bluuebunny/crossref_metadata_2025 huggingface dataset:
A Qualitative Study of Naturally Living Parents and Child Oral Health: Omissions and Commissions
Authors: McLean C. , Slack-Smith L. , Matic Girard I. , Ward P.R.
Published: September 2024

Background:

Oral health continues to be one of the most common and costly diseases in early childhood, and there is a need for further, innovative research.

Purpose:

We explored the ways naturally living parents (those who embody the “natural” within their parenting ideology and behavior) navigated and perceived their children’s oral health.

Methods:

Twelve participants who identified as being “naturally living parents” participated in semistructured interviews. Data were thematically analyzed, and findings were aligned to an omissions and commissions framework to exhibit the complexity of parent decision-making.

Results:

Parents performed distinct omissions, including omitting fluoride, sugar, and “toxins” to maintain their children’s oral health. Parents talked about having a commitment to knowledge building to protect their children’s oral health (e.g., ingredient label reading and increasing knowledge of “safe” ingredients). Findings also provide insight into how parents consider and trust health information and health care providers and ways they gather information relating to oral health.

Conclusions:

Analysis indicated that although parents navigated both omissions and commissions, omissions were more overtly present. Compared to previous health research using this framework, omissions and commissions were not as clearly demarcated in relation to oral health. The results show that oral health is a complex interplay of omissions and commissions, and parents must navigate not only discrete elements that affect the oral health of their children but also how these are influenced by considerations including social well-being.

Knowledge Transfer Statement:

The study highlights the need for dentists and early childhood health professionals to consider the complex way some parents perceive, inform, and rationalize decisions regarding their children’s oral health. There is a need for nuance when considering children’s oral health and naturally living parenting, especially in relation to effectively communicating health information that fosters trust and is considerate of broader lifestyle and health factors.
Removal of Arsenic from Contaminated Water by Polypyrrole-Based Adsorbents
Authors: Pandey Shivangi , Maity Subhankar , Vishnoi Prashant
Published: September 2024

Worldwide, there is growing concern over the toxicity of arsenic in drinking water. The US Environmental Protection Agency and Central Pollution Control Board (India) have set a safe limit of 50 parts per billion for arsenic in drinking water. Millions of people are at immediate risk due to high concentrations of arsenic in drinking water, particularly in developing nations where arsenic poisoning symptoms have been observed. One of the essential techniques described in this article is the absorption of arsenic from contaminated water by sustainable cellulosic materials like jute and wood sawdust after suitable modification. Jute and sawdust are cheap and abundantly available in South Asia. They are functionalized with polypyrrole coating by in situ chemical polymerization of pyrrole in aqueous medium in the presence of ferric chloride. Polypyrrole-coated jute fabric (with 11.28% polypyrrole add-on) and polypyrrole-coated sawdust (with 5.28% polypyrrole add-on) are found to be excellent adsorbers of arsenic ion (As3+) from water. The effect of dosage of polypyrrole-coated adsorbents, treatment time and pyrrole concentration on the As removal efficiency have been investigated in this work. The arsenic concentration in water is determined using a microwave plasma atomic emission spectrometer with the highest level of accuracy. Maximum As removal efficiency by the polypyrrole-coated sawdust and polypyrrole-coated jute fabric is found to be 80.90% and 97.3%, respectively, from a 50 mL, 7.5 parts per million As solution with a dosage of 1 g at neutral pH. The polypyrrole-coated jute and sawdust are characterized by Fourier-transform infrared spectroscopy to understand the chemical interaction between cellulose and polypyrrole molecules. The scanning electron microscope studies reveal a uniform coating of polypyrrole around the surface of jute fibre and sawdust particles. Thermo-gravimetric analysis shows good thermal stability of jute and sawdust after polypyrrole coating.
Bridging Divide with Innovative Media: Telexistence and Human Augmentation
Authors: Lee Jiunde
Published: September 2024

This paper explores the transformative potential of haptic design and human augmentation, inspired by Dr. Minamizawa's keynote address at the 2024 Emerging Media for Communicating Sustainable Development Goals conference (held in Yang Ming Chiao Tung University, 30 March, 2024). By integrating tactile feedback into prosthetics and wearable devices, and employing robotic avatars and virtual interfaces, these technologies bridge the physical and virtual realms, redefining presence and interaction. The convergence of haptic design with telexistence and human augmentation enhances sensory engagement and bodily awareness, challenging traditional boundaries between biology and technology. However, these advancements might also raise ethical considerations and societal concerns about privacy, accessibility, autonomy, and safety. The future of human augmentation demands responsible development and inclusive dialogue to ensure empowerment, equity, and collective progress. This paper highlights the need for a human-integration approach to navigate the opportunities and challenges presented by these emerging technologies.
On resisting the seduction of theory
Authors: Lake Robert W.
Published: September 2024

