bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisiting Cultural Theory Through Baiga Dance-Songs
Authors: Raj Prithvi
Published: September 2023

Cultural theory is assumed to be a tool or set of ideas to explain, interpret or analyse cultures or cultural realities. The realisation of embracing and internalising theory as a kind of transcendental signifier, within and beyond our undertaking at the same time, fixes our attention on the validity and prevalence that theory has gained in academic circles. Its ubiquity is perhaps its strength, which sustains it and makes it indispensable across disciples. However, theory has its own internal functioning, often stopping it from achieving the desired results. There is a constant need to weigh theories before we use them as tools to analyse something. The central concern of this article is to interrogate the validity and legitimacy of cultural theory to deal with problems arising in contextualising cultural theories to frame Baiga dance-songs and consequent issues arising out of it. The article points out an inherent discrepancy in cultural theory through Biaga dance-songs.
Renal cell carcinoma on imaging unveiled as a primary Ewing’s sarcoma
Authors: Gupta Shivangi , Khullar Tamanna , Puri Sunil Kumar
Published: September 2023

Background

Ewing sarcoma represents a spectrum of aggressive malignancies with the poor outcome. Primary renal Ewing sarcoma is rare and accounts for less than 1% of renal masses.

Case presentation

We present a case of a 45-year-old male presented in OPD with complaint of right flank pain and hematuria. He underwent a contrast-enhanced CT abdomen which depicted a right renal mass with liver lesions. He underwent Robotic Right Radical Nephrectomy and a pathological diagnosis of Ewing Sarcoma was made after which he was started on chemotherapy.

Conclusions

Owing to presentation in younger age group with poor prognosis, an integrated analysis including radiological imaging, histopathology, and immune-histological staining is essential for early detection of renal Ewing sarcoma.
Cost-effective approach to explore key impacts on the environment from agricultural tools to inform sustainability improvements: inversion tillage as a case study
Authors: Green Laura , Webb Elise , Johnson Elizabeth , Wynn Sarah , Bogen Christian
Published: September 2023

The United Nations Food Systems Summit and the European Green Deal have prompted various policy and regulatory initiatives aiming to transition agricultural practices to become more sustainable. An array of agricultural systems (e.g., regenerative, conservation agriculture, integrated crop management) have been lauded as potential solutions to improve food production sustainability. These systems use combinations of agricultural tools (e.g., crop rotation) to modify the crop environment to reduce weeds, pests and disease, alongside chemical (e.g., plant protection products) tools. Each tool has the potential to impact both the abiotic and biotic environment, with different combinations of tools having different overall outcomes. To improve the sustainability of agricultural practices it is important to understand, and where possible, quantify the environmental costs and benefits of the various tools that are applied within diverse cropping systems, as well as their potential interactions. While extensive literature exists, practical approaches are needed to cost-effectively synthesise key impacts and interactions to support decision making. A cost-effective methodology, adapting a rapid evidence assessment, was developed to review evidence and enable identification of the key environmental impacts for commonly applied agricultural tool options. The approach was applied to each tool individually (e.g., inversion tillage, crop rotation) to, where possible, isolate their specific impacts on the environment. Focused categories were assessed, considering biotic (insect, earthworms, etc.) and abiotic (soil, water, air quality, climate) impacts. This paper considers inversion tillage (also known as ploughing) as a case study to illustrate findings using the approach. Evidence is presented for direct and indirect impacts on the environment, selectivity of impacts and data gaps. The approach quickly provided robust evidence summaries of the key environmental implications of inversion tillage, facilitating identification of opportunities and trade-offs that can inform practice. The evidence highlighted how inversion tillage can offer effective weed control to reduce herbicide use, but carries increased risk to soil health, with connected implications for water, air and climate. This time-efficient review methodology can facilitate development of clear guidance to inform farmers in their decision making to improve on-farm sustainability, while serving as a useful starting point for conducting evidence reviews for policy development.
De novo genome assembly resolving repetitive structures enables genomic analysis of 35 European Mycoplasmopsis bovis strains
Authors: Triebel Sandra , Sachse Konrad , Weber Michael , Heller Martin , Diezel Celia , Hölzer Martin , Schnee Christiane , Marz Manja
Published: September 2023

