with the portable autorefractor against open-field refractometer and SR values. It has a potential application in population-based community vision screening programs for refractive error correction without the need for highly trained personnel.
A comparison of medically serious suicide attempters admitted to intensive care units versus other medically serious suicide attempters
Authors: Quesada-Franco Marta , Braquehais Mª Dolores , Valero Sergi , Beneria Anna , Ramos-Quiroga J. A. , Baca-García Enrique , Pintor-Pérez Luis
Published: December 2022

Background

Medically serious suicide attempts (MSSA) represent a subgroup of clinically heterogeneous suicidal behaviours very close to deaths by suicide. A simple definition of an MSSA is a suicide attempt with life-threatening consequences, regardless of the severity of the attempter’s mental disorder. Few studies have specifically analysed the heterogeneity of MSSA. Therefore, the aim of this study is to describe the profile of individuals who made a highly severe MSSA and to compare those admitted to Intensive Care Units (ICU) – including Burn Units– with other MSSA admitted to other medical and surgical units.

Methods

The study sample consisted of 168 patients consecutively admitted to non-psychiatric wards from two public hospitals in Barcelona after an MSSA during a 3-year period. In order to select more severe MSSA, the minimum hospital stay was expanded from Beautrais’ definition of ≥ 24 h to ≥ 48 h. Mean hospital stay was 23.68 (SD = 41.14) days. Patients needing ICU treatment (n = 99) were compared to other MSSArs (n = 69) that were admitted to other medical and surgical units, not requiring intensive care treatment, with an initial bivariant analysis followed by a logistic regression analysis using conditional entrance.

Results

Medically serious suicide attempters (MSSArs) spent more time hospitalized, more frequently reported recent stressful life events, were more likely to have at least one prior suicide attempt (SA) and their current attempt was more frequently non-planned, compared to the profile of MSSArs reported in previous studies. The most frequent method was medication overdose (67.3%) and jumping from heights (23.2%). Among those who chose more than one method (37.6%), the most frequent combination was medication overdose and drug use. Affective disorders and personality disorders were the most frequent diagnoses. Higher educational level, history of previous mental disorders and prior lifetime suicide attempts were significantly more frequent among those admitted to ICU compared to other MSSArs. Patients needing admission to ICU less frequently used self-poisoning and cuts.

Conclusions

MSSA needing ICU admission can be regarded clinically as similar to attempts resulting in suicide. More research on this type of highly severe suicide behaviour is needed due to its serious implications both from a clinical and public health perspective.
Preoperative imaging contributes to pathologically complete resection of the urachal remnant by determining an appropriate surgical approach without unnecessary and excessive surgical invasion: a retrospective study
Authors: Nakagawa Yoichi , Sumida Wataru , Amano Hizuru , Uchida Hiroo , Hinoki Akinari , Shirota Chiyoe , Makita Satoshi , Okamoto Masamune , Ogata Seiya , Takimoto Aitaro , Takada Shunya , Kato Daiki , Gohda Yousuke
Published: December 2022

Background

The urachus is an embryonic structure that connects the bladder to the allantois during early embryonic development. Occasionally, it fails to disappear at birth, leading to a case of urachal remnant (UR). This study aimed to determine whether our policy for selecting an appropriate UR resection approach is valid. We performed preoperative imaging to examine whether UR continued toward the bladder apex. If so, the UR and bladder apex were excised using the trans-umbilical approach, in addition to laparoscopy, if necessary. If preoperative imaging indicated that the UR ended near the umbilicus, the UR from the umbilicus to the duct end was resected. Pathological evaluations were performed to determine the appropriateness of the surgical approach indicated by preoperative imaging.

Methods

We retrospectively reviewed pediatric patients with UR who underwent surgery between 2015 and 2021. Their background characteristics and surgical outcomes were evaluated.

Results

Twenty patients with UR were included (median age, 7 [interquartile range, 2–10.25] years). UR continued toward the bladder apex in 10 patients and ended near the umbilicus in 10 patients. Urachus tissue at the bladder site was observed when the UR and bladder apex were excised. When UR was resected from the umbilicus to the duct end, urachus tissue was not pathologically detected at the resection margin.