Theory carries a heavy workload in the academic enterprise, offering access to Truth or Understanding of an external world. But theory has proven to be a capricious guide amidst the actual practice of academic theory production, in which the unending cycle of theoretical fashionability vanquishes hope for access to an enduring Truth and the obdurate complexity of the world poses impediments to Understanding at least as severe as those inhibiting the quest for Truth. The route of escape from the seduction of theory is to give up the idea that the problem lies in choosing the right representational lens through which to know or understand the world and, instead, to engage in a dialogical effort to build the world we collectively wish to inhabit. Successful transition from knowing to doing rests on overcoming the conceptual, institutional, personal and psychic costs imposed by relinquishing aspirations to Truth or Understanding in the present and accepting the collective – and far more challenging – task of imagining and creating a better future.
Effectiveness of anti-IL5/5Rα biologics in severe asthma in real world studies: a systematic review and meta-analysis
Authors: Kyriakopoulos Christos , Papadopoulou Efthymia , Potonos Dimitrios , Exarchos Konstantinos , Beris Evangelos , Aggelopoulou Christina , Tryfon Stavros , Gogali Athena , Kostikas Konstantinos
Published: September 2024

Background

Three biologics targeting interleukin 5 (anti-IL5) or its receptor-α (anti-IL5Ra) are approved for patients with severe asthma.

Methods

We conducted a systematic search until May 1, 2023, to identify observational studies and non-randomised trials that assess the response to anti-IL5/5Rα of real-life patients with severe eosinophilic asthma in MEDLINE and EMBASE. We performed random-effects meta-analyses.

Results

We identified 6,401 studies of which 92 with 9546 patients were analysed. Biologics use was associated with 62% reduction in severe exacerbations (risk ratio, RR, 0.38, 95%CI 0.29 to 0.50) and 54% reduction in hospitalisations (RR 0.46, 95%CI 0.35 to 0.61) at 12 months of treatment, compared to pre-treatment. Biologics improved asthma control [decrease in asthma control questionnaire (ACQ) by 1.11 points (95%CI −1.29 to −0.94) and increase in asthma control test (ACT) by 6.41 points (95%CI 5.66 to 7.16)], and increased the asthma quality of life questionnaire (AQLQ) by 1.08 points (95%CI 0.88 to 1.28) and forced expiratory volume in 1 s (FEV1) by 0.21 L (95% CI 0.15 to 0.27) at 12 months. There was a significant reduction in oral corticosteroids use by 51% (RR 0.49, 95%CI 0.42 to 0.56), with a mean dose reduction of 6.01 mg/d (95%CI −7.55 to −4.48) at 12 months of treatment. Similar findings were observed at 3–4, 6 and 24 months. Biomarker-related response to treatment was also noted.

Conclusions

This comprehensive meta-analysis summarises the significant clinical response to anti-IL5/5Rα biologics in real-life studies, providing important insights for clinical practice use of these agents.
Conductivity optimisation of graphene oxide-M13 bacteriophage nanocomposites: towards graphene-based gas micronano-sensors
Authors: Stokes Kate , Sun Yiwei , Thomas Jarrod L. , Passaretti Paolo , White Henry , Goldberg Oppenheimer Pola
Published: September 2024

Graphene oxide (GO) and M13 bacteriophage can self-assemble to form ultra-low density porous structures, known as GraPhage13 aerogels (GPA). Due to the insulating nature of GPA and the challenges in producing highly conductive aerogels, it is paramount to explore ways to enhance the conductivity of GPA. Herein, we have developed a method to enhance the conductivity of GPA, via the integration and optimisation of 5 nm and 20 nm diameter gold nanoparticles (AuNPs) into the aerogel structure and systematically analysed the morphology, composition and spectroscopic properties of the resulting GPA-Au nanocomposite. The fabricated GPA-Au nanocomposites exhibited remarkable increases in conductivity, with the integration of 5 nm AuNPs leading to a 53-fold increase compared to GPA, achieving a performance of up to 360 nS/cm, which is within the range suitable for miniaturised semiconductor devices. The mechanism behind the conductivity enhancement was further investigated and attributed to GO-AuNP interactions increasing the carrier density by introducing new energy levels in the GO band gap or shifting its Fermi level towards the conduction band. These findings demonstrate the potential of functionalised AuNPs to significantly improve the electrical properties of GPA, paving the way for their application in gas sensors for biological and chemical detection and a new range of advanced semiconductor devices.
Fluocinolone acetonide 0.18-mg implant for treatment of recurrent inflammation due to non-infectious uveitis: a case series of 15 patients
Authors: Sisk Robert A. , Kiernan Daniel F. , Almeida David , Kolomeyer Anton M. , Eichenbaum David , Kitchens John W.
Published: September 2024

Introduction

Uncontrolled non-infectious uveitis affecting the posterior segment (NIU-PS) can lead to vision loss due to repeated bouts of inflammation and consequent tissue damage. Patients with chronic NIU-PS who experience recurrent uveitis after being treated with systemic and short-acting local corticosteroids may benefit from the sustained-release 0.18-mg fluocinolone acetonide implant (FAi).

Methods

In this case series, 18 eyes with chronic, recurrent NIU-PS and cystoid macular edema (CME) treated with the 0.18-mg FAi were analyzed retrospectively. Data on patient demographics, clinical history, previous and concomitant treatments for uveitis recurrence, time to and number of uveitis recurrences, intraocular pressure (IOP), central subfield thickness (CST), and visual acuity (VA) were collected and summarized.