Mycoplasmopsis (M.) bovis, the agent of mastitis, pneumonia, and arthritis in cattle, harbors a small genome of approximately 1 Mbp. Combining data from Illumina and Nanopore technologies, we sequenced and assembled the genomes of 35 European strains and isolate DL422_88 from Cuba. While the high proportion of repetitive structures in M. bovis genomes represent a particular challenge, implementation of our own pipeline (available on GitHub www.github.com/sandraTriebel/mycovista) in a hybrid approach enabled contiguous assembly of the genomes and, consequently, improved annotation rates considerably. To put our European strain panel in a global context, we analyzed the new genome sequences together with 175 genome assemblies from public databases. Construction of a phylogenetic tree based on core genes of these 219 strains revealed a clustering pattern according to geographical origin, with European isolates positioned on clades 4 and 5. Genomic data allowing assignment of strains to tissue specificity or certain disease manifestations could not be identified. Seven strains isolated from cattle with systemic circular condition (SCC), still a largely unknown manifestation of M. bovis disease, were located on both clades 4 and 5. Pairwise association analysis revealed 108 genomic elements associated with a particular clade of the phylogenetic tree. Further analyzing these hits, 25 genes are functionally annotated and could be linked to a M. bovis protein, e.g. various proteases and nucleases, as well as ten variable surface lipoproteins (Vsps) and other surface proteins. These clade-specific genes could serve as useful markers in epidemiological and clinical surveys.
Molecular characterization and evolution of the resident population of some alfalfa mosaic virus (AMV) isolates in Egypt
Authors: Amin Hala A. , Younes H. A. , Shafie Radwa M. , Fathallah Mervat M.
Published: September 2023

Background

Alfalfa mosaic virus (AMV) is an important virus affecting many vegetable crops in Egypt. In this study, virus isolates were collected from naturally infected potato, tomato, alfalfa and clover plants that showed suspected symptoms of AMV in different locations of Beheira and Alexandria governorates during the 2019–2020 growing season. The relative incidence of the virus ranged from 11–25% based on visual observations of symptoms and ELISA testing. A total of 41 samples were tested by ELISA using polyclonal antisera for AMV. Four AMV isolates collected from different host plants, named AM1 from potato, AM2 from tomato, AM3 from alfalfa and AM4 from alfalfa, were maintained on Nicotiana glutinosa plants for further characterization of AMV.

Results

Electron micrographs of the purified viral preparation showed spheroidal particles with a diameter of 18 nm and three bacilliform particles with lengths of roughly 55, 68, and 110 nm and diameters identical to those of the spheroidal particles. The CP gene sequence comparisons of four AMV isolates (AM1, AM2, AM3 and AM4) showed the highest nucleotide identity of 99.7% with the Gomchi isolate from South Korea infecting Gomchi (Ligularia fischeri) plants. Phylogenetic analysis showed that the present isolates were grouped together into a distinct separate clade (GPI) along with the Gomchi isolate from South Korea. Similarly, the deduced amino acid sequence comparisons of Egyptian AMV isolates revealed that amino acids Q29, S30, T34, V92 and V175 were conserved among the Egyptian isolates in GPI.

Conclusion

The present study found strong evolutionary evidence for the genetic diversity of AMV isolates by the identification of potential recombination events involving parents from GPI and GPII lineages. Additionally, the study found that Egyptian AMV isolates are genetically stable with low nucleotide diversity. Genetic analysis of the AMV population suggested that the AMV populations differ geographically, and AMV CP gene is under mild purifying selection. Furthermore, the study proposed that the Egyptian AMV population had common evolutionary ancestors with the Asian AMV population. Antioxidant enzymes activity was assessed on N. glutinosa plants in response to infection with each AMV isolate studied, and the results revealed that the enzyme activity varied.
Uptake of signposting to web-based resources: pregnant women’s use of a preventive web-based intervention
Authors: Sørensen Emil Rønn , Rasmussen Ida Scheel , Overbeck Gritt , Siersma Volkert , Appel Clara Lundmark , Wilson Philip
Published: September 2023

Background

Signposting to web-based interventions is becoming increasingly popular in primary care. Most resources are focused on individuals with clinical problems, but less is known about the uptake of general practice (GP) signposted web-based interventions. GPs in Denmark are responsible for scheduled preventive care during pregnancy and the child’s first five years. In the “Family Well-being in General Practice” trial the web-based intervention “Resilientchild.dk” is introduced at these consultations. Resilientchild.dk is designed to improve the capacity of parents to understand the mental state of themselves, their partners, and their children. In this study we assess the uptake and use of this web-based intervention.

Objective

To describe participant and practice characteristics associated with the use of a web-based psychoeducational intervention. Eligible participants were pregnant women presenting at their first antenatal assessment, usually around 6–10 gestational weeks.

Methods

The study was nested in a cluster randomised trial of resilientchild.dk. We conducted a relative importance analysis, which allows for determination of the variables most strongly associated with website use. To assess the direction and magnitude of the influences of the identified variables, we applied multinomial generalized linear mixed modelling. A practice random effect allows us to account for clustering of women within practices.

Results

Parity and the absence of a nurse or midwife in the practice were important factors driving a decrease in the likelihood of using resilientchild.dk. Being a student or living outside the capital city were important factors driving an increase in the likelihood of using resilientchild.dk.

Conclusion

The data offer unique opportunities to assess the utilisation of a web-based mental health-promotion intervention following advice from a clinician. This study draws conclusions about which patients are likely to access similar resources and which practice characteristics encourage their use.