Conclusion

Our policy results in complete resection without excessive surgical invasion.
Women’s experiences of living with involuntary childlessness in Uganda: a qualitative phenomenological study
Authors: Asiimwe Susan , Osingada Charles Peter , Mbalinda Scovia N. , Muyingo Mark , Ayebare Elizabeth , Namutebi Mariam , Muwanguzi Patience A.
Published: December 2022

Background

Involuntary childlessness is a global phenomenon that negatively impacts the couple, or the family involved. The experiences of women living with involuntary childlessness have not been well documented in the literature, specifically in the Ugandan context. The purpose of the study was to explore the experiences of women living with involuntary childlessness in Uganda.

Methods

A qualitative phenomenological approach was used. Fifteen in-depth interviews were conducted among women experiencing involuntary childlessness attending a National Referral Hospital. Purposive sampling was, and data saturation determined the actual sample size. Thematic analysis was used for data analysis. The results are presented in the form of text and narrative quotes from participants.

Results

Six themes emerged (i) Inadequate social support (ii) psychological torture (iii) continued grief (iv) marital instability (v) failure attributed to childlessness and (vi) financial constraints. Inadequate social support was in the form of having an unsupportive partner, altered social relation, and altered social status, while women experienced name-calling, emotional abuse, stigma, and blame under the psychological torture theme. Women experienced feelings of distress and grief, including anger, irritability, sadness, stress, and feelings of despair. Women with involuntary childlessness recounted experiencing unstable marriages characterized by infidelity, divorce, abandonment, and polygamous marriages. Some women coped positively, while others employed negative coping strategies such as social withdrawal and isolation. Women who their partners and families well supported coped positively. In contrast, those who did not receive as much support were stressed, sad, angry, and had lost hope of pregnancy.

Conclusions

In this study, women with involuntary childlessness lacked social support amidst experiences of marital turmoil, psychological torture, feelings of distress and grief, unfulfilled motherhood expectations, and financial constraints while seeking treatment, therefore, there is a need to screen the women for psychological / mental illness symptoms and provide empathetic care and counseling. The prevalence of involuntary childlessness is not well documented in Uganda and a study can be done to determine its extent.
On usage of artificial intelligence for predicting mortality during and post-pregnancy: a systematic review of literature
Authors: Silva Rocha Elisson da , de Morais Melo Flavio Leandro , de Mello Maria Eduarda Ferro , Figueiroa Barbara , Sampaio Vanderson , Endo Patricia Takako
Published: December 2022

Background

Care during pregnancy, childbirth and puerperium are fundamental to avoid pathologies for the mother and her baby. However, health issues can occur during this period, causing misfortunes, such as the death of the fetus or neonate. Predictive models of fetal and infant deaths are important technological tools that can help to reduce mortality indexes. The main goal of this work is to present a systematic review of literature focused on computational models to predict mortality, covering stillbirth, perinatal, neonatal, and infant deaths, highlighting their methodology and the description of the proposed computational models.

Methods

We conducted a systematic review of literature, limiting the search to the last 10 years of publications considering the five main scientific databases as source.

Results

From 671 works, 18 of them were selected as primary studies for further analysis. We found that most of works are focused on prediction of neonatal deaths, using machine learning models (more specifically Random Forest). The top five most common features used to train models are birth weight, gestational age, sex of the child, Apgar score and mother’s age. Having predictive models for preventing mortality during and post-pregnancy not only improve the mother’s quality of life, as well as it can be a powerful and low-cost tool to decrease mortality ratios.

Conclusion

Based on the results of this SRL, we can state that scientific efforts have been done in this area, but there are many open research opportunities to be developed by the community.
Perceptions of public health nursing Team Leaders (TLs) and Team Supervisors (TSs) on nurse’s development in Fiji
Authors: Singh Sheenal Shivangani , Mohammadnezhad Masoud , Tamani Ledua
Published: December 2022

Background

Nurse team leaders are responsible for contributing to managing the quality of service delivery and facility output of their nurses to ensure there is a high quality of care delivered by the health system. This study aimed to explore the perceptions of public health nursing Team Leaders (TLs) and public health nursing Team Supervisors (TSs) on nurses’ development in Fiji.