Results

A majority of patients (14/15 [93%]) had a history of ocular surgery, largely cataract extraction, and all developed chronic and recurrent NIU-PS and CME. At baseline, patients had a mean age of 72 years (range: 46 to 93), were 53% male, and had a mean duration of NIU-PS of 3 years (range: 1 to 19). Patients were followed for an average of 16.5 months (range: 2 to 42.5 months) post FAi. Eleven of the 18 eyes (61%) had ≥ 5 recurrences of uveitis since diagnosis, with an average time to recurrence of approximately 12 weeks (range: 1 to 27). All eyes treated with the 0.18-mg FAi showed reduced NIU-PS recurrence and visual and anatomical improvement, as measured by VA and CST, respectively. Two eyes had an IOP elevation that was managed with topical therapy, and one eye was treated with topical prednisolone for additional inflammation management. Two eyes required adjunct therapy with short-acting intravitreal corticosteroids at 7 and 16 weeks for NIU-PS recurrence after 0.18-mg FAi insertion.

Conclusion

After receiving the 0.18-mg FAi, eyes with uncontrolled NIU-PS had sustained resolution of CME and inflammation with limited need for supplementary steroid drops or injections and minimal steroid class-specific adverse effects; none required incisional IOP-lowering surgery.
Mouse blood cells types and aging prediction using penalized Latent Dirichlet Allocation
Authors: Wu Xiaotian , Teo Yee Voan , Neretti Nicola , Wu Zhijin
Published: September 2024

Background

Aging is a complex, heterogeneous process that has multiple causes. Knowledge on genomic, epigenomic and transcriptomic changes during the aging process shed light on understanding the aging mechanism. A recent breakthrough in biotechnology, single cell RNAseq, is revolutionizing aging study by providing gene expression profile of the entire transcriptome of individual cells. Many interesting information could be inferred from this new type of data with the help of novel computational methods.

Results

In this manuscript a novel statistical method, penalized Latent Dirichlet Allocation (pLDA), is applied to an aging mouse blood scRNA-seq data set. A pipeline is built for cell type and aging prediction. The sequence of models in the pipeline take scRNA-seq expression counts as input, preprocess the data using pLDA and predict the cell type and aging status.

Conclusions

pLDA learns a dimension reduced representation of the expression profile. This representation allows identification of cell types and has predictability of the age of cells.
Efficacy and safety of choline alphoscerate for amnestic mild cognitive impairment: a randomized double-blind placebo-controlled trial
Authors: Jeon Jongwook , Lee Su Young , Lee Seunghoon , Han Changwoo , Park Geum Duck , Kim Se-Joo , Chang Jhin Goo , Kim Woo Jung
Published: September 2024

Background

Effective interventions for overall healthy subjects with mild cognitive impairment are currently limited. Choline alphoscerate (alpha glyceryl phosphorylcholine, αGPC) is a choline-containing phospholipid used to treat cognitive function impairments in specific neurological conditions. This study aimed to investigate the efficacy and safety of αGPC in individuals diagnosed with mild cognitive impairment.

Methods

In this multicenter, randomized, placebo-controlled trial, 100 study subjects with mild cognitive impairment underwent a double-blind SHCog™ soft capsule (600 mg αGPC) or placebo treatment for 12 weeks. The primary efficacy outcome included changes from baseline on the Alzheimer’s Disease Assessment Scale–cognitive subscale (ADAS-cog). Safety assessments included regular monitoring of adverse events, and clinical laboratory tests were conducted at baseline and the end of the trial.

Results

After 12 weeks of αGPC treatment, the ADAS-cog score decreased by 2.34 points, which was significantly greater than the change observed in the placebo group. No serious AEs were reported, and no study subjects discontinued the intervention because of AEs. There was no significant difference in incidence rate of AEs between the αGPC group and the placebo group.

Conclusion

This study suggests that αGPC is a safe and effective intervention for improving cognitive function in study subjects with mild cognitive impairment.

Trial registration

Clinical Research Information Service; Osong (Chungcheongbuk-do): Korea Centers for Disease Control and Prevention, Ministry of Health and Welfare (Republic of Korea); KCT0008797; A 12-week, multicenter, randomized, double-blind, placebo-controlled human application study to evaluate the efficacy and safety of SH_CAPK08 on cognitive function improvement in mild cognitive decline.
Long COVID is not the same for everyone: a hierarchical cluster analysis of Long COVID symptoms 9 and 12 months after SARS-CoV-2 test
Authors: Moniz Marta , Ruivinho Carolina , Goes Ana Rita , Soares Patrícia , Leite Andreia
Published: September 2024

Background

Identifying symptom clusters in Long COVID is necessary for developing effective therapies for this diverse condition and improving the quality of life of those affected by this heterogeneous condition. In this study, we aimed to identify and compare symptom clusters at 9 and 12 months after a SARS-CoV-2 positive test and describe each cluster regarding factors at infection.

Methods

This is a cross-sectional study with individuals randomly selected from the Portuguese National System of Epidemiological Surveillance (SINAVE) database. Individuals who had a positive SARS-CoV-2 test in August 2022 were contacted to participate in a telephonic interview approximately 9 and 12 months after the test. A hierarchical clustering analysis was performed, using Euclidean distance and Ward’s linkage. Clustering was performed in the 35 symptoms reported 9 and 12 months after the SARS-CoV-2 positive test and characterised considering age, sex, pre-existing health conditions and symptoms at time of SARS-CoV-2 infection.