Trial registration

Registered in clinicaltrials.gov, Trial number: NCT04129359 Date of registration: 16/10/2019 (https://clinicaltrials.gov/ct2/show/NCT04129359).
Plant-based dietary pattern and low muscle mass: a nation-wide cohort analysis of Chinese older adults
Authors: Ren Longbing , Tang Yuhong , Yang Rui , Hu Yang , Wang Jingjing , Li Shaojie , Yu Mingzhi , Jiang Yuling , Liu Zhouwei , Wu Yifei , Dong Ziqi , Zeng Yi , Lv Faqin , Yao Yao
Published: September 2023

Background

It remains unclear whether plant-based or animal-based dietary patterns are more beneficial for older adults more in maintaining muscle mass. Using a prospective cohort with nationwide sample of China older adults in this study, we aimed to examine the relationship between adhering to plant-based diet patterns or animal-based diet patterns and muscle loss.

Methods

We included 2771 older adults (≥ 65 years) from the Chinese Longitudinal Health Longevity Survey (CLHLS) with normal muscle mass at baseline (2011 and 2014 waves), which followed up into 2018. Plant-based dietary pattern scores and preference subgroups were constructed using 16 common animal-based and plant-based food frequencies. We used the corrected appendicular skeletal muscle mass (ASM) prediction formula to assess muscle mass. We applied the Cox proportional hazard risk regression to explore associations between dietary patterns and low muscle mass (LMM).

Results

During a mean of 4.1 years follow-up, 234 (8.4%) participants with normal muscle mass at baseline showed LMM. The plant-based dietary pattern reduced the risk of LMM by 5% (Hazard Ratios [HR]: 0.95, 95% confidence intervals [95%CI]: 0.92–0.97). In addition, a high plant-based food company with a high animal-based food intake pattern reduced the risk of LMM by 60% (HR: 0.40, 95% CI: 0.240–0.661) and 73% (HR: 0.27, 95% CI: 0.11–0.61) in the BADL disability and IADL disability population compared with a low plant-based food and high animal-based food intake, whereas a high plant-based food and low animal-based food intake was more beneficial in reducing the risk of LMM in the normal BADL functioning (HR: 0.57, 95% CI: 0.35–0.90) and IADL functioning (HR: 0.51, 95% CI: 0.28–0.91) population.

Conclusions

When it comes to maintaining muscle mass in older Chinese people with functional independence, a plant-based diet pattern is more beneficial and effective than the animal-based one. People with functional dependence may profit from a combination of plant-based and animal-based diets to minimize muscle loss.
Trajectories of CVD medication after statutory retirement: contributions of pre-retirement sociodemographic, work and health-related factors: a register study in Finland
Authors: Harkko Jaakko , Pietiläinen Olli , Jousilahti Pekka , Rahkonen Ossi , Kouvonen Anne , Lallukka Tea
Published: September 2023

Background

Cardiovascular diseases (CVDs) are prevalent in older people, but few studies focus on developmental patterns in CVD medication directly after transition to statutory retirement.

We thus aimed to identify trajectories of CVD medication after retirement, and their sociodemographic, work and health-related determinants.

Methods

We used complete register data of former employees of the City of Helsinki, Finland. All who reached their statutory retirement in 2000–2013, with five-year follow-up data (n = 6,505, 73% women), were included. Trajectories of CVD medication were identified with group-based trajectory modelling using data from Finnish Social Insurance Institution’s reimbursement register. Sociodemographic, work and health-related determinants of trajectory group membership were analysed using multinomial logistic regression.

Results

Six trajectories of CVD medication were distinguished: "constant low" (35%), “late increase” (6%), “early increase” (5%), "constant high" (39%), "high and decreasing " (8%), and "low and decreasing” (7%). The majority (74%) of the retirees fell into the "constant low" and "constant high" categories. Lower occupational class and increased pre-retirement sickness absence were associated with the "constant high" trajectory. Further, those with lower educational attainment were more prone to be in the “early increase” trajectory.

Conclusions

Individuals in lower socioeconomic positions or with a higher number of pre-retirement sickness absence may be considered at higher risk and might benefit from early interventions, e.g. lifestyle interventions and interventions targeting working conditions, or more frequent monitoring.
Comparison of the risk of hospital admission, need for ventilation, sepsis, pneumonitis and death among the recent monkeypox outbreak and historical outbreaks
Authors: Gaertner Florian , Preissner Saskia , Petri William Arthur , Atolani Olubunmi , Heiland Max , Nahles Susanne , Preissner Robert , Hertel Moritz
Published: September 2023

Background

The course of monkeypox can be severe. Our aim was to retrospectively compare the risk of hospital admission, the need for ventilation, sepsis, pneumonitis and death between the recent outbreak and historical outbreaks.

Materials and Methods

Cases of monkeypox were retrieved from the TriNetX database and assigned to either cohort I (recent outbreak between May 1st and September 16th, 2022) and cohort II (historical outbreaks before May 1st, 2022). After matching for age distribution, statistical analysis was performed.

Results

Of 640 patients with monkeypox 81 subjects per cohort remained after matching (mean age±standard deviation = 36.1±18.3 years). Within 56 days after diagnosis 10 patients per cohort were hospitalized (12.4%) and/or developed sepsis (12.4%). The risk of ventilation and pneumonitis were significantly lower among cohort I compared with cohort II (0 vs. 10 cases; risk difference = 12.4%; p = 0.001; Log-Rank test). No cases of death were recorded.