Methods

A qualitative study was used to gather information using in-depth phone interviews among TLs and TSs comprising Chief Midwifery Nursing Officer (CMNO), Director of Nursing (DON), Sub-divisional Nursing Managers (SDNMs), acting SDNMs and Nursing Manager (NM) at Central health division in Fiji. The data was collected through semi-structured open-ended questionnaires and were audio recorded. The data was analyzed using manual thematic analysis process.

Results

The study comprised of 26 participants, which included 10 TSs and 16 TLs. Four themes were identified for the results amongst TSs and TLs: ethical development; professional development; psychological development; and recommendations. However, nine sub- themes were identified for TSs and eight sub-themes were identified for the result amongst TLs.

Conclusion

This study highlighted that TLs and TSs elaborated on the need for the ethical, professional, psychological development, nursing development and also on the importance of policies and guidelines. Professional ethics should be integrated into the Continuous Profession Development (CPD) points that are used to renew yearly nursing licenses as well as exposing the need for having competencies on professional ethics in nurses’ logbooks. Further research is needed to determine the in-depth barriers.
The effect of time-varying capacity utilization on 14-day in-hospital mortality: a retrospective longitudinal study in Swiss general hospitals
Authors: Sharma Narayan , Moffa Giusi , Schwendimann René , Endrich Olga , Ausserhofer Dietmar , Simon Michael
Published: December 2022

Background

High bed-occupancy (capacity utilization) rates are commonly thought to increase in-hospital mortality; however, little evidence supports a causal relationship between the two. This observational study aimed to assess three time-varying covariates—capacity utilization, patient turnover and clinical complexity level— and to estimate causal effect of time-varying high capacity utilization on 14 day in-hospital mortality.

Methods

This retrospective population-based analysis was based on routine administrative data (n = 1,152,506 inpatient cases) of 102 Swiss general hospitals. Considering the longitudinal nature of the problem from available literature and expert knowledge, we represented the underlying data generating mechanism as a directed acyclic graph. To adjust for patient turnover and patient clinical complexity levels as time-varying confounders, we fitted a marginal structure model (MSM) that used inverse probability of treatment weights (IPTWs) for high and low capacity utilization. We also adjusted for patient age and sex, weekdays-vs-weekend, comorbidity weight, and hospital type.

Results

For each participating hospital, our analyses evaluated the ≥85th percentile as a threshold for high capacity utilization for the higher risk of mortality. The mean bed-occupancy threshold was 83.1% (SD 8.6) across hospitals and ranged from 42.1 to 95.9% between hospitals. For each additional day of exposure to high capacity utilization, our MSM incorporating IPTWs showed a 2% increase in the odds of 14-day in-hospital mortality (OR 1.02, 95% CI: 1.01 to 1.03).

Conclusions

Exposure to high capacity utilization increases the mortality risk of inpatients. Accurate monitoring of capacity utilization and flexible human resource planning are key strategies for hospitals to lower the exposure to high capacity utilization.
Interaction of network and rehabilitation therapy parameters in defining recovery after stroke in a Bilateral Neural Network
Authors: Elango Sundari , Francis Amal Jude Ashwin , Chakravarthy V. Srinivasa
Published: December 2022

Background

Restoring movement after hemiparesis caused by stroke is an ongoing challenge in the field of rehabilitation. With several therapies in use, there is no definitive prescription that optimally maps parameters of rehabilitation with patient condition. Recovery gets further complicated once patients enter chronic phase. In this paper, we propose a rehabilitation framework based on computational modeling, capable of mapping patient characteristics to parameters of rehabilitation therapy.

Method

To build such a system, we used a simple convolutional neural network capable of performing bilateral reaching movements in 3D space using stereovision. The network was designed to have bilateral symmetry to reflect the bilaterality of the cerebral hemispheres with the two halves joined by cross-connections. This network was then modified according to 3 chosen patient characteristics—lesion size, stage of recovery (acute or chronic) and structural integrity of cross-connections (analogous to Corpus Callosum). Similarly, 3 parameters were used to define rehabilitation paradigms—movement complexity (Exploratory vs Stereotypic), hand selection mode (move only affected arm, CIMT vs move both arms, BMT), and extent of plasticity (local vs global). For each stroke condition, performance under each setting of the rehabilitation parameters was measured and results were analyzed to find the corresponding optimal rehabilitation protocol.