Results

552 individuals were included at 9 months and 458 at 12 months. The median age was 52 years (IQR: 40–64 years) and 59% were female. Hypertension and high cholesterol were the most frequently reported pre-existing health conditions. Memory loss, fatigue or weakness and joint pain were the most frequent symptoms reported 9 and 12 months after the positive test. Four clusters were identified at both times: no or minor symptoms; multi-symptoms; joint pain; and neurocognitive-related symptoms. Clusters remained similar in both times, but, within the neurocognitive cluster, memory loss and concentration issues increased in frequency at 12 months. Multi-symptoms cluster had older people, more females and more pre-existing health conditions at 9 months. However, at 12 months, older people and those with more pre-existing health conditions were in joint pain cluster.

Conclusions

Our results suggest that Long COVID is not the same for everyone. In our study, clusters remained similar at 9 and 12 months, except for a slight variation in the frequency of symptoms that composed each cluster. Understanding Long COVID clusters might help identify treatments for this condition. However, further validation of the observed clusters and analysis of its risk factors is needed.
Effectiveness of implemented global dietary interventions: a scoping review of fiscal policies
Authors: Dogbe Wisdom , Akaichi Faical , Rungapamestry Vanessa , Revoredo-Giha Cesar
Published: September 2024

Background

Although the World Health Organisation (WHO) has proposed the use of fiscal policies to mitigate consumption externalities such as overweight and obesity-related diseases, very little is known about the impacts of the different types and framing of national and/or regional fiscal policies that have been implemented over the years. There is the need to provide up-to-date evidence on the impact of fiscal policies that have been enacted and implemented across the globe.

Methods

We conducted a scoping review of all implemented government fiscal policies in the food and drinks sector to identify the different types of fiscal policies that exist and the scope of their impact on consumers as well as the food environment. Electronic databases such as the Web of Science and Google Scholar were used to search for appropriate literature on the topic. A total of 4,191 articles were retrieved and 127 were synthesized and charted for emerging themes.

Results

The results from this review were synthesized in MS Excel following Arksey & O’Malley (2005). Emerging themes were identified across different countries/settings for synthesis. The results confirms that fiscal policies improve consumers’ health; increase the prices of foods that are high in fats, sugar, and salt; increase government revenue; and shift consumption and purchases towards healthier and untaxed foods.

Conclusion

Governments already have the optimum tool required to effect changes in consumer behaviour and the food environment.
Potential for trans-pulmonary tumor markers in the early diagnosis of lung cancer: a case report
Authors: Monahan Ken , Kammer Michael , Su Yan Ru , Iams Wade , Grogan Eric , Maldonado Fabien
Published: September 2024

Background

Measurement of tumor markers from peripheral venous blood is an emerging tool to assist in the early diagnosis of lung cancer. Samples from the pulmonary artery and pulmonary artery wedge position (trans-pulmonary samples) are accessible via right-heart catheterization and, by virtue of their proximity to lung tumors, may increase diagnostic yield.

Case presentation

We report a case of a 64 year-old woman from whom trans-pulmonary samples were obtained and who was diagnosed 16 months later with recurrent metastatic small cell lung cancer. Carcinoembryonic antigen, cytokeratin fragment 21 − 1 (CYFRA), and human epididymis protein 4 (HE4) levels demonstrated increasing concentrations across the pulmonary circulation. These gradients exceeded the assays’ coefficient of variation by several-fold. For CYFRA and HE4, pulmonary artery wedge concentrations exceeded peripheral venous levels by more than 10% and peripheral arterial levels were up to 8% higher than peripheral venous levels.

Conclusions

Evaluating the feasibility and utility of trans-pulmonary tumor markers for lung cancer diagnosis in a larger cohort should be considered. The addition of a peripheral arterial sample to standard peripheral venous samples may be a more practical alternative.
Surface and deep learning: a blended learning approach in preclinical years of medical school
Authors: Khong Mei Li , Tanner Julian Alexander
Published: September 2024

Background

Significant challenges are arising around how to best enable peer communities, broaden educational reach, and innovate in pedagogy. While digital education can address these challenges, digital elements alone do not guarantee effective learning. This study reports a blended learning approach integrating online and face-to-face components, guided by the Student Approaches to Learning framework.

Methods

This study was carried out investigating learning in first and second year medical students over two academic years, 2019/20 and 2020/21. We evaluated: (1) comparison of students engaged with blended learning and traditional learning; and (2) student learning engaged with blended learning approach over a two-year preclinical curriculum. A revised two-factor study process questionnaire (R-SPQ-2F) evaluated students’ surface/deep learning before and after an academic year. Learning experience (LE) questionnaire was administered over the domains of learning engagement, and outcomes of learning approach. In-depth interviews were carried out to understand the context of students’ responses to the R-SPQ-2F and LE questionnaires.

Results

The R-SPQ-2F analysis indicated first year students maintained deep learning but second year students became neutral across the academic year, regardless of learning approach, with workload contributing to this outcome. R-SPQ-2F sub-scales showed that students engaged with blended learning maintained an intrinsic interest to learning, as compared to traditional learning which led to surface learning motives. The LE questionnaire showed students engaged with blended learning had deeper subject interest, and more positive perceptions of workload, feedback, and effectively developed skills and knowledge. However, peer interactions from blended learning were significantly lacking. In-depth interviews revealed that the flexibility and multi-modality of blended learning enabled learning, but the best use of these features require teacher support. Online interactions could be cultivated through intentional institutional efforts.