Conclusion

Even though monkeypox provides a risk of severe courses, the infection is self-limiting in most cases. Unlike past outbreaks, the risk of ventilation and pneumonitis may be relatively low among recent outbreaks.
Access to support during childbirth?: women’s preferences and experiences of support person integration in a cross-sectional facility-based survey
Authors: Nakphong Michelle K. , Afulani Patience A. , Opot James , Sudhinaraset May
Published: September 2023

Background

Integrating support persons into maternity care, such as making them feel welcome or providing them with information, is positioned to increase support for women and improve birth outcomes. Little quantitative research has examined what support women need and how the healthcare system currently facilitates support for women. We introduce the Person-Centered Integration of Support Persons (PC-ISP) concept, based on a review of the literature and propose four PC-ISP domains—Welcoming environment, Decision-making support, Provision of information and education and Ability to ask questions and express concerns. We report on women’s preferences and experiences of PC-ISP.

Methods

We developed PC-ISP measures based on the literature and applied these in a facility-based survey with 1,138 women after childbirth in six health facilities in Nairobi and Kiambu counties in Kenya from September 2019 to January 2020.

Results

We found an unmet need for integrating support persons during childbirth. Between 73.6 and 93.6% of women preferred integration of support persons during maternity care, but only 45.3–77.9% reported to have experienced integration. Women who reported having a male partner support person reported more PC-ISP experiences (B0.13; 95% CI 0.02, 0.23) than those without. Employed women were more likely to report having the opportunity to consult support persons on decisions (aOR1.26; 95% CI 1.07, 1.50) and report that providers asked if support persons should be informed about their condition and care (aOR1.29; 95% CI 1.07, 1.55). Women with more providers attending birth were more likely to report opportunities to consult support persons on decisions (aOR1.53; 95% CI 1.09, 2.15) and that support persons were welcome to ask questions (aOR1.84, 95% CI 1.07, 2.54).

Conclusions

Greater efforts to integrate support persons for specific roles, including decision-making support, bridging communication and advocacy, are needed to meet women’s needs for support in maternity care.
How do underage youth access e-cigarettes in settings with minimum age sales restriction laws? A scoping review
Authors: Graham-DeMello Anna , Hoek Janet , Drew Jonathan
Published: September 2023

Background

Despite measures to reduce young people’s access to electronic cigarettes (ECs), or “vapes”, many countries have recorded rising youth vaping prevalence. We summarised studies documenting how underage youth in countries with minimum age sales restrictions (or where sales are banned) report accessing ECs, and outline research and policy implications.

Methods

We undertook a focused literature search across multiple databases to identify relevant English-language studies reporting on primary research (quantitative and qualitative) and EC access sources among underage youth.

Results

Social sourcing was the most prevalent EC access route, relative to commercial or other avenues; however, social sourcing dynamics (i.e., who is involved in supplying product and why) remain poorly understood, especially with regard to proxy purchasing. While less prevalent, in-person retail purchasing (mainly from vape shops) persists among this age group, and appears far more common than online purchasing.

Conclusions

Further research examining how social supply routes operate, including interaction and power dynamics, is crucial to reducing youth vaping. Given widespread access via schools and during social activities and events, exploring how supply routes operate and evolve in these settings should be prioritized. Inadequate compliance with existing sales regulations suggest greater national and local policy enforcement, including fines and licence confiscation for selling to minors, is required at the retailer level.
Ability to predict surgical outcomes by surgical Apgar score: a systematic review
Authors: Mirzaiee Mina , Soleimani Mahdieh , Banoueizadeh Sara , Mahdood Bahareh , Bastami Maryam , Merajikhah Amirmohammad
Published: September 2023

Background

The Surgical Apgar score (SAS) is a straightforward and unbiased measure to assess the probability of experiencing complications after surgery. It is calculated upon completion of the surgical procedure and provides valuable predictive information. The SAS evaluates three specific factors during surgery: the estimated amount of blood loss (EBL), the lowest recorded mean arterial pressure (MAP), and the lowest heart rate (LHR) observed. Considering these factors, the SAS offers insights into the probability of encountering postoperative complications.

Methods

Three authors independently searched the Medline, PubMed, Web of Science, Scopus, and Embase databases until June 2022. This search was conducted without any language or timeframe restrictions, and it aimed to cover relevant literature on the subject. The inclusion criteria were the correlation between SAS and any modified/adjusted SAS (m SAS, (Modified SAS). eSAS, M eSAS, and SASA), and complications before, during, and after surgeries. Nevertheless, the study excluded letters to the editor, reviews, and case reports. Additionally, the researchers employed Begg and Egger's regression model to evaluate publication bias.