Results

Upon analysis, we found that regardless of patient characteristics network showed better recovery when high complexity movements were used and no significant difference was found between the two hand selection modes. Contrary to these two parameters, optimal extent of plasticity was influenced by patient characteristics. For acute stroke, global plasticity is preferred only for larger lesions. However, for chronic, plasticity varies with structural integrity of cross-connections. Under high integrity, chronic prefers global plasticity regardless of lesion size, but with low integrity local plasticity is preferred.

Conclusion

Clinically translating the results obtained, optimal recovery may be observed when paretic arm explores the available workspace irrespective of the hand selection mode adopted. However, the extent of plasticity to be used depends on characteristics of the patient mainly stage of stroke and structural integrity. By using systems as developed in this study and modifying rehabilitation paradigms accordingly it is expected post-stroke recovery can be maximized.
Osimertinib showed efficacy on contralateral multiple ground-glass nodules after segmentectomy for lung adenocarcinoma harboring primary EGFR-T790M mutation: a case report and review of the literature
Authors: Dong Haijun , Zhang Jianbin , Min Weiwei , Shen Qibin
Published: December 2022

Background

Multiple ground-glass nodules (mGGNs) in the lung has been defined as synchronous multiple primary lung cancer (SMPLC), it is has been very difficult challenging to differentiate SMPLC from intrapulmonary metastases, and its treatment remains controversial.

Case presentation

We report a case simultaneously involving mGGNs and lung adenocarcinoma harboring primary EGFR-T790M mutation, in which the patient underwent the radical resection of lesions in the left upper lung, and continued the osimertinib treatment for the residual mGGNs in all lobes of the right lung. These mGGNs displayed different responses to osimertinib.

Conclusions

We reported a successful strategy on the postoperative treatment for mGGNs. For those that cannot be completely resected, the chemotherapy, radiotherapy, stereotactic body radiation therapy, immunotherapy and targeted therapy have been performed instead. The EGFR-TKI therapy strategy showed significant advantages, but how to achieve even better therapeutic effect needs more researches.
Resilience, well-being and informal and formal support in multi-problem families during the Covid-19 pandemic
Authors: Koper Natasha , Creemers Hanneke E. , van Dam Levi , Stams Geert Jan J. M. , Branje Susan
Published: December 2022

Background

The Covid-19 pandemic may have had negative effects on youth and parental mental health, especially in high-risk populations such as multi-problem families (i.e., families that experience problems in multiple domains, such as mental health and social network problems). Using one to four assessments during all phases of the Covid-19 pandemic up until January 2022, we examined the associations between pandemic-related stress and mental health (resilience and well-being) of youth and parents from multi-problem families. We also investigated whether experienced informal (i.e., youth informal mentoring) and formal support (i.e., therapist support) served as protective factors in this association.

Methods

A total of 92 youth aged 10–19 years (46.7% girls; mean age 16.00 years) and 78 parents (79.5% female; mean age 47.17 years) filled in one to four questionnaires between March 2020 and January 2022. Multi-level analyses were conducted to account for the nested structure of the data.

Results

For youth, pandemic-related stress was associated with lower well-being, but not with resilience. Perceived support from both mentors and therapists was positively associated with youth mental health. Furthermore, high perceived therapist support protected youth from the negative effect of pandemic-related stress on resilience. For parents, pandemic-related stress was not related to mental health, irrespective of therapist support. Yet, therapist support was directly and positively associated with parental mental health.