Conclusions

This study highlights the importance of designing blended learning that leverages technology-enabled flexibility while prioritising collaborative, learner-centred spaces for deep engagement and knowledge construction.
Empowering medical students: bridging gaps with high-fidelity simulations; a mixed-methods study on self-efficacy
Authors: Koçkaya Pınar Daylan , Alvur Tuncay Müge , Odabaşı Orhan
Published: September 2024

Background

High-fidelity simulations play a crucial role in preparing for high-mortality events like cardiopulmonary arrest, emphasizing the need for rapid and accurate intervention. Proficiency in cardiopulmonary resuscitation(CPR) requires a strong self-efficacy(SE); training for both is crucial. This study assesses the impact of Advanced Life Support(ALS) simulation on SE changes in final-year medical students.

Methods

This mixed-methods prospective simulation study involved medical students in emergency medicine internships, examining self-efficacy perceptions regarding ALS technical skills(ALS-SEP). A comparison was made between students who underwent scenario-based ALS simulation training and those who did not. Competencies in chest compression skills were assessed, and the concordance between ALS-SEP scores and observed CPR performances were evaluated. Focus group interviews were conducted and analyzed using content analysis techniques.

Results

The study involved 80 students, with 53 in the experimental group(EG) and 27 in the control group(CG). The EG, underwent simulation training, showed a significantly higher ALS-SEP change than the CG(p < 0.05). However, there was low concordance between pre-simulation SEP and actual performance. Compression skills success rates were inadequate. Qualitative analysis revealed main themes as"learning“(32.6%), “self-efficacy“(29%), “simulation method“(21.3%), and “development“(16.5%).

Discussion

Post-simulation, students reported improved SEP and increased readiness for future interventions. The findings and qualitative statements support the effectiveness of simulation practices in bridging the gap between SEP and performance. Utilizing simulation-based ALS training enhances learners’ belief in their capabilities, raises awareness of their competencies, and encourages reflective thinking. Given the importance of high SEP for ALS, simulation trainings correlating self-efficacy perception and performance may significantly reduce potential medical errors stemming from a disparity between perceived capability and actual performance.
Training healthcare professionals in assessment of health needs in older adults living at home: a scoping review
Authors: Larsen Bente Hamre , Dyrstad Dagrunn Nåden , Falkenberg Helle K. , Dieckmann Peter , Storm Marianne
Published: September 2024

Background

Interprofessional assessment and management of health needs for older adults living at home can help prioritize community service resources and enhance health, yet there is a shortage of professionals with the necessary competencies. Therefore, support and training for healthcare professionals in community settings to assess older adults’ health with the aim of for health promotion are needed.

Aim

To identify and provide an overview of published papers describing approaches for training healthcare professionals in assessing physical, mental, and social health needs in older adults living at home.

Method

A systematic literature search of the Cinahl, Medline, Academic Search Ultimate, Scopus, Embase, and British Nursing Index databases was performed. We considered studies focusing on the training of healthcare professionals in assessing a single or multiple health needs of older adults aged 65 and above living at home. We considered studies published between 1990 – and March 2024. The review evaluated qualitative, quantitative, and mixed methods studies published in English-language peer-reviewed academic journals. A quality appraisal was conducted via the Mixed Methods Appraisal Tool (MMAT).

Results

Twenty-three studies focused on training healthcare professionals to assess health needs and plan care for older adults living at home were included. The majority of the included studies combined teacher-driven pedagogical approaches consisting of educational sessions, written materials or e-learning, and more participant-engaging pedagogical approaches such as knowledge exchange or various forms of interactive learning. Healthcare professionals were trained to detect and manage single and multiple health needs, and some studies additionally incorporated interprofessional collaboration. Healthcare professionals were satisfied with the training content and it increased their confidence and competencies in health needs assessment and care planning for older adults. Moreover, some studies have reported that training interventions foster the implementation of new and effective ways of working and lead to positive outcomes for older adults.

Conclusion

Healthcare professionals were satisfied with a combination of participant-engaging and teacher-driven pedagogical approaches used to train them in assessing health needs and planning care for older adults living at home. Such training can lead to enhanced assessment skills and facilitate improvements in practice and health promotion for older adults. Future research is recommended on interprofessional simulation training for conducting structured and comprehensive health needs assessments of older adults living at home, as well as on the implementation of such assessments and health-promoting interventions.
Evaluation of a collaborative multi-disciplinary train-the-trainer program for first responders in chemical, radiologic and nuclear emergencies — a pre- and post-test
Authors: Hedberg Pia , Saveman Britt-Inger , Gyllencreutz Lina
Published: September 2024

Background

In significant events like chemical, biological, radiological, nuclear, and explosive (CBRNE) incidents, additional expertise in specific chemical substances becomes essential. Train-the-trainer programmes are used to increase knowledge and skills in a variety of fields and have been shown to be a cost-effective training method, eliminating the necessity of bringing in external experts or requiring participants to travel outside their region. Care in Hazardous Environments (CiHE) is one example of a course which comprises basic multi-disciplinary training together with personnel from rescue, police, and emergency medical services to prepare them to handle chemical and radioactive nuclear incidents. The train-the-trainer programme described in this study contains both theoretical and practical components, intended for instructors who will lead training on CiHE incidents. This study aimed to evaluate trainers’ level of knowledge before and after a train-the-trainer programme, as well as their thoughts about becoming an instructor i.e. the pedagogical competence for the Care in Hazardous Environments course.