Results

In this systematic study, a total of 78 studies \were examined. The findings exposed that SAS was effective in anticipating short-term complications and served as factor for a long-term prognostic following multiple surgeries. While the SAS has been validated across various surgical subspecialties, based on the available evidence, the algorithm's modifications may be necessary to enhance its predictive accuracy within each specific subspecialty.

Conclusions

The SAS enables surgeons and anesthesiologists to recognize patients at a higher risk for certain complications or adverse events. By either modifying the SAS (Modified SAS) or combining it with ASA criteria, healthcare professionals can enhance their ability to identify patients who require continuous observation and follow-up as they go through the postoperative period. This approach would improve the accuracy of identifying individuals at risk and ensure appropriate measures to provide necessary care and support.
Dissemination and Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC): a study protocol for a hybrid type 1 randomized controlled trial
Authors: Siddiqi Amn , Monton Olivia , Woods Alison , Masroor Taleaa , Fuller Shannon , Owczarzak Jill , Yenokyan Gayane , Cooper Lisa A. , Freund Karen M. , Smith Thomas J. , Kutner Jean S. , Colborn Kathryn L. , Joyner Robert , Elk Ronit , Johnston Fabian M.
Published: September 2023

Background

There are persistent racial and ethnic health disparities in end-of-life health outcomes in the United States. African American patients are less likely than White patients to access palliative care, enroll in hospice care, have documented goals of care discussions with their healthcare providers, receive adequate symptom control, or die at home. We developed Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC) to address these disparities. DeCIDE PC is an integrated community health worker (CHW) palliative care intervention that uses community health workers (CHWs) as care team members to enhance the receipt of palliative care for African Americans with advanced cancer. The overall objectives of this study are to (1) assess the effectiveness of the DeCIDE PC intervention in improving palliative care outcomes amongst African American patients with advanced solid organ malignancy and their informal caregivers, and (2) develop generalizable knowledge on how contextual factors influence implementation to facilitate dissemination, uptake, and sustainability of the intervention.

Methods

We will conduct a multicenter, randomized, assessor-blind, parallel-group, pragmatic, hybrid type 1 effectiveness-implementation trial at three cancer centers across the United States. The DeCIDE PC intervention will be delivered over 6 months with CHW support tailored to the individual needs of the patient and caregiver. The primary outcome will be advance care planning. The treatment effect will be modeled using logistic regression. The secondary outcomes are quality of life, quality of communication, hospice care utilization, and patient symptoms.

Discussion

We expect the DeCIDE PC intervention to improve integration of palliative care, reduce multilevel barriers to care, enhance clinic and patient linkage to resources, and ultimately improve palliative care outcomes for African American patients with advanced cancer. If found to be effective, the DeCIDE PC intervention may be a transformative model with the potential to guide large-scale adoption of promising strategies to improve palliative care use and decrease disparities in end-of-life care for African American patients with advanced cancer in the United States.

Trial registration

Registered on ClinicalTrials.gov (NCT05407844). First posted on June 7, 2022.
Recurrent urethral obstruction secondary to large vulval inclusion cyst: a remote complication of female genital mutilation: a case report
Authors: Ali AbdelAziem A. , Badreldin Israa
Published: September 2023

Background

Female genital mutilation/cutting (FGM/C) is a major public health problem, particularly in developing countries.

Case presentation

The authors reported a case of 48-year old multiparous woman presented to Kassala Hospital, east Sudan, with recurrent urine retention resulting from urethral obstruction, which was caused by large vulval inclusion cyst. A traditional birth attendant circumcised her when she was 5 year old. Five years before her presentation the patient observed a painless swelling in her vulva, which was gradually increasing in size. She presented to the hospital with urine retention seeking medical care. Local examination showed a large cystic swelling originating in the circumcision line and covering the introitus. A diagnosis of inclusion cyst at the site of circumcision was made. The cyst was large enough causing bladder outlet obstruction and when the patient advised to tilt it away from the urethral orifice she passed urine without difficulties. The cyst was surgically removed by dissection along the lines of cleavage, which measured 10 × 9.2 cm and weighed 1.2 kg.

Conclusion

This case report indicates that FGM is a serious public health problem and there should an urgent intervention such as planned health education campaigns to end FGM practice.
Indigenous medicinal plants used in folk medicine for malaria treatment in Kwara State, Nigeria: an ethnobotanical study
Authors: Evbuomwan Ikponmwosa Owen , Stephen Adeyemi Oluyomi , Oluba Olarewaju Michael
Published: September 2023

Background

Folk medicine is crucial to healthcare delivery in the underdeveloped countries. It is frequently used as a primary treatment option or as a complementary therapy for malaria. Malaria is a deadly disease which greatly threatens global public health, claiming incredible number of lives yearly. The study was aimed at documenting the medicinal plants used for malaria treatment in folk medicine in Kwara State, Nigeria.

Methods

Ethnobotanical information was collected from selected consenting registered traditional medicine practitioners (TMPs) through oral face-to-face interviews using in-depth, semi-structured interview guide. The ethnobotanical data were analysed, and descriptive statistical methods were used to compile them.