Conclusions

Youth from multi-problem families who experience pandemic-related stress are at risk of (elevated) mental health problems during the pandemic, specifically if they have no or weak therapist support. The mental health of parents, however, was minimally affected by pandemic-related stress, indicating strength and flexibility. Youth and parents who experienced support during the pandemic reported higher levels of resilience and well-being, demonstrating the importance of support for individuals’ mental health during stressful times such as a pandemic.
Tumor mutation burden involving epigenetic regulatory genes and the RhoA GTPase predicts overall survival in nodal mature T-cell lymphomas
Authors: de Pádua Covas Lage Luís Alberto , Culler Hebert Fabrício , Barreto Guilherme Carneiro , Reichert Cadiele Oliana , Levy Débora , de Oliveira Costa Renata , Rocha Vanderson , Pereira Juliana
Published: December 2022

Nodal mature T-cell lymphomas (nMTCL) comprises a heterogeneous group of rare malignancies with aggressive biological behavior and poor prognosis. Epigenetic phenomena, including mutations in genes that control DNA methylation and histone deacetylation, in addition to inactivating mutations in the RhoA GTPase, play a central role in its pathogenesis and constitute potential new targets for therapeutic intervention. Tumor mutational burden (TMB) reflects the process of clonal evolution, predicts response to anti-cancer therapies and has emerged as a prognostic biomarker in several solid neoplasms; however, its potential prognostic impact remains unknown in nMTCL. In this study, we conducted Sanger sequencing of formalin-fixed paraffin-embedded (FFPE) diagnostic tumor samples using a target-panel to search for recurrent mutations involving the IDH-1/IDH-2, TET-2, DNMT3A and RhoA genes in 59 cases of nMTCL. For the first time, we demonstrated that high-TMB, defined by the presence of ≥ two mutations involving the aforementioned genes, was associated with decreased overall survival in nMTCL patients treated with CHOP-like regimens. Additionally, high-TMB was correlated with bulky disease, lower overall response rate, and higher mortality. Future studies using larger cohorts may validate our preliminary results that indicate TMB as a potential molecular biomarker associated with adverse prognosis in nMTCL.
3D printing of injury-preconditioned secretome/collagen/heparan sulfate scaffolds for neurological recovery after traumatic brain injury in rats
Authors: Liu Xiao-Yin , Chang Zhe-Han , Chen Chong , Liang Jun , Shi Jian-Xin , Fan Xiu , Shao Qi , Meng Wei-Wei , Wang Jing-Jing , Li Xiao-Hong
Published: December 2022

Background

The effects of traumatic brain injury (TBI) can include physical disability and even death. The development of effective therapies to promote neurological recovery is still a challenging problem. 3D-printed biomaterials are considered to have a promising future in TBI repair. The injury-preconditioned secretome derived from human umbilical cord blood mesenchymal stem cells showed better stability in neurological recovery after TBI. Therefore, it is reasonable to assume that a biological scaffold loaded with an injury-preconditioned secretome could facilitate neural network reconstruction after TBI.

Methods

In this study, we fabricated injury-preconditioned secretome/collagen/heparan sulfate scaffolds by 3D printing. The scaffold structure and porosity were examined by scanning electron microscopy and HE staining. The cytocompatibility of the scaffolds was characterized by MTT analysis, HE staining and electron microscopy. The modified Neurological Severity Score (mNSS), Morris water maze (MWM), and motor evoked potential (MEP) were used to examine the recovery of cognitive and locomotor function after TBI in rats. HE staining, silver staining, Nissl staining, immunofluorescence, and transmission electron microscopy were used to detect the reconstruction of neural structures and pathophysiological processes. The biocompatibility of the scaffolds in vivo was characterized by tolerance exposure and liver/kidney function assays.

Results

The excellent mechanical and porosity characteristics of the composite scaffold allowed it to efficiently regulate the secretome release rate. MTT and cell adhesion assays demonstrated that the scaffold loaded with the injury-preconditioned secretome (3D-CH-IB-ST) had better cytocompatibility than that loaded with the normal secretome (3D-CH-ST). In the rat TBI model, cognitive and locomotor function including mNSS, MWM, and MEP clearly improved when the scaffold was transplanted into the damage site. There is a significant improvement in nerve tissue at the site of lesion. More abundant endogenous neurons with nerve fibers, synaptic structures, and myelin sheaths were observed in the 3D-CH-IB-ST group. Furthermore, the apoptotic response and neuroinflammation were significantly reduced and functional vessels were observed at the injury site. Good exposure tolerance in vivo demonstrated favorable biocompatibility of the scaffold.