Methods

A pre- and post-test, along with an evaluation of open-ended response options were employed to assess the effectiveness of the train-the-trainer programme for teaching the basic course (CiHE). A total of 49 participants were enrolled in the programme.

Results

Participants showed significant improvement in chemical, radiological and nuclear (CRN) response knowledge in two of the eight questions between the pre- and post-tests. The two questions that improved pertained to chemical substances and basic principles of radiation protection. Instructors trained in the train-the-trainer programme are intended to bring new knowledge, incorporate a rarely discussed topic into instruction regularly, and de-stigmatise CRN incidents by helping raise the minimum competency levels in their respective organisation.

Conclusion

An effective response to CBRNE events begins with readiness. First responders must be prepared and possess knowledge of both CRN components as well as protective gear to keep themselves and others safe at the incident scene. This study shows the importance of the train-the-trainer programme in continuing to educate police, and personnel from rescue and emergency medical services in CiHE, enable them to collaboratively prepare to handle CRN incidents.
Clinical characteristics, treatment, and outcomes for elderly patients in a dedicated Covid-19 ward at a primary health care facility in western Norway: a retrospective observational study
Authors: Kittang Bård Reiakvam , Øien Ane Tveiten , Engtrø Einar , Skjellanger Marian , Krüger Kjell
Published: September 2024

Background

The coronavirus pandemic has hit the oldest and frailest individuals hard, particularly patients and residents in nursing homes. In March 2020, we established a Covid-19 ward at a nursing home in Bergen, western Norway for elderly patients with Sars-CoV-2 infection and in the need of treatment and care in a primary health care facility. The aims of this study were to describe the organization of the ward, the clinical outcomes of infection, treatment, mortality rates in the population, the level of advanced care planning, and end-of-life care for those who died.

Methods

We present patient characteristics, outcomes, vaccination status, treatment, decisions regarding treatment intensity upon clinical deterioration, and mortality for the patients in the ward. Clinical factors possibly related to a fatal outcome were analysed with chi square test (categorical variables) or t-test (continuous variables).

Results

257 patients were included from March 2020 to April 2022. Fifty-nine patients (23.0%) developed respiratory failure. Ten patients (3.9%) were admitted to hospital. Advance care planning was undertaken for 245 (95.3%) of the patients. 30-day mortality rate decreased from 42 to 4% during the study period. Of the 29 (11.3%) patients who died, all were well alleviated in the terminal phase, and 26 (89.7%) of them had a Clinical Frailty Scale (CFS) value ≥ 7. A high score for CFS, respiratory failure and respiratory co-infection were significantly associated with Covid-19 related death within 30 days.

Conclusions

Covid-19-related mortality markedly decreased during the study period, and a high score for CFS was related to a fatal outcome. Thorough planning of treatment intensity upon deterioration, low hospitalization rates, and good relief for those who died suggest that dedicated Covid-19 wards in nursing homes can provide good treatment for the patients and relieve other nursing homes and specialist health care services.
A guided single session intervention to reduce intrusive memories of work-related trauma: a randomised controlled trial with healthcare workers in the COVID-19 pandemic
Authors: Kanstrup Marie , Singh Laura , Leehr Elisabeth Johanna , Göransson Katarina E. , Pihlgren Sara Ahmed , Iyadurai Lalitha , Dahl Oili , Falk Ann-Charlotte , Lindström Veronica , Hadziosmanovic Nermin , Gabrysch Katja , Moulds Michelle L. , Holmes Emily A.
Published: September 2024

Background

Intrusive memories of psychologically traumatic events bring distress both sub-clinically and clinically. This parallel-group, two-arm randomised controlled trial evaluated the effect of a brief behavioural intervention on reducing intrusive memories in frontline healthcare workers exposed to traumatic events during the COVID-19 pandemic.

Methods

Participants with at least two intrusive memories of work-related trauma in the week before recruitment were randomised 1:1 to an imagery-competing task intervention (n = 73) or attention-based control task (n = 71). The number of intrusive memories was assessed at baseline and 5 weeks after the guided session (primary endpoint).

Results

The intervention significantly reduced intrusive memory frequency compared with control [intervention Mdn = 1.0 (IQR = 0–3), control Mdn = 5.0 (IQR = 1–17); p < 0.0001, IRR = 0.30; 95% CI = 0.17–0.53] and led to fewer post-traumatic stress-related symptoms at 1, 3 and 6 month follow-ups (secondary endpoints). Participants and statisticians were blinded to allocation. Adverse events data were acquired throughout the trial, demonstrating safety. There was high adherence and low attrition.

Conclusions

This brief, single-symptom, repeatable digital intervention for subclinical-to-clinical samples after trauma allows scalability, taking a preventing-to-treating approach after trauma.