Results

Sixty-two indigenous medicinal plants, including 13 new plants, used for malaria treatment were identified in this study. The TMPs preferred decoction in aqueous solvent (34%) and steeping in decaffeinated soft drink (19%) for herbal preparations. Oral administration (74%) was the main route of administration, while leaves (40%) and stem barks (32%) were the most dominant plant parts used in herbal preparations. The most cited families were Fabaceae (15%) and Rutaceae (6%), whileMangifera indica(77.14%),Enantia chlorantha(65.71%),Alstonia boonei(57.14%) followed byCymbopogon citratus(54.29%) were the most used plants. Besides, the antimalarial activities of many of the plants recorded and their isolated phytocompounds have been demonstrated. Furthermore, the conservation status of 4 identified plants were Vulnerable.

Conclusion

The study showed strong ethnobotanical knowledge shared by the TMPs in the State and provides preliminary information that could be explored for the discovery of more potent antimalarial compounds.
Effect of Baduanjin exercise on primary osteoporosis: study protocol for randomized controlled trial
Authors: Sun Chuanrui , Chen Ming , Wang Xiaoyang , Qi Baoyu , Yin He , Ji Yingxia , Yuan Na , Wang Shangquan , Zhu Liguo , Wei Xu
Published: September 2023

Background

Lack of exercise is often a major cause of chronic disease. Osteoporosis (OP) is a chronic disease with multifactorial co-morbidity. Baduanjin (BDJ) exercise may be a powerful tool for modifying risk factors. The aim is to provide more evidence about the effectiveness of BDJ exercise in improving pain and balance ability in patients with OP.

Methods

In the prospective randomized controlled trial, 160 participants will be recruited and randomized to the treatment group (BDJ exercise combined with Calcium carbonate and D3) or the control group (Calcium carbonate and D3) at 1:1 ratio. Participants in the treatment group will receive 24-week BDJ exercise for 30–60 min, 3 times a week, along with Calcium carbonate and D3 at each day, while participants in the control group will receive Calcium carbonate and D3 only. All outcome indicators will be measured at baseline, after the 6th month of treatment and 6th month after the end of treatment. The primary outcomes include pain and balance ability, as measured by the visual analogue scale (VAS) and Berg balance scale (BBS). The secondary outcomes will primarily include bone mineral density (BMD), laboratory tests (including P1NP, β-CTX, MSTN, FDF-23, NPY), the timed “up and go” (TUG) test, the morse fall scale (MFS), the five-times sit-to-stand test (FTSST).

Discussion

The study will hopefully confirm that BDJ exercise, as a non-drug intervention, should be recommended for patients with OP to prevent bone loss, falls and fractures.

Trial registration

International standard randomized controlled trial number (ISRCTN) registry: ISRCTN76945140 registered on 07/06/2022.
Dual anticancer activity of Aspergillus nidulans pigment and Ionizing γ-Radiation on human larynx carcinoma cell line
Authors: Ahmed Hanaa Y. , Gazzar Eman M. El , Safwat Nesreen , Badawy Monda M. M.
Published: September 2023

Background

Fungi are a readily available source of naturally generated colored compounds. These compounds might be used as radiosensitizers for treating cancer cells.

Methods

Aspergillus nidulans was examined for its color-producing ability in Potato dextrose agar (PDA) broth medium. The pigment was characterized by Ultraviolet (UV) spectrophotometer and Gas Chromatography Mass Spectrometry (GC/MS). Pigment extracts from A. nidulans were studied for their cytotoxic effects on the growth of human larynx carcinoma cell line (HEp-2) with or without exposure to γ-radiation at three different doses (5, 10, and 15 Gy). A. nidulans pigment cytotoxic activity was tested against normal Vero cells. Cell apoptosis was studied using flow cytometry. Gene expression of P53, Caspase 3 and Bcl-2 were quantified.

Results

Ultraviolet spectrum and GC/MS revealed the ability of Aspergillus nidulans to produce Rhodopin pigment. HEp-2 cells treated with A. nidulans pigment only give IC50 about 208 µg/ml. In contrast, when treated with the pigment +10 Gy γ-radiation, it give about 115 µg/ml. However, for normal cells, lower cytotoxic activity was detected. Treatment with pigment (208 g/mL) caused about 50% ± 1.0 total apoptosis level and gene expression of P53: 2.3 fold and Caspase 3: 1.84 fold in respect to untreated HEp-2), while Bcl-2 was decreased (Bcl-2: 0.63 fold in respect to untreated HEp-2). Furthermore, treated with pigment (115 µg/mL) + 10Gy caused about 47.41% ± 1.7 total apoptosis level and P53: 2.53 fold and Caspase 3: 2.0 fold in respect to untreated HEp-2, while Bcl-2 was downregulated (Bcl-2: 0.61 fold in respect to untreated HEp-2).