Conclusions

Our results demonstrated that injury-preconditioned secretome/collagen/heparan sulfate scaffolds fabricated by 3D printing promoted neurological recovery after TBI by reconstructing neural networks, suggesting that the implantation of the scaffolds could be a novel way to alleviate brain damage following TBI.

Graphical abstract
High pulse pressure is associated with an increased risk of diabetes in females but not in males: a retrospective cohort study
Authors: Jia Sheng , Wang Xinyue , Yao Qing , Gao Jian
Published: December 2022

Objective

Accumulating evidence suggests a close relationship between metabolic disturbance and increased arterial stiffness. However, whether there is an association between pulse pressure (PP) and diabetes and how this association might be impacted by sex is not clear.

Methods

A total of 209,635 adult Chinese individuals > 20 years old across 32 sites and 11 cities in China (Shanghai, Beijing, Nanjing, Suzhou, Shenzhen, Changzhou, Chengdu, Guangzhou, Hefei, Wuhan, Nantong) were included in the study; participants were free of diabetes at baseline. In the present study, we analyzed the relationship between PP at baseline and incident diabetes using the Cox proportional hazard model.

Results

During a median follow-up of 2.99 years, a total of 3971 participants (2885 men and 1086 women) developed diabetes, and the incidence was 6.3 per 1000 person-years. With each 10 mmHg increase in PP, the multivariable adjusted hazard ratio (HR) (95% confidence interval) for incident diabetes was 1.117 (1.061, 1.176) in females and 0.981 (0.951, 1.012) in males. Using the lowest quartile of PP as the reference category, the hazard ratio (HR) (95% CI) of the highest quartile of PP for incident diabetes was 1.494 (1.225, 1.822) in females and 0.939 (0.843, 1.045) in males. Smooth plots revealed a significant difference between males and females in the HRs for new-onset diabetes according to PP.

Conclusion

Higher PP was related to future diabetes development in females but not in males and further research is needed to explore the mechanism.
Sex and out-of-hospital cardiac arrest survival: a systematic review
Authors: Lakbar Ines , Ippolito Mariachiara , Nassiri Aviv , Delamarre Louis , Tadger Philippe , Leone Marc , Einav Sharon
Published: December 2022

Background

The literature is unresolved on whether female receive advanced cardiac life support less than do male and on whether female have a survival advantage over male after cardiopulmonary resuscitation.

Methods

We systematically searched PubMed, Embase and Web of Science databases (from inception to 23-April-2022) for papers reporting outcomes in adult male and female after out-of-hospital cardiac arrest. The main study outcome was the rate of adjusted survival to hospital discharge or 30 days. Secondary outcomes included unadjusted survival to hospital discharge and favourable neurological outcome.

Results

A total of 28 studies were included, involving 1,931,123 patients. Female were older than male, their cardiac arrests were less likely to be witnessed and less likely to present with a shockable rhythm. Unadjusted analysis showed that females had a lower likelihood of survival than males (OR 0.68 [0.62–0.74], I2 = 97%). After adjustment, no significant difference was identified between male and female in survival at hospital discharge/30 days (OR 1.01 [0.93–1.11], I2 = 87%). Data showed that male had a significantly higher likelihood of favorable neurological outcome in unadjusted analysis but this trend disappeared after adjustment. Both the primary outcome (adjusted for several variables) and the secondary outcomes were associated with substantial heterogeneity. The variables examined using meta-regression, subgroup and sensitivity analyses (i.e., study type, location, years, population, quality of adjustment, risk of bias) did not reduce heterogeneity.

Conclusions

The adjusted rate of survival to hospital discharge/30 days was similar for male and female despite an initial seeming survival advantage for male. The validity of this finding is limited by substantial heterogeneity despite in-depth investigation of its causes, which raises concerns regarding latent inequalities in some reports nonetheless. Further study on this topic may require inclusion of factors not reported in the Utstein template and in-depth analysis of decision-making processes.