Trial registration

2020–07-06, ClinicalTrials.gov identifier: NCT04460014.
Prophylactic para-aortic lymph node dissection in Colo-rectal cancer; pilot study
Authors: Abdalwahab Abdalwahab R. , Abdelhamed Mohamed A. , Gad Mai , Allam Rasha Mahmood , Hussien Alaadin
Published: September 2024

Background

Colorectal cancer is the 3rd most common cancer worldwide, representing 10% of all cancer types, and is considered the 2nd leading cause of cancer-related deaths. It usually metastasizes to the liver or lung. Para-aortic lymph node metastasis is considered a metastatic disease (stage 4) according to the AJCC and is considered a regional disease (stage 3) according to the JSCCR. Para-aortic lymph node metastases occur in about 1% of cases. Neoadjuvant CTH, followed by PALN, is the best option for metastatic para-aortic LNs in colorectal cancer patients. This study addresses the value of prophylactic para-aortic LN dissection among colon-rectal cancer patients (overtreatment protocol).

Methodology

This is a prospective study that included patients attending NCI, Cairo University, from December 2020 to December 2023 who were complaining of left colonic cancer or recto-sigmoid cancer and underwent left hemicolectomy, sigmoid colectomy, or LAR. All patients underwent formal mesenteric LN dissection and prophylactic para-aortic LN dissection.

Results

Among 60 patients who underwent colorectal surgery with prophylactic para-aortic LN dissection, 21 cases (35%) were in the descending colon, 22 cases (36.7%) were in the sigmoid colon, 11 cases (18.3%) were in the recto-sigmoid, and 6 cases (10%) were in the upper rectum. 55 cases (91.7%) were in grade 2, and 5 cases (8.3%) were in grade 3. Neoadjuvant CTH was given in 3 cases (5%) while neoadjuvant RTH was given in 6 cases (10%). Regarding reported postoperative complications, lymphorrhea was reported in 2 patients (3.3%) and wound infection occurred in 6 patients (10%). A recurrence was reported among 8 cases (13.4%).

Conclusions

We aimed in this study to highlight the value of prophylactic para-aortic lymph node dissection among colorectal cancer patients (over-treatment protocol) and report its reflection on predicting the behavior of the disease and subsequently selecting the patients who will be suitable to do this procedure.
Experience of a vascular ultrasound-guided program: from the ICU to the hospital
Authors: Oviedo-Torres Miguel Angel , Yepes-Velasco Andrés Felipe , Moreno-Araque Jeimy Lorena , Rodríguez-Lima David Rene , Mora-Salamanca Andrés Felipe
Published: September 2024

Background

The use of peripherally inserted central venous catheters (PICCs) has increased worldwide in the last decade. However, PICCs are associated to catheter-related thrombosis (CRT) and central line-associated bloodstream infections (CLABSIs). We describe the characteristics of patients requiring a PICC, estimate the incidence rate, and identify potential risk factors of PICC-related complications.

Methods

All adult patients requiring a PICC at our institution (Fundación Santa Fe de Bogotá, Bogota, Colombia) from September 2022 to May 2024 were included in the analysis. The database from active PICC monitoring collected demographic and PICC-related information. The incidence rate of CLABSI and CRT, and crude odds ratios (cORs) were estimated.

Results

Overall, 1936 individuals were included in the study. The median age was 67 years (IQR: 50–78 years), and 51.5% were females. The median duration of PICC lines was 10 days (IQR: 4–17). Seventy-nine patients had catheter-related complications, mostly in the Intensive Care Unit (ICU). The CLABSI and CRT institutional incidence rates per 1000 catheter-days were 2.03 (2.96 in the ICU) and 0.58 (0.61 in the ICU), respectively. Prolonged catheter use (≥ 6 days), PICC insertion in the intensive care unit, and postoperative care after cardiac surgery were identified as potential risk factors for CLABSI, while a catheter insertion into the brachial vein was associated with CRT.

Conclusion

Daily PICC assessment, particularly in patients with prolonged catheter use, PICC insertion into the brachial vein, or in postoperative care after cardiac surgery may significantly reduce CLABSI and CRT cases. Implementing Vascular Access Teams, venous catheter care bundles, and institutional insertion protocols optimize clinical outcomes.
Distribution of ABO and D antigen expression in Yogyakarta, Java Island: a pioneer large-scale study in Indonesia
Authors: Bidayah Hasna Fadlilatul , Triyono Teguh , Fichou Yann , Pratiwi Rarastoeti , Nurpratami Diah , Sofro Abdul Salam
Published: September 2024

Objective

Here, we sought to report ABO and D antigen distribution in blood donors from Yogyakarta, Java Island, Indonesia. Phenotype data (ABO/D) from donors who donated blood between January 1, 2018, and December 31, 2023, at the Yogyakarta Blood Donor Unit were extracted from the blood donor registry, and phenotype frequency was calculated subsequently.

Results

In the 245,307 blood donors collected over six years, ABO phenotype frequency: O (frequency: 38.5%) > B (29.4%) > A (24.1%) > AB (8.0%). The D-positive phenotype was far more common (99.5%) than the D-negative phenotype (0.5%). The phenotypic pattern globally is similar to previous reports in Southeast Asia. The D antigen distribution is similar to world distribution as the most common blood group. For the first time in Indonesia, this distribution of ABO and D phenotype is reported in a large-scale study. This work is a pioneer in the coordinated optimization of transfusion guidelines at the national level.
Severe exacerbation of facial dermatitis with swelling following introduction of abrocitinib in a patient with atopic dermatitis
Authors: Chen Shirui , Yang Chongtu , Lu Yonghong
Published: September 2024

Background

Abrocitinib, an oral small-molecule Janus kinase 1 (JAK1) inhibitor, has been widely accepted for the treatment of moderate-to-severe atopic dermatitis (AD). Currently there is a paucity of data on the adverse events (AEs) after abrocitinib treatment, especially on rare events such as exacerbation of facial dermatitis, and their causal relationship and subsequent management remains poorly elucidated.