Conclusion

This study concluded that the anti-cancer activity of Aspergillus nidulans pigment was enhanced by ionizing radiation at 10 Gy, as well as its low cytotoxic activity against normal Vero cells.
Analysis of different gamification-based teaching resources for physiotherapy students: a comparative study
Authors: Sandoval-Hernández Irene , Molina-Torres Guadalupe , León-Morillas Felipe , Ropero-Padilla Carmen , González-Sánchez Manuel , Martínez-Cal Jesús
Published: September 2023

Background

For health professionals, gamification is a new teaching method that has achieved an important role in recent years, with excellent results in learning and knowledge acquisition. Thus, the objective of this study was to analyze the gaming experience through different gamification resources in the classroom with physiotherapy students.

Methods

A comparative study on gamification-based teaching resources was carried out during the first semester of the 2021–2022 academic year. A total of 33 physiotherapy students participated in this study. After the theoretical topics were taught, the participants were invited to participate in different gamification resources such as Kahoot!, Physiotherapy Party and Escape Room. The gaming experience with the different gamification resources was measured with the GAMEX scale.

Results

The Physiotherapy Party showed a higher score in relation to the enjoyment dimension compared to the Kahoot! and Escape Room (p = 0.004). The Escape Room presented higher scores in absorption, creative thinking, activation and dominance compared to Kahoot! and Physiotherapy Party (p < 0.005).

Conclusions

Gamification resources promote enjoyment and creativity in the students in the classroom. The use of new teaching methods based on gamification, such as Escape Room as Physiotherapy Party should be considered as first choice in the use of gamification resources due to the benefits they bring to students.
Determining the frequency of burn wound dressing for clinically competent nursing students: establishing standards based on learning curves
Authors: Alizadeh-Taghiabad Batoul , Mazloum Seyyed Reza , Miri Kheizaran , Namazinia Mohammad
Published: September 2023

Background

The primary objective of clinical practice in nursing education is to achieve mastery of clinical skills through repetitive practice. Therefore, there exists a correlation between the frequency of skill demonstration and clinical competency. This study aimed to address the following question: How many times should a nursing student perform burn wound dressing to attain clinical competency?

Methods

This time series study was conducted on 41 junior nursing students who were selected through a census sampling method at Neyshabur School of Nursing from spring 2015 to summer 2021. The data collection tool was a researcher-made competency evaluation checklist (CEV). The competency score of each student for each skill demonstraion episode was evaluated using the Competency Evaluation Checklist (CEV) and recorded on the learning curve until a plateau was reached. SPSS16 and repeated measures analysis of variance (ANOVA) were used.

Results

The mean competency score of burn wound dressing was 67.5 ± 11.0 (out of 100) during the first attempt, which increased to 95.9 ± 4.3 by the ninth attempt. The learning curve for the burn wound dressing skill reached a plateau after five attempts. Additionally, by the fifth attempt of dressing the burn wound, all students could accurately identify the depth, extent, and severity of the wound.

Conclusions

Establishing a standardized frequency for clinical skill performance and ensuring ample practice opportunities can have significant benefits in nursing education systems. These benefits include long-lasting learning, reduced costs, and improved effectiveness. As a result, nurse managers and lecturers should consider the resources available in their educational systems and strive to provide students with adequate opportunities and a supportive environment to practice their skills.
Combining unsupervised, supervised and rule-based learning: the case of detecting patient allergies in electronic health records
Authors: Berge Geir Thore , Granmo Ole-Christoffer , Tveit Tor Oddbjørn , Ruthjersen Anna Linda , Sharma Jivitesh
Published: September 2023

Background

Data mining of electronic health records (EHRs) has a huge potential for improving clinical decision support and to help healthcare deliver precision medicine. Unfortunately, the rule-based and machine learning-based approaches used for natural language processing (NLP) in healthcare today all struggle with various shortcomings related to performance, efficiency, or transparency.

Methods

In this paper, we address these issues by presenting a novel method for NLP that implements unsupervised learning of word embeddings, semi-supervised learning for simplified and accelerated clinical vocabulary and concept building, and deterministic rules for fine-grained control of information extraction. The clinical language is automatically learnt, and vocabulary, concepts, and rules supporting a variety of NLP downstream tasks can further be built with only minimal manual feature engineering and tagging required from clinical experts. Together, these steps create an open processing pipeline that gradually refines the data in a transparent way, which greatly improves the interpretable nature of our method. Data transformations are thus made transparent and predictions interpretable, which is imperative for healthcare. The combined method also has other advantages, like potentially being language independent, demanding few domain resources for maintenance, and able to cover misspellings, abbreviations, and acronyms. To test and evaluate the combined method, we have developed a clinical decision support system (CDSS) named Information System for Clinical Concept Searching (ICCS) that implements the method for clinical concept tagging, extraction, and classification.

Results

In empirical studies the method shows high performance (recall 92.6%, precision 88.8%, F-measure 90.7%), and has demonstrated its value to clinical practice. Here we employ a real-life EHR-derived dataset to evaluate the method’s performance on the task of classification (i.e., detecting patient allergies) against a range of common supervised learning algorithms. The combined method achieves state-of-the-art performance compared to the alternative methods we evaluate. We also perform a qualitative analysis of common word embedding methods on the task of word similarity to examine their potential for supporting automatic feature engineering for clinical NLP tasks.

Conclusions

Based on the promising results, we suggest more research should be aimed at exploiting the inherent synergies between unsupervised, supervised, and rule-based paradigms for clinical NLP.
Clinician consensus on “Inappropriate” presentations to the Emergency Department in the Better Data, Better Planning (BDBP) census: a cross-sectional multi-centre study of emergency department utilisation in Ireland
Authors: Cummins Niamh M , Barry Louise A , Garavan Carrie , Devlin Collette , Corey Gillian , Cummins Fergal , Ryan Damien , Wallace Emma , Deasy Conor , Flynn Mary , McCarthy Gerard ,   BDBP Team, Barry Tomas , Boyd Martin , Fitzgerald Des , Hayes Peter , Lane Gerry , McMahon Geraldine , McNamara Rosa , McNamee Lisa , Moore Anna , O’Hare Darragh , O’Regan Andrew , Reynolds Lorraine , Galvin Rose
Published: September 2023

Background

Utilisation of the Emergency Department (ED) for non-urgent care increases demand for services, therefore reducing inappropriate or avoidable attendances is an important area for intervention in prevention of ED crowding. This study aims to develop a consensus between clinicians across care settings about the “appropriateness” of attendances to the ED in Ireland.

Methods

The Better Data, Better Planning study was a multi-centre, cross-sectional study investigating factors influencing ED utilisation in Ireland. Data was compiled in patient summary files which were assessed for measures of appropriateness by an academic General Practitioner (GP) and academic Emergency Medicine Consultant (EMC) National Panel. In cases where consensus was not reached charts were assessed by an Independent Review Panel (IRP). At each site all files were autonomously assessed by local GP-EMC panels.

Results

The National Panel determined that 11% (GP) to 38% (EMC) of n = 306 lower acuity presentations could be treated by a GP within 24-48 h (k = 0.259; p < 0.001) and that 18% (GP) to 35% (EMC) of attendances could be considered “inappropriate” (k = 0.341; p < 0.001). For attendances deemed “appropriate” the admission rate was 47% compared to 0% for “inappropriate” attendees. There was no consensus on 45% of charts (n = 136). Subset analysis by the IRP determined that consensus for appropriate attendances ranged from 0 to 59% and for inappropriate attendances ranged from 0 to 29%. For the Local Panel review (n = 306) consensus on appropriateness ranged from 40 to 76% across ED sites.

Conclusions

Multidisciplinary clinicians agree that “inappropriate” use of the ED in Ireland is an issue. However, obtaining consensus on appropriateness of attendance is challenging and there was a significant cohort of complex heterogenous presentations where agreement could not be reached by clinicians in this study. This research again demonstrates the complexity of ED crowding, the introduction of evidence-based care pathways targeting avoidable presentations may serve to alleviate the problem in our EDs.
Addressing housing-related social needs for Medicaid beneficiaries: a qualitative assessment of Maryland’s Medicaid §1115 waiver program
Authors: DeGrazia Robert , Abdullahi Abdikarin , Mood MaryAnn , Diehl Christin , Stockwell Ian , Pollack Craig Evan
Published: September 2023

Background

While health care payers are increasingly considering approaches that help support stable and affordable housing for their beneficiaries, experience with these initiatives is limited. Through its §1115 HealthChoice waiver, Maryland Medicaid has begun experimenting with programs designed to pay for housing and tenancy support/case management services. This study investigates barriers and facilitators to the success of Maryland’s pilot program initiative — Assistance in Community Integration Services (ACIS).

Methods

The study focused on key stakeholders employed by the four Lead Entities that currently participate in the ACIS program. The stakeholders included members of each Lead Entity’s administration, direct service providers, state and local government officials, and case managers from local hospitals. The convenience sample was selected through an initial list of stakeholders and was supplemented using snowball sampling methods. Interviews were audio recorded and turned into transcripts via Otter.ai and then analyzed using NVivo by two independent reviewers.

Results

A total of 23 interviews were conducted between February 2022 and May 2022, representing a broad range of stakeholders across different Maryland geographies. A total of 4 themes were identified through the course of the interviews. Stakeholders identified difficulty finding housing for the target population in a tight housing market, challenges with communication within the program and with its clients, and problems with non-healthcare providers documenting services for reimbursement. At the same time, ACIS was seen as creating opportunities for organizations to work together across siloes in meeting client needs.

Conclusions

The findings of this study helps to highlight Medicaid §1115 waivers as a novel approach to using Medicaid funds to support tenancy-based services, such as ACIS and to improve the lives of individuals while reducing healthcare costs. Implementation of the ACIS program in Maryland has been a resounding success in helping individuals obtain and sustain stable housing. However, continued efforts to align capacity with demand, streamline billing and reimbursement and improve communication with clients and across partners will need to be prioritized. The program also highlights the growing need to address root causes of housing insecurity including the limited supply of affordable housing.