Case presentation

A 43-year-old female patient with moderate AD received dupilumab after failure of topical treatments. Facial dermatitis persisted and became refractory after dupilumab treatment, and the patient changed treatment to oral abrocitinib. Fifteen hours after the first dose of abrocitinib, she developed exacerbation of facial dermatitis with swelling. The patient was initially diagnosed as abrocitinib-induced hypersensitivity. However, a score of 3 of the Naranjo adverse drug reaction assessment indicates week correlation between abrocitinib therapy and exacerbation of facial dermatitis, and negative results from subsequent drug provocation test further suggests no causal relationship.

Conclusions

The present case report highlights the necessity of careful determination of abrocitinib-induced hypersensitivity, which should not be diagnosed simply based on the time sequence between drug exposure and symptom occurrence. In addition, caution should be exercised for drug withdrawal, especially when confirmative evidence is absent. Drug provocation test can be helpful and effective treatments could be continued unless severe AEs occur.
Diagnostic performance of new BAST score versus FIB-4 index in predicating of the liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease
Authors: Helal Eman , Elgebaly Fatma , Mousa Nasser , Elbaz Sherif , Abdelsalam Mostafa , Abdelkader Eman , El-Sehrawy Amr , El-wakeel Niveen , El-Emam Ola , Hashem Manal , Elmetwalli Alaa , Mansour Shimaa
Published: September 2024

Background and aim

Metabolic dysfunction-associated steatotic liver disease (MASLD) formerly known as non-alcoholic fatty liver disease (NAFLD) is the most common liver condition globally. The FIB-4 test is used to detect fibrosis in fatty liver disease but has limited accuracy in predicting liver stiffness, resulting in high rates of false positives and negatives. The new BAST scoring system, incorporating waist circumference, AST, and BMI, has been developed to assess the presence of fibrosis in NAFLD patients. This study compares the effectiveness of BAST and FIB-4 in predicting liver fibrosis in MASLD patients.

Patients and methods

The study included 140 non-diabetic MASLD patients who underwent transient elastography measurement. BAST score and FIB-4 were calculated for each patient. Patients were grouped based on fibrosis severity; F1, F2, and F3–F4. The sensitivity and specificity of the BAST score and FIB-4 were assessed using receiver operating characteristic curves.

Results

The BAST score increased significantly with fibrosis progression from F1 to F3–F4. In differentiating advanced fibrosis (F2–F3) from mild/moderate fibrosis (F1–F2), the BAST score at cutoff ≤ − 0.451 showed better diagnostic performance with 90.70% sensitivity, 74.07% specificity, 84.8% PPV and 83.3% NPV compared to FIB-4 that had 60.47% sensitivity, 50.0% specificity, 65.8% PPV and 44.3% NPV. Similarly, for differentiating between F1 and F2 fibrosis, the BAST score at cutoff ≤ − 1.11 outperformed FIB-4, with 80.23% sensitivity, 79.49% specificity, 89.6% PPV and 64.6% NPV, while FIB-4 had 59.30% sensitivity, 51.28% specificity, 72.9% PPV and 36% NPV.

Conclusions

The BAST score is a better predictor of liver fibrosis in MASLD compared to FIB-4, especially in cases of advanced fibrosis or cirrhosis.
Advocacy through storytelling: challenging eating disorders and eating disorders stigma
Authors: Habibagahi Kiana , Ferrari Michel
Published: September 2024

Background

Although eating disorders (EDs) are among the most stigmatised mental illnesses, a number of individuals break past this stigma and engage in ED advocacy by sharing their recovery stories. Little is known, however, about the role of such advocacy in their healing journeys.

Methods

To bridge this gap, the authors examined the role of autobiographical oral storytelling in the ED recovery of adult advocates. Autobiographical oral history interviews were carried out with adult advocates (n = 16) recovering from EDs. The data were analysed using a mixture of actantial and thematic analyses. Authors also used activity theory to categorise how storytelling was translated into concrete social actions. Results were then interpreted through frameworks of embodiment and the intersectionality of identity.

Results

Advocates chose to share their ED stories as a way to embody resilience and make meaning from their ED experiences. Beyond personal gains, the social benefits of sharing their stories included raising hope and openness to converse further with audiences, advocating for greater ED resources (e.g., ED literacy among school staff), and offering new training initiatives for healthcare professionals. The ties between storytelling and the unique aspects of one’s identity are also discussed.

Conclusions

Engaging in advocacy through storytelling can positively affect both the advocates and the audiences with whom they connect. Future studies, informed by feminist biopsychosocial frameworks, can examine storytelling as a therapeutic intervention. Such frameworks serve as alternatives to biomedical models of EDs and mental illnesses. They also emphasise the need for broader changes that destabilise oppressive body cultures and display how storytelling can help mobilise